What is Intraperitoneal Chemotherapy?
Intraperitoneal chemotherapy is a treatment for cancer of the abdomen and belly. In the treatment, anti-cancer drugs are delivered into the peritoneal cavity, and into the areas of the belly in the liver, stomach, and intestine.
During the procedure, the peritoneal cavity is filled with anti-cancer medication and fluids. This helps in giving higher doses and minimizing side effects.
The traditional method of chemotherapy is ineffective for treating cancer of the belly as the drugs cannot effectively reach the affected areas. (1)
In intraperitoneal chemotherapy, the drugs effectively reach the site of cancer and penetrate deeper into the tumor. However, it is only effective for small tumors measuring 2.5 mm. Sometimes doctors remove as many tumors as possible to reduce their size and then start intraperitoneal chemotherapy.
Intraperitoneal chemotherapy is of 2 types:
- Hyperthermic intraperitoneal chemotherapy
- Intraperitoneal chemotherapy
Hyperthermic intraperitoneal chemotherapy is used during surgery to reduce the size of the tumor. The chemical cocktail is heated to temperatures between 42-43°C. This treatment usually lasts for 1-2 hours.
After this systemic chemotherapy is recommended through veins depending on the location and stage of the cancer.
Intraperitoneal chemotherapy can be effectively used for the treatment of people with ovarian cancer, colorectal cancer, stomach cancer, and appendiceal cancer.
How Does Intraperitoneal Chemotherapy Work?
During surgery, the size of the tumor is reduced by inserting a catheter connected to an access port in the abdominal cavity. (2) The access port is attached near a rib or pelvis, depending on which part of the affected peritoneal cavity is being targeted.
The port is placed under the skin while the catheter reaches the targeted area. The chemotherapy drug is inserted into the port and it seeps into the abdominal area.
Intraperitoneal chemotherapy can be administered as an inpatient or outpatient procedure. The number of treatments and type of medication may also vary depending on the cancer.
Before the Intraperitoneal Chemotherapy
Before starting the chemotherapy, it is important to ensure that after treatment the person can get home safely as they may feel sick after treatment.
One should wear loose-fitting clothing and eat a light meal the evening before the scheduled treatment date.
During the Intraperitoneal Chemotherapy
During the treatment, the person needs to lie down constantly but can get up to use the washroom.
Most of the chemotherapy drugs are mixed with saline solution and transferred to the abdominal cavity via an access port and catheter. Once the fluid reaches the belly the person is asked to shift position or roll from side to side every 15 minutes. This helps in distributing the chemotherapy drugs around the area bathing as many organs as possible.
After the Treatment
After intraperitoneal chemotherapy, doctor advice to rest, drink and eat small regular meals.
One should keep a check on the access port and alert the doctor for any redness or swelling.
According to the American Cancer Society, the number of treatments depends on the type of cancer, goals of treatment, chemo drugs, and the response to the treatment. (3)
Most chemotherapy treatments include a treatment period followed by a rest period. During the rest period, the liver and kidney break down the chemotherapy drugs and excrete them from the body.
Side Effects of Intraperitoneal Chemotherapy
Some of the most common side effects of intraperitoneal chemotherapy include:
- Bloating
- Urgency to urinate
These may be due to the excess fluid in the abdomen.
Other side effects include: (4)
- Fatigue
- Nausea and vomiting
- Mood swings
- Difficulty in concentrating
- Decreased appetite
- Constipation
- Diarrhea
Everyone reacts differently to the medication. A doctor should be consulted in the following experiences:
- There is soreness, swelling, or leakage from the site of the access port
- Severe constipation
- Fever
- Nausea and vomiting lasting for longer than 24 hours
- Constant and severe stomach pain
- Inability to eat and drink for more than 24 hours
- Diarrhea lasting longer than 24 hours
Outlook for Intraperitoneal Chemotherapy
Study shows that people undergoing hyperthermic intraperitoneal chemotherapy and starting regular intraperitoneal chemotherapy immediately after surgery have better survival chances. (1)
According to the American Cancer Society, those undergoing intraperitoneal chemotherapy live longer than those who undergo traditional treatment. (2)
However, how everyone reacts to therapy is different. A person can discuss the effectiveness of the procedure with a doctor before going ahead with it.
