Your Guide to Intraperitoneal Chemotherapy
Intraperitoneal (IP) Chemotherapy is a method that allows chemotherapy to be given into the abdomen. This treatment allows the drug to be sent to the cancer sites with fewer side effects to the rest of the body.
How is it Given?
The chemotherapy will be placed into the abdomen. A port or a catheter can be used.
An Implanted port is a catheter is placed beneath the skin during a brief operation (Figure 1).
Figure 1
There are two parts to the implanted catheter: a port and a thin tube. The port 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 and can be punctured many times. The thin tube attached to the port is placed within the abdomen.
A needle will be placed through the skin and into the port so that the chemotherapy can be given.
(Figure 2). You may ask your nurse to use a cream to numb the skin before the needle is placed.
Figure 2
This will feel like an IV needle puncture or a shot. During the treatment, the needle will be taped in place. A small dressing will cover the site. When the treatment is finished, the needle will be removed. Since the port is under your skin, no bandages or dressings will be needed between treatments. You may bathe, shower, or swim without worry. The port does not need any care on your part.
The Tenkoff catheter is an external catheter. It is also placed during a brief operation (Figure 3).
Part of the catheter is outside the skin. This allows access to the catheter without the use of needles. The catheter must be capped at all times to prevent infection. The chemotherapy will be given through the outside catheter. With this type of catheter, you may shower when the incisions are healed. It is important that you do not take a bath or swim. You should discuss this with your nurse or doctor.
Figure 3
Care of the catheter: Dressings must be used to prevent infection. Sterile technique is used for the first 10-14 days after placement. After that, "clean" technique is used. You will be taught how to care for your catheter before you go home.
Where Is the Treatment Given?
IP chemotherapy may be given to you 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?
The treatment is given through IV tubing through your port or catheter into your belly. Your chemo will be mixed in about two quarts of fluid. This helps the chemotherapy to reach all parts of the abdomen.
The treatment takes several hours. The fluid will be left in the abdomen to be absorbed with time. During the treatment, you may notice a feeling of fullness and swelling of the abdomen. This will lessen in a few days.
IV fluids will be given into your veins to increase the amount of fluids in your system. It also allows other medicines such as anti-nausea drugs to be given.
You will need to stay in bed during the treatment to keep the catheter in the proper place. This is also done for your safety since you may be given medicine to make you sleepy. Your nurse will ask you every so often to roll from side to side during the treatment. This action helps to evenly spread the chemotherapy.
Side Effects of IP Chemo
Although not all people who receive this treatment have side effect, some of these may occur.
- Nausea and vomiting - Medicines to decrease these symptoms will be given to you before your treatment and when you go home.
- Bloating - You may notice pressure that will slowly decrease after the treatment. Pressure from the abdomen 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 cause a decrease in appetite. Try eating smaller 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 abdominal 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 to flush the chemotherapy out of your system. Abdominal fullness may last for several days. Plan to bring pants or a skirt with an expandable waistline to wear home from the hospital.
- Peritonitis - This is the inflammation of the lining around the abdomen. Although rare, this can be the result of the chemotherapy. It may also be a sign of an infection. It can cause abdominal pain, chills, or fever. If you have any of these symptoms during or between treatments you should call your doctor or nurse right away.
- Extravasation - This may occur if the needle becomes dislodged from the port during treatment. If this happens chemotherapy can leak into the tissue. Although this leakage rarely occurs, if it does happen, it may cause damage to your skin at the site. To prevent this, we ask you to remain in bed during the treatment.
- Other Symptoms - The type of drugs used for your treatment, will affect which side effects you have. Your doctor or nurse will discuss these with you.
When to call your doctor
Call your doctor if you have
- Any unusual abdominal pain
- 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
- Catheter comes out
Questions?
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The information provided should not be used during any medical emergency or for the diagnosis or treatment of any medical condition. A licensed physician should be consulted for diagnosis and treatment of any and all medical conditions. Call 911 for all medical emergencies. Any duplication or distribution of the information contained herein is strictly prohibited.
Last Updated: 05/14/2012
Copyright © 05/14/2012 University of Wisconsin Hospitals and Clinics Authority. All rights reserved. Produced by the Department of Nursing. HF#4208
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