Your Guide To Intraperitoneal Therapy

Introduction

This booklet is designed to provide you with information about intraperitoneal therapy and prepare you to participate in activities which will assist you during the time you receive this therapy.

Intraperitoneal therapy is the delivery of anti-cancer drugs directly into the peritoneal space (abdominal cavity). This space lies between the abdominal muscles and abdominal organs. The anticancer drug is missed in a large volume of fluid and instilled into the peritoneal space through a port and catheter. Your surgeon will insert a peritoneal access port into a pocket beneath the skin near your rib cage.

The port consists of a raised chamber. Embedded into the top of the chamber is a self-sealing silicone rubber septum (disc). The chamber also has a side arm for attaching the flexible catheter, which is placed in your peritoneal space.Your surgeon usually inserts the port and catheter at the time of your surgery.

Intraperitoneal therapy allows direct contact of the cancer-fighting drug with the cancer within you r peritoneal space. The drug is left in the peritoneal space to “bathe” the cancer. This method of delivering it directly into the cavity where the cancer is located allows a higher concentration of the drug to be given.

Where Your Intraperitoneal Therapy Will Be Administered

Intraperitoneal therapy may be given in the inpatient or outpatient setting. Where you receive your intraperitoneal therapy, how many treatments you receive, and the duration of therapy, depend on your condition, and the particular anti-cancer drug your doctor has recommended. During the actual treatment you will be asked to remain in your bed.

Who Will Administer Your Intraperitoneal Therapy

Your intraperitoneal therapy will be administered by a registered nurse. Your nurse will review with you information explained in this booklet as well as review the Chemotherapy Fact Card about your anti-cancer drug. The Chemotherapy Fact cards contain the important information you need to know about the drugs you will receive.

How Your Intraperitoneal Therapy Will Be Administered

Before and during the intraperitoneal treatment, intravenous fluid may be administered through a vein. The purpose of this fluid is to maintain your fluid level and to allow the administration of antinausea medicine if it is necessary during your treatment.

To begin your intraperitoneal therapy, the nurse will place a special needle through your skin and into the self-sealing septum in the port chamber. This will feel similar to a small pin prick. The needle will be taped securely and covered with a small dressing. A fluid administration set, which contains the anti-cancer drug will be attached the needle. The volume of fluid your medication is mixed in is determined by the treatment you are receiving. This amount is given to allow the drug to reach and “bathe” all parts of the peritoneal space. The solution will be allowed to flow into your peritoneal space by gravity. The actual intraperitoneal therapy treatment time varies, but it is usually no more than 2 to 3 hours. More solution may be ordered after the treatment to improve the bathing of the peritoneal space.

After the solution has flowed into your intraperitoneal space, the special needle will be removed and a bandage will be placed on the site. This bandage can be removed after about 30 minutes. Your nurse will ask you to move from side to side in bed a few times. This will help to distribute the anti-cancer drug solution evenly throughout your peritoneal space. Your intraperitoneal therapy will then be complete and you may be out of bed as desired. The solution in your peritoneal space will be absorbed by your body over the next few days. During this time, your abdomen may be bloated and you may feel some abdominal pressure.

What To Do At Home To Prepare For Your Intraperitoneal Treatment

  • Wear expandable or loose-fitting clothing to the hospital.
  • Eat a light dinner the night before and a light breakfast the morning of the treatment.
  • If you wish, bring a cassette or CD player or iPod® and your favorite music to listen to during treatment. A television is provided in the room where you receive your treatment.
  • It may be helpful to have a relative or friend accompany you home as some medicine may make you feel drowsy.

Possible Side Effects Of Intraperitoneal Therapy And Comfort Measures To Minimize These Effects

You may not experience any side effects from your intraperitoneal therapy. The following are some effect that some patients have reported, and the comfort measures they have found helpful.

POSSIBLE SIDE EFFECTS COMFORT MEASURES
Abdominal pressure and bloating. (caused by the large volume of fluid injected into the peritoneal space) Walk around after the treatment is completed. Wear comfortable clothing with an expandable waistline especially for the first few days after treatment.
Frequent urination/bladder fullness (a desired side effect caused by the intravenous fluids) Empty your bladder just before beginning treatment. You will be allowed to use the bathroom, if needed, during the treatment.
Breathing faster and more frequently (caused by the large volume of fluid injected into the peritoneal space) Elevate the head of your bed during treatment. Walk around after the treatment. Sit in an upright chair after the treatment
Decrease in appetite (caused by anti-cancer drugs) Eat smaller meals more frequently. Drink high nutrition liquid supplements.
Nausea, vomiting, or both (caused by anti-cancer drugs) Antinausea medicine may be given to you before, during the therapy, or both. Your doctor will prescribe antinausea medicine for you to take at home if needed.

Some of the drug you receive is absorbed and carried throughout your body. The effects you feel may be caused by the drug(s) given to you.

What You Need To Know About Home Care Of The Peritoneal Port

  • Since the peritoneal access port is located under your skin, no covering or bandage is required.
  • You may bathe or shower.
  • Having a port and catheter in place should not restrict your activities. Reasonable exercise is allowed after the incision is healed and your recovery from other surgery is complete. Ask your doctor or nurse about resuming your normal activities.
  • Inspect the skin around your port daily. If this area becomes reddened, swollen, or tender to the touch, you should report this to your doctor or nurse.
  • The port and catheter do not affect your dietary habits. You may continue on the diet which you normally eat.

When You Should Notify Your Doctor

Call your doctor if you:

  • Experience unusual abdominal pain.
  • Have a fever of 100.5.F (38.3.C) or higher.
  • Develop redness, swelling, or tenderness around the port site.
  • Have severe nausea, vomiting, diarrhea, or constipation that lasts more than 24 hours.
  • Are unable to eat or drink for more than 24 hours.
  • Have any unexpected or unexplained problems.