Right now, cytoreductive surgery and HIPEC are the treatment of choice for appendix cancers.  Cytoreduction surgery is the removal of ALL visible tumors in the abdomen.  HIPEC is Heated IntraPeritoneal Chemotherapy.  HIPEC is heated chemotherapy solution that is placed directly into the abdomen, not the IV chemotherapy that is given through a post or a vein.

I don’t know if you’ve heard of the “blood-brain barrier”?   Your body protects your brain by not allowing harmful substances to be delivered by the blood into the brain or into the central nervous system.  It prevents germs in the blood from being delivered to the brain and also blocks toxic substances from being delivered from the blood to the brain.  This can be a problem, because sometimes you might want a toxic substance from the blood to get in the brain, for instance chemotherapy to be able to get to a brain tumor.  This can make brain cancer difficult to treat.

There is something similar in the abdomen, the plasma (blood) peritoneal (inside of the abdomen) barrier, the plasma-peritoneal barrier.  This barrier also prevents harmful or toxic things in the blood from getting into the abdomen.  This make chemotherapy that goes into your blood via a port or vein not very effective against tumors in the abdomen.  But just as not much of the chemotherapy from the blood  goes into your abdomen, chemotherapy placed directly in the abdomen works better than the IV chemotherapy. Your abdomen gets the full effect of the chemotherapy placed directly in the abdomen as it passes the barrier.   Also, the barrier works in reverse, so toxic things in your abdomen don’t go back into your bloodstream. This means you can use chemotherapy in a stronger concentration when it is placed into the abdomen, because not much will get back into the blood stream because of the barrier.   I had no side effects from the chemotherapy placed in my abdomen.

This is a good article to read about the plasma-peritoneal barrier and HIPEC:

Breaking Through the Barricade