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Introduction
This information explains what hyperthermic intraperitoneal chemotherapy (HIPEC) is. It includes information about the risks, benefits and alternatives of the treatment. It also tells you what you can expect during your hospital stay. If you have any questions about HIPEC or information from this webpage, speak to the team looking after you.
What is HIPEC?
HIPEC is a type of treatment available to people with ovarian, tubal or peritoneal cancer. It works by adding a heated chemotherapy drug into your abdomen (tummy) during surgery to remove your tumour. The drug stays in the abdomen for 90 minutes and it’s removed before the surgery ends.
Previous studies have shown that patients having HIPEC are likely to:
- have more time before the cancer comes back, and
- live longer
compared with patients who do not have this treatment.
No, HIPEC is an optional addition to your standard chemotherapy.
No. At present, HIPEC is only suitable for patients having interval cytoreductive surgery. This surgery is performed after three to four cycles of chemotherapy and aims to remove any remaining tumour.
All treatments and procedures have risks. We have listed some general risks of having HIPEC below. These side effects can occur with both cytoreductive surgery and with HIPEC. Studies show that addition of HIPEC does not increase the risk of these side effects occurring compared to surgery alone.
Your doctor will talk to you in detail about the risks specific to you and answer any questions you may have.
Common risks include:
- Abdominal pain. Your nurse will give you painkillers but if you are still in pain, it is important to let them know.
- Nausea (feeling sick) and/or vomiting. Your doctor will prescribe medication for this.
- Fatigue (feeling very tired).
- Numbness in hands or feet.
- Vaginal bleeding or discharge. This can last up to six weeks and it may be like a light period (red or brown in colour).
- Infection.
Less common risks include:
- Constipation or diarrhoea. Your doctor can prescribe medicines to help with your bowel problems.
- Hair loss (alopecia).
- Fever.
- Worsening kidney function. We will monitor how well your kidneys are working with blood tests.
Your doctor will also explain the risks of having interval cytoreductive surgery before you sign a consent form. Please ask if there is anything you would like to be clarified.
You may choose not to have HIPEC. In this case you will have surgery without HIPEC and you will continue to have standard chemotherapy through your vein. Your doctor will talk to you about any other treatments that may be suitable for you.
Before surgery
You will have a pre-operative assessment appointment. This will either be on the same day as your outpatient appointment with
the surgeon, or on another day. The purpose of this appointment is to make sure you are fit for surgery. You will have some routine tests, such as blood tests and an ECG (heart tracing).
The pre-assessment nurse will explain when to stop eating and drinking before your surgery. They will also advise you whether you need to stop any of your regular medicines. For this reason, please bring a list of your regular medicines to your appointment.
If you need support giving up smoking, talk to your GP or visit nhs.uk/
Make a plan for how you will get home from hospital after your surgery. Arrange for relatives or friends to support you with any household chores. If this is a problem, please talk to your clinical nurse specialist (CNS) or ward nurse.
We want to involve you in all the decisions about your care and treatment. We will talk to you in detail about HIPEC and explain the risks, benefits and alternatives specific to you. If you decide to go ahead with the treatment, we will ask you to sign a consent form. This confirms that you agree to have the procedure and understand what it involves.
You will have general anaesthetic for the interval cytoreductive surgery and HIPEC. This means that you will be asleep for the procedure and you will not feel any pain.
Once you are asleep, a small tube (catheter) will be passed into your bladder. This will allow for your urine to be drained into a collection bag.
During your surgery, the surgeon will remove as much tumour as possible, leaving none or only small amounts behind.
A chemotherapy drug will then be put into your abdomen via a few small plastic tubes (drains). This drug is called cisplatin. As cisplatin works better at temperatures of around 40 degrees, it is warmed before being given. It will stay inside your abdomen for 90 minutes and will be removed before the end of the operation. During this time, the surgeon and a nurse will control the HIPEC machine and make sure that the procedure runs smoothly. The anaesthetist will monitor you throughout the whole procedure.
The surgeon will remove the drains used to add the chemotherapy drug before you wake up from the general anaesthetic. They may leave one of them in to monitor the fluid that is drained from your abdomen. If this is the case, they will remove the drain a few days after the operation.
The team looking after you will transfer you to the Post-operative Anaesthetic Care Unit (PACU) after your surgery. You will stay there for two or three days and the team will monitor you closely.
Your gynaecology doctor and the PACU doctors will see you regularly after your surgery. They will assess your recovery and advise when you can be transferred to the ward.
When you get back to the ward, your doctors and nurses will continue to monitor you closely. They will check your blood pressure, pulse, breathing and temperature regularly. They will also examine your wounds and check for any vaginal bleeding.
You will be encouraged to start moving about as soon as possible. This will include gentle leg and breathing exercises which can help with circulation. They can also help to prevent a chest infection.
You may feel nauseous (feel sick or like you need to vomit), or you may vomit after your surgery. This is a common side effect of having a general anaesthetic and long surgery. We will give you anti- sickness medicine to try to prevent this.
