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Intraperitoneal (IP) chemotherapy (chemo) is a way for chemo to be given into the belly. This lets the drug get to the cancer sites with fewer side effects to the rest of the body.
How It Works
IP chemo is given through the catheter of an implanted port. This port is placed under the skin in your belly during a brief procedure.
Implanted Catheter Parts
Port: This is a small chamber with a rubber disc (septum) on the top. The needle is placed into the rubber disc. The disc is self-sealing. It can be punctured many times.
Catheter (thin tube): This is attached to the port and is placed within the belly.
Caring for Your Port
Since the port is under your skin, no bandages or dressings are needed between treatments. You may bathe, shower, and swim without worry. The port does not need any care on your part.
Where is Treatment Done
IP chemo may be given while you are in the hospital or in the clinic. A nurse trained in giving chemo will give the drug. They will also watch you closely during the treatment.
How Is Treatment Done
You will have a needle placed through the skin and into the port. It will feel like an IV needle prick or a shot. Your skin may be numbed with numbing cream before the needle placement.
The needle will be taped into place during the treatment. A small dressing covers the site. The needle will be removed when the treatment is done.
Chemo is given into your belly through IV tubing that connects to your port or catheter. You receive a total of 2 liters of fluid. This helps the chemo to reach all parts of the belly.
The treatment takes several hours. The fluid is left in your belly to be absorbed over time. During the treatment, you may feel fullness in your belly and notice swelling. This will decrease in a few days.
You will also receive IV fluids to increase the amount of fluids in your system. This also allows you to get other medicines such as anti-nausea drugs.
You need to stay in bed during the treatment. This keeps the IP catheter in the proper place.
When the chemo is done, you need to roll from side to side for 2 hours. Your nurse can help you. This helps to evenly spread the chemo drug.
Possible Side Effects
Nausea and vomiting – You get medicines to decrease these symptoms both before your treatment and when you go home.
Bloating - You may notice pressure that will slowly decrease after the treatment. Belly fullness may last for several days. Plan to bring pants or a skirt with an expandable waistline to wear home. Pressure in the belly may make it hard for you to take a deep breath. This may cause you to breathe faster and take more shallow breaths. Raising the head of your bed will help in most cases. The increase in pressure can also make you feel less hungry. Try to eat small meals more often. You may also have changes in bowel habits, either diarrhea or constipation. Medicines can be given if this happens.
Frequent urination - The belly pressure and extra fluids may cause you to urinate more often. Drink as much fluid as you can after the treatment to flush the chemo out of your system.
Peritonitis - This is an inflammation of the lining around the belly. Although rare, this can be a result of the chemo. It may also be a sign of an infection. It can cause belly pain, chills, or fever. If you have any of these symptoms during or between treatments, call your doctor or nurse right away.
Extravasation – This is when the chemo drug leaks out of the catheter and into your tissue. This may occur if the needle becomes dislodged from the port during treatment. Although this leakage rarely occurs, if it does happen, it may cause damage to your skin and tissue at the site. To prevent this, we ask you to stay in bed during the treatment.
Other side effects - The type of drugs used for your treatment affects which side effects you have. Your oncology team will discuss these with you.
When to Call
Any unusual belly pains.
Your belly gets larger between treatments.
Chills, or fever greater than 100 F.
Shortness of breath.
Nausea or vomiting that does not go away after a few days.
Diarrhea or constipation that does not go away after a few days.
Soreness, redness, or swelling at the port or catheter site.
Change or increase in vaginal fluid.
Reproduced, with permission, from Clinical Guideline to Antineoplastic Therapy: A Chemotherapy Handbook (2001) Mary Magee Gullatte, RN, MN, ANP, AOCN