Intraperitoneal (IP) Chemotherapy (chemo) is a method that allows the 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 is it given?
IP chemo is given through the catheter of an implanted port. This port is placed beneath the skin in your belly during a brief procedure. (Figure 1)
There are two parts to the implanted catheter:
A 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.
A thin tube (catheter). This is attached to the port and is placed within the belly.
A needle is placed through the skin and into the port so that the chemo can be given. (Figure 2). Your nurse may put numbing cream the skin before the needle is placed. This will feel like an IV needle puncture or a shot. During the treatment, the needle is taped in place. A small dressing covers the site. When the treatment is finished, the needle is removed. 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 the treatment given?
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 the treatment given?
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 with time. During the treatment, you may notice a feeling of fullness and swelling in your belly. This will decrease in a few days.
IV fluids are given into your veins to increase the amount of fluids in your system. This also allows other medicines such as anti-nausea drugs to be given.
You need to stay in bed during the treatment. This keeps the IP catheter in the proper place. After the chemo has been given, you need to roll from side to side for 2 hours. Your nurse can help you. This action helps to evenly spread the chemo drug.
Possible Side Effects of IP Chemotherapy:
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. 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. Changes in bowel habits, either diarrhea or constipation, may be caused by the treatment. Medicines can be given if this happens.
Frequent urination - The belly pressure, along with the extra fluid given to you, may cause you to urinate more often. It is important to drink as much fluid as you can after the treatment. This helps to flush the chemo out of your system. Belly fullness may last for several days. Plan to bring pants or a skirt with an expandable waistline to wear home.
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 Symptoms - The type of drugs used for your treatment affects which side effects you have. Your oncology team will discuss these with you.
Call your doctor if you have:
Any unusual belly pains.
Your waistline gets larger between treatments.
Chills, or fever greater than 100° F.
Shortness of breath.
Nausea or vomiting that doesn’t go away after a few days.
Diarrhea or constipation that doesn’t go away after a few days.
Soreness, redness, or swelling around the port or catheter site
You notice a 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