You will have been given support stockings to wear during your surgery and recovery. It is important that you wear them because they can help to prevent blood clots in your legs or lungs. We will also give you blood-thinning injections under the skin (subcutaneously).
You will need to take these injections for 28 days after your surgery. Your ward nurse will teach you, a family member or a friend how to do this before you leave hospital.
You may have an intravenous drip to give you fluids directly into a vein until you are able to eat and drink normally. The urinary catheter will be removed as soon as it is safe to do so.
The length of hospital stay following an operation with HIPEC depends on:
- how long the operation took
- other health conditions you may have
- any complications which may occur as a result of your operation.
On average, patients stay in the hospital for seven to 10 days.
Yes. You will have an appointment at the Gynaecology Oncology clinic about three weeks after your surgery. This is to check if you are recovering as expected and to discuss any results.
We will try to schedule this appointment on the same day as your chemotherapy review. This will help to avoid having too many appointments on different days.
For recovery advice in the first two weeks after your surgery, call our gynaecology enhanced recovery nurse.
Telephone: 07815 642930 (Monday to Friday, 9am to 4pm)
If we can’t answer your call, please leave a voicemail including:
- full name
- date of birth or hospital number
- your contact number
- a brief reason for your call.
Consult your GP or NHS 111 if you experience any of the following:
- constipation which lasts longer than three or four days and does not get better after taking a laxative
- red and painful skin around your wound
- discharge (pus) from your wound or your wound opening
- smelly, yellow or green discharge from your vagina and feeling itchy
- burning pain or discomfort when passing urine (peeing).
Contact us without delay on one of the numbers listed on page 11, or go to your nearest Emergency Department (A&E), if you notice any of the symptoms listed below:
- sudden feeling short of breath and/or chest pain
- a temperature of 38 degrees or above
- severe pain or increasing pain after taking your painkillers
- nausea and/or vomiting that is stopping you from eating and drinking
- not being able to pee or peeing very small amounts, and feeling your bladder isn’t empty
- heavy bleeding from your vagina (bright red blood or clots)
- pain, swelling or redness in your calf.
When will I be able to drive?
You can drive again once you are able to do an emergency stop safely and without being in discomfort. This usually takes at least four weeks after the surgery. You must make sure you are not drowsy from any painkillers you may be taking.
It’s important that you tell your insurance company that you have had surgery.
When can I return to work?
This will depend on the job you do, but most women feel able to return to work six to eight weeks after their surgery. You may need longer that this as you will be continuing with your chemotherapy. Please talk to your gynaecology doctor or your GP if you need a sick certificate.
When can I fly?
We recommend that you wait four to six weeks before flying. This may also depend on your chemotherapy schedule. Please talk to your healthcare team before arranging any travel.
When can I swim?
Avoid swimming or using a hot tub until your wounds have completely healed and any vaginal bleeding or discharge has stopped. Where possible, use a shower instead of having a bath.
When can I have sex?
We advise that you don’t have sex for six weeks after your surgery and until any vaginal bleeding or discharge has stopped. This is to allow your internal wounds to heal. You may also find that you don’t feel ready psychologically. If this is a concern, please talk to your gynaecology doctor or CNS.
Cancer Research UK
Helpline: 0808 800 4040
Email: supporter.
Website: cancerresearchuk.org
Contact details
Gynaecology Oncology Clinical Nurse Specialists (CNSs)
Telephone: 020 3447 8636 (Monday to Friday, 9am to 4.30pm)
Outside of these hours, call ward T7 South (Women’s Health)
Telephone: 020 3447 7828
Nurse in charge: 07930 263122
Gynaecology enhanced recovery nurse
Telephone: 07815 642930 (Monday to Friday, 9am to 4pm)
Pre-operative assessment
Telephone: 020 3347 3167 or 020 3447 3170
Surgical reception
Telephone: 020 3447 3184 or 07930 608267
The Macmillan Support and Information Service is available to people with cancer and blood conditions, and their families, friends and carers. It offers:
- complementary therapies, such as massage and relaxation
- diet and nutrition advice
- emotional support, advice and information
- psychological care and counselling
- welfare and benefits advice
- wig and scarf tying advice
- a programme of workshops, courses and events.
If you would like to use any of these services, please talk to your CNS. You can also drop in to talk to one of the support and information specialists.
Address: Ground floor, University College Hospital Macmillan Cancer Centre
Huntley Street, London WC1E 6AG
Opening hours: 9am to 4.45pm, Monday to Friday
Telephone: 020 3447 8663 or 020 3447 3816
Email: uclh.
Website: uclh.nhs.uk/
X (formerly known as Twitter): @supportandinfo
PALS is a patient-friendly, easy-to-access service designed to provide a personal contact point to assist patients, relatives and carers. If you have a problem that you have not been able to resolve, PALS can help you.
The University College Hospital PALS office is located on the ground floor of the main hospital building and is open from 9am to 4pm, Monday to Friday.
Telephone: 020 3447 3042
Email: uclh.
Services
Page last updated: 18 July 2024
Review due: 28 February 2026