Intraperitoneal (IP) Chemotherapy for Gynecologic Cancer
Intraperitoneal (IP) chemotherapy is a type of cancer treatment. It delivers cancer-fighting drugs directly into the abdominal cavity instead of orally or through a vein.
Because IP chemotherapy is confined to the abdominal cavity, side effects on healthy tissue are limited.
This type of chemotherapy can treat primary peritoneal cancer, or cancer that begins in the abdominal lining. It can also treat advanced cancers that have metastasized (spread) to the abdominal lining.
What Is Intraperitoneal Chemotherapy?
IP chemotherapy is a delivers cancer-fighting drugs directly into the abdominal cavity (peritoneal cavity) instead of orally or through a vein.
This type of chemotherapy treats peritoneal cancer that begins in the abdominal lining. It also treats advanced cancers, like ovarian cancer, that have spread to the abdominal lining.
During IP chemotherapy, doctors pump cancer-fighting drugs into the abdominal cavity through a flexible tube called a catheter. The fluid slowly fills the abdomen, washing over and killing cancer cells. Depending on the type of IP chemotherapy, the fluid may be heated to make the drugs more lethal to cancer cells.
IP chemotherapy is confined to the abdominal cavity. That allows care teams to use stronger drugs to fight the cancer while limiting damage to healthy tissue.
Types of intraperitoneal chemotherapy
- Intraperitoneal (IP) chemotherapy — IP chemotherapy uses a catheter to deliver cancer-fighting drugs into the abdominal cavity instead of through a vein. Often, the catheter is connected to a port, a semi-permanent device placed under the skin to help drug delivery. The fluid flows through the catheter and slowly fills the abdominal cavity, washing over and killing cancer cells. It is then absorbed by the abdominal lining and bloodstream.
- Hyperthermic intraperitoneal chemotherapy (HIPEC) — HIPEC delivers very high doses of heated cancer-fighting drugs into the abdominal cavity. It is usually performed right after cytoreductive surgery, which removes large cancer nodules. HIPEC kills invisible, microscopic cancer cells left after surgery.
Conditions we treat with intraperitoneal chemotherapy
Doctors use IP chemotherapy and HIPEC to treat cancers in the abdominal region. This includes peritoneal cancer that begins in the abdominal lining. It can also include advanced cancers that have spread to the abdominal lining, such as cancers of the:
HIPEC also can treat peritoneal mesothelioma. This type of cancer is linked to asbestos exposure.
Why Would I Need Intraperitoneal Chemotherapy?
IP chemotherapy can help patients who have cancer in the abdominal region.
People can receive other chemotherapy types by mouth or through a vein. But IP chemotherapy delivers the cancer-fighting drugs right to the abdominal cavity. That allows IP chemotherapy to use much stronger drugs than classic chemotherapy.
Is intraperitoneal chemotherapy right for me?
IP chemotherapy can treat advanced or difficult-to-treat cancers that are confined to the abdomen. If your cancer is in another part of the body, you're not a candidate for IP chemotherapy or HIPEC.
What Are the Risks and Complications of Intraperitoneal Chemotherapy?
IP chemotherapy delivers cancer-fighting drugs right into the abdominal cavity. That allows people to avoid side effects that are common in classic chemotherapy, like mouth sores and hair loss.
However, IP chemotherapy can cause severe nausea and vomiting. HIPEC can cause gastrointestinal complications, including injuries to the intestines, such as:
- Abscess (a collection of pus).
- Fistula (dead tissue that leaves a tunnel-like space between organs).
- A leak in the abdominal cavity or intestinal wall.
- A tear of the intestinal wall.
HIPEC often occurs after surgery to remove visible cancer. That means it can also carry risks associated with surgery, including:
- Bleeding.
- Blood clots.
- Infection.
- Poor nutrition or weight loss.
What Should I Expect from Intraperitoneal Chemotherapy?
IP chemotherapy and HIPEC both allow doctors to pump cancer-fighting drugs right into the abdominal cavity. But doctors use different procedures to deliver them.
IP chemotherapy typically occurs in an outpatient setting. Cancer care teams insert a needle into the patient’s port to deliver the chemotherapy. Patients can go home after the needle is removed.
Like classic chemotherapy, patients may need several infusions of IP chemotherapy.
HIPEC usually occurs immediately after cytoreductive surgery. The surgery removes all visible cancer. Doctors then use HIPEC to destroy any cancer cells that may remain after surgery.
The drugs used in HIPEC are powerful, and the heat makes them even more lethal to cancer cells. Because of that, doctors perform it just once. The recovery requires a lengthy hospital stay.
How to prepare for intraperitoneal chemotherapy
IP chemotherapy
For IP chemotherapy, you will need someone to drive you to and from your appointment. You should eat light meals and wear loose, comfortable clothing.
