Pressurized intraperitoneal aerosolized chemotherapy is a way to deliver chemotherapy to the abdominal lining. PIPAC is different from traditional chemo because it uses pressure and turns the medicine into a mist. This may help the medicine better reach cancer cells.
Written by Karen Selby, RN | Edited by Walter Pacheco | Last Update: February 9, 2026
"Most helpful, steered us in the right direction for treatmen...." see more
Elaine C. - Mesothelioma Patient
"Because of their guidance, I was able to navigate getting my...." see more
Deanna B. - Daughter of a Mesothelioma Patient
"Hearing the news about my mother's diagnosis was heartbreaki...." see more
Danielle W. - Daughter of a Mesothelioma Patient
"My son Carlos was diagnosed with this terrible and unknown d...." see more
Martha M. - Mother of a Mesothelