Learning Objective #1: Understand the process of intraperitoneal chemotherapy and identify at least three side effects of IP chemotherapy

Learning Objective #2: Provide effective patient education on intraperitoneal chemotherapy and reduce the mortality rate in ovarian cancer patients receiving IP chemo

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Ovarian cancer is the fifth leading cause of tumor death in women. According to the Federation of Gynecology and Obstetrics (FIGO), 80% of all women are diagnosed in advanced stages (III-IV), and the long-term survival for women with advanced stage disease remains low. The main line of treatment for ovarian cancer is cytoreductive surgery and tumor debulking. Interperitoneal chemotherapy (IP chemo) with platinum and taxane is one of the newest treatments for ovarian cancer patients with peritoneal metastasis. Peritoneal space has anatomic advantage as a site for ovarian cancer, because ovarian cancer tends to remain confined within the peritoneal cavity. IP chemotherapy has the advantages of maintaining high concentrations of drugs within peritoneal cavity with less systemic toxicity and improved cell kill than with IV administration of similar doses. Most drugs are 90% absorbed within 4 hours of administration. The peak ascitic fluid levels are 18-24 times higher than peak serum levels for IP carboplatin. Factors affecting IP chemotherapy include drug distribution, penetration, exposure and resistance. Patient eligibility for IP chemotherapy includes those with disease of <1cm confined to the abdominal cavity, patients with ascites but no dense adhesions, and those with prior whole abdominal radiation. Major adverse effects are pain, dyspnea, peritonitis, extravasation, or bowel perforation. During IP chemotherapy administration, the chemotherapy will be diluted in 1000cc of NS, and a total of 2000cc of fluid will be infused into peritoneal cavity through a peritoneal catheter. Patients will be asked to change position at 15-min intervals for 2 hours to ensure adequate intra-abdominal distribution. Pertinent nursing documentation include patients' understanding of treatment, use of sterile techniques, amount of fluid infused, and dose of drug administered. Patient education includes discussion of the rationale and adverse effects for IP chemotherapy, and overview of IP procedure.