HIPEC
HIPEC occurs in a hospital under general anesthesia. That means you may need to fast (stop eating and drinking) or stop taking certain medications before your surgery. Your doctor will give you specific instructions.
How long does intraperitoneal chemotherapy take?
IP chemotherapy typically occurs in an outpatient setting. It can take as little as 30 minutes or as long as three hours.
HIPEC, when done with surgery to remove large tumors, can take several hours. You will also need to stay in the hospital for up to two weeks.
During your intraperitoneal chemotherapy
IP chemotherapy
You will lie in a bed as doctors deliver drugs through a small tube that goes directly to your abdomen. You may also need an IV for fluids or medications.
Your abdominal cavity will slowly fill with fluid. This may cause pressure, bloating, or the urge to use the bathroom. You may also breathe faster.
Your doctor will likely ask you to move around during the procedure or right after. This ensures that the fluid reaches every part of your abdominal cavity and touches every cancer cell.
You can go home shortly after your chemotherapy session is over. Your abdominal lining and bloodstream absorb the fluid. Like classic chemotherapy, you may need several sessions of IP chemotherapy.
HIPEC
The surgeon first removes all visible cancer with cytoreductive surgery. They then insert small tubes and temperature probes into the abdomen.
One tube delivers the heated chemotherapy solution into your abdomen. The other tube circulates the fluid back to a heating element. This helps maintain a temperature in the abdomen between 105 F and 107.6 F (40.6 C and 42 C).
Your surgeon will rock you back and forth for about two hours. This ensures the fluids reach every part of your abdomen and touch every cancer cell. The goal is to kill any cancer left after surgery.
At the end of the procedure, the surgeon will:
- Turn off the pump and let your body return to normal temperature.
- Flush the abdomen with saline to clear the medicine.
- Remove the tubes and temperature probes and close the incisions with sutures.
Recovery after intraperitoneal chemotherapy
IP chemotherapy
You will go home shortly after your IP chemotherapy session.
You may continue to feel bloated while the fluid is absorbed. You may also lose your appetite or feel nauseous. Some people vomit or have stomach pain.
HIPEC
You will need to stay in the hospital for up to two weeks after HIPEC to allow your body to heal.
You will receive fluids and medications through an IV, and you also may need nutrition. Your digestive system and bowel function often need time to recover after surgery.
It’s possible to feel tired for several months after HIPEC. Your doctor will let you know when you can return to your normal activities.
When to call your doctor about intraperitoneal chemotherapy
IP chemotherapy
It’s normal to experience some nausea, vomiting, and stomach pain after IP chemotherapy. But you should call your doctor if you have:
- Diarrhea that lasts more than 24 hours.
- Fever.
- Nausea or vomiting that lasts more than 24 hours.
- Severe or constant stomach pain.
HIPEC
After HIPEC, you will be in the hospital and under your doctor’s care for up to two weeks.
After you go home, you should call your doctor if you experience:
- Fever.
- Nausea or vomiting.
- Swelling around your incision.
- Worsening pain.
What’s the outcome of intraperitoneal chemotherapy?
Studies have shown that cytoreductive surgery with HIPEC has a lower recurrence rate and longer survival rate than cytoreductive surgery alone.
But IP chemotherapy and HIPEC are not considered cures for cancer. They are life-extending treatments.
Why Choose UPMC for Intraperitoneal Chemotherapy?
Only a few medical centers in the country perform as many cytoreductive surgeries with HIPEC as UPMC surgeons do.
At UPMC, you can also expect:
- Cancer expertise — UPMC Hillman Cancer Center is one of just 57 National Cancer Institute-designated Comprehensive Cancer Centers in the country — and the only one in western Pennsylvania. Your cancer treatment is grounded in the latest advances in clinical care and supported by evidence-based research.
- Compassionate care — At UPMC Hillman Cancer Center, you're not alone in your fight against gynecologic cancer. Our team of researchers, caregivers, and clinicians will guide and support you through diagnosis, treatment, and survivorship. They'll also provide you with the latest advancements in cancer care.
- Locations close to home — UPMC offers gynecologic oncology services in communities across the region. You won’t have to travel far from home to receive the world-class care you need.
- Top doctors — Nearly 500 UPMC physicians have been recognized as “Top Doctors” across more than 60 different specialties, including gynecologic oncology.
By UPMC Editorial Staff. Last reviewed on 2026-08-06.
- Hyperthermic Intraperitoneal Chemotherapy in Ovarian Cancer, New England Journal of Medicine.
- Chemotherapy for Ovarian Cancer, American Cancer Society.
- Chemotherapy for intraperitoneal use: a review of hyperthermic intraperitoneal chemotherapy and early post-operative intraperitoneal chemotherapy, Journal of Gastrointestinal Oncology.
