HIPEC and PIPAC: What’s the Difference?
Oct 01, 2026
Read Time: 3 Minutes
Takeaways: HIPEC and PIPAC are both innovative ways to treat cancers that have spread to the abdomen. While both deliver chemotherapy directly to the abdominal cavity, they are used in different situations depending on whether the cancer can be surgically removed. Impact: Huntsman Cancer Institute is the only hospital in the Mountain West to offer these cutting-edge treatments, expanding access to new options and delivering hope for people with advanced cancer.
Cancer that has spread to the abdomen can be especially challenging to treat. However, innovative treatments are now helping doctors deliver chemotherapy in new ways that can offer more effective options for people with advanced cancer. Traditional chemotherapy is delivered through the bloodstream to reach cancer cells. The abdominal lining, or peritoneum, has less blood flow than other areas of the body, which can make it more difficult for chemotherapy to reach tumors there effectively. Newer treatment options like HIPEC and PIPAC both tackle this problem by delivering chemotherapy directly to the abdomen.
“These treatments allow us to deliver chemotherapy in ways we couldn’t before,” says T. Clark Gamblin, MD, MS, MBA, FACS, Huntsman Cancer Institute investigator and inaugural chief of the Division of Surgical Oncology at the University of Utah. “While each approach is different, both expand options for patients when standard treatments may not be enough.”
What is HIPEC?
Heated intraperitoneal chemotherapy (HIPEC) is a cutting-edge treatment that combines surgery and heated chemotherapy directly into the abdomen. During surgery, doctors remove as much visible cancer as possible—a process called cytoreduction—which may include removing affected organs. After surgery, while the patient is still in the operating room, heated chemotherapy is circulated throughout the abdomen to destroy cancer cells and tumors that are too small to see.
What is PIPAC?
Pressurized intraperitoneal aerosolized chemotherapy (PIPAC) is an innovative, minimally invasive way to deliver chemotherapy directly into the abdominal cavity. Using small, band aid-sized incisions, chemotherapy is aerosolized and gently pressurized so it can spread throughout the abdominal cavity. The pressurized mist helps chemotherapy spread evenly and reach deeper into cancer tissue, particularly in areas that can be hard to treat with standard chemotherapy.
“These treatments allow us to deliver chemotherapy in ways we couldn’t before. While each approach is different, both expand options for patients when standard treatments may not be enough.”
— T. Clark Gamblin, MD, MS, MBA, FACS
Choosing Between HIPEC and PIPAC
HIPEC and PIPAC both treat advanced cancers that have spread to the abdomen, but they are used in different situations. HIPEC is typically considered when cancer can be surgically removed, while PIPAC may be an option for patients whose cancer cannot be safely treated with major surgery. “At Huntsman Cancer Institute, we carefully select patients for these procedures,” says Gamblin. “Our focus is matching patients with the treatment most appropriate for their cancer.” Here are the key differences between the two procedures:
HIPEC
PIPAC
Surgical Approach
Open abdominal surgery
Minimally invasive (laparoscopic)
Chemotherapy
Method
Heated liquid chemotherapy
Pressurized aerosol chemotherapy
Procedure Time
Over 6 hours
Less than 2 hours
Recovery
Prolonged hospital stay
(5 - 7 days)
Overnight monitoring or outpatient
Patient Selection
For selected patients whose cancer can be surgically removed
For patients who are not candidates for major surgery
Leading the Way in Innovative Treatments
Huntsman Cancer Institute is one of only a small number of hospitals in the country to offer both HIPEC and PIPAC, bringing advanced abdominal cancer treatments to patients across the Mountain West. “Compared to even just five years ago, we can offer more options to patients with advanced cancer,” explains Gamblin. As a regional leader in advanced cancer care, Huntsman Cancer Institute continually evaluates emerging therapies and invests in innovations to expand treatment possibilities for patients. “We are excited to partner with medical oncology to provide coordinated care for patients with peritoneal surface malignancies” Gamblin shares. “We feel a responsibility to keep pushing forward,” Gamblin says. “That means looking for what’s next and bringing new opportunities to patients who need better options than what was previously available.”
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