Intraperitoneal Chemotherapy

This information will help you get ready for your intraperitoneal (IP) chemotherapy.

About Your IP Therapy

Your peritoneal (payr-ih-toh-NEE-ul) space is the area between the muscles and organs in your abdomen (belly). There is a little fluid in between the peritoneal lining and your organs. If your cancer spreads to your abdomen or peritoneal space, IP chemotherapy can help target the cancer cells there.

Before you begin IP chemotherapy, you will have an access port placed into a pocket under your skin near your rib cage. The catheter (thin, flexible tube) will be inserted into your peritoneal space (see Figure 1). For your IP chemotherapy, your medication will be mixed with fluids, such as normal saline. It will be injected directly into your peritoneal space through your access port.

The port has a raised chamber. On top of the chamber is a self-sealing rubber septum (disc). The chamber also has a side arm to attach the catheter to (see Figure 2). You may see or feel the port under your skin. This is normal.

During IP chemotherapy, the medication will directly target the cancer in your peritoneal space. This treatment method uses a higher dose of chemotherapy medication. Your nurse will teach you about the medication that will be used for your IP chemotherapy.

You may get your IP chemotherapy as an inpatient or an outpatient. Depending on the type of cancer you have and the medication you need, your doctor will let you know:

• Where you will get your IP chemotherapy
• How many treatments you will have
• How long your therapy will last

Some people may need to switch between having intravenous (through a vein) therapy and IP chemotherapy given at different times.

Getting Ready for Your IP Chemotherapy

• Eat a light dinner the night before and a light breakfast on the morning of your treatment.
• Dress comfortably the morning of your treatment. Wear loose fitting shirts and pants with an elastic band or a draw string.
• If you want to, you can bring a music player so you can listen to music during treatment. There will be a TV in the room where you will get your treatment. Someone can also stay with you during your treatment.
• You can bring food and drinks with you into the treatment room.

Arrange for someone to take you home

You must have a responsible care partner take you home after your procedure. A responsible care partner is someone who can help you get home safely. They should be able to contact your care team if they have any concerns. Make sure to plan this before the day of your procedure.

If you don’t have a responsible care partner to take you home, call one of the agencies below. They’ll send someone to go home with you. There’s a charge for this service, and you’ll need to provide transportation. It’s OK to use a taxi or car service, but you still need a responsible care partner with you.

During Your IP Chemotherapy

During your IP chemotherapy, you will need to lie down in your bed unless you need to go to the bathroom. You may get fluids or medication intravenously (through an IV).

Your nurse will put a needle through your skin and into the self-sealing disc on the port chamber. This will feel like a small pinprick. They will tape the needle in place and cover it with a small bandage.

The fluid and medication mixture will be in a bag that’s attached to the needle. This mixture will flow into your peritoneal space. You may need to have more solution after your treatment to make sure the medication fills your entire peritoneal space.

After the solution flows fully into your peritoneal space, your nurse will take out the needle and put a bandage on the area. This bandage can be taken off after about 30 minutes.

If you’re inpatient and can’t get out of bed, your nurse will ask you to move from side to side in bed every 15 minutes for 1 hour (4 times total). This will help move the solution throughout your peritoneal space. Then your IP chemotherapy will be over and you can get out of bed. Your body will absorb the solution over the next few days.

If you’re an outpatient, make sure you move around for the next hour after your treatment is over. This lets the medication reach all parts of your peritoneal space.

The time the treatment will take can be different for everyone, but it’s usually no more than 1.5 to 2 hours. Some treatments may last as long as 6 hours because of the extra IV fluid that has to be given. Ask your doctor or nurse how long your treatment may take.

Side Effects of IP Chemotherapy

The side effects of IP chemotherapy are different for everyone. This section lists the most common side effects and how you can manage them. The side effects may be caused by the amount of fluid that is injected into your peritoneal space during your IP chemotherapy, or by the medication itself. You may have none, some, or all of these side effects.

Abdominal pressure or bloating

• After your treatment is over, try to walk around. This will help with the pressure or bloating. Wear comfortable clothes, such as pants with an elastic band, for your treatments and for a few days after your treatments.

Full bladder or the need to urinate (pee) often

• Try to empty your bladder just before you start your treatments. You can also use the bathroom during your treatments.

Faster breathing

• Raise your head on a pillow during your treatment. When your treatment is over, you can walk around or sit upright in a chair.

Nausea (feeling like you might throw up) and vomiting (throwing up)

• Your doctor or nurse may give you an anti-nausea medication before or during your IP chemotherapy. Your doctor may also prescribe this medication for you to take at home if you need it.

Decreased appetite (not feeling hungry)

• Try to eat smaller meals more often and drink liquid nutritional supplements.

Caring for Your Peritoneal Port at Home

Since the access port is under your skin, you don’t need to cover or bandage it. You can bathe and shower as you usually do. You can follow your normal diet.

Having a port and catheter shouldn’t limit your activities. Ask your doctor or nurse about going back to your normal activities. Check the skin around your port everyday and call your doctor or nurse if there are any problems or changes.

When to Call Your Healthcare Provider:

Call your healthcare provider if you have any of the following:

• Serious or constant stomach pain
• A fever of 100.4° F (38° C) or higher
• Redness, swelling, or tenderness in the area around your port site
• Leaking or drainage from your port site
• Nausea or vomiting that lasts more than 24 hours
• Diarrhea (loose, watery stool) that lasts more than 24 hours
• Constipation (not able to have a bowel movement) that lasts more than 24 hours
• If you can’t eat or drink for more than 24 hours
• Any unexpected or unexplained problems