Chemotherapy within the Abdominal Cavity: Procedure and Potential Complications
Intraperitoneal chemotherapy (IPC) is a groundbreaking cancer treatment that offers a unique approach to fighting abdominal cancers such as ovarian cancer, colorectal tumors, stomach cancer, and appendiceal cancer. This method allows doctors to deliver higher doses of necessary drugs directly into the peritoneal cavity, minimising side effects to the rest of the body.
The treatment process involves a series of cycles, each consisting of a treatment period followed by a rest period. During the treatment, doctors inject chemotherapy drugs into a port connected to an access catheter, which is implanted in the abdominal cavity during surgery. The port lies under the skin while the catheter reaches the targeted area.
IPC is performed by a healthcare professional who inserts a needle through the skin and access port to connect them. Patients may find it helpful to tape the needle in place. Doctors often ask patients to shift their position or roll from side to side once every 15 minutes for about an hour during treatment.
The common side effects of IPC include abdominal pain or cramping, nausea or vomiting, bloating, temporary loss of appetite, and changes in bowel habits such as constipation or diarrhea. These side effects are primarily localised but can still be significant.
For procedures like pressurized intraperitoneal aerosol chemotherapy (PIPAC), which uses lower doses than systemic chemotherapy, side effects are generally mild and transient. These side effects are:
- Abdominal pain or cramping
- Upset stomach or vomiting
- Bloating
- Temporary loss of appetite
- Constipation or diarrhea
Serious but rarer side effects due to the procedure itself may include infection, surgical complications (such as bowel or organ injury), and scar tissue formation inside the abdomen, which can affect bowel function.
In addition to these localised effects, systemic chemotherapy side effects often overlap and may include fatigue, hair loss, mouth sores, and increased risk of infection due to chemotherapy's impact on rapidly dividing cells throughout the body. However, IPC aims to reduce systemic toxicity compared to intravenous routes.
The number of treatments a person will have depends on their cancer type, treatment goals, chemo drugs, and how they respond to them. After the initial treatment, doctors often recommend systemic chemo through a vein.
IPC is not without its benefits. People with ovarian cancer who undergo IPC live longer than those who only undergo traditional intravenous chemotherapy. Those who undergo hyperthermic IPC and start regular IPC immediately after surgery have a better chance of survival than those who do not.
To help manage the discomfort associated with bloating, patients can wear loose-fitting, comfortable clothes. It is also important to ensure the person undergoing treatment can get home safely before starting any chemotherapy.
Patients should eat light meals the evening before and on the morning of the treatment to help prepare their bodies. Depending on how long the treatment will last, some people may wish to prepare snacks and drinks to take into the treatment room. During treatment, patients need to lie down but can walk to and from a bathroom if necessary.
In conclusion, IPC offers a promising approach to treating abdominal cancers. While it does have side effects, these are often localised and manageable. With proper care and guidance, patients can navigate this treatment effectively.
- Intraperitoneal chemotherapy (IPC) is utilized for fighting various abdominal cancers, including ovarian, colorectal, and pancreatic, leveraging a method that delivers high doses of drugs directly into the peritoneal cavity.
- IPC treatments proceed in cycles, with periods of treatment followed by rest, during which doctors administer chemotherapy drugs through a port connected to an access catheter implanted in the abdominal cavity.
- After the IPC procedure, patients may experience side effects such as abdominal pain or cramping, nausea or vomiting, bloating, temporary loss of appetite, and changes in bowel habits, with these effects primarily localized.
- The healthcare profession performs IPC by inserting a needle through the skin and access port, and patients may find it helpful to tape the needle in place during treatment.
- Besides managing discomfort associated with bloating by wearing loose-fitting clothes, patients should carefully consider their evening meal before and morning meal on treatment days to help prepare their bodies for the procedure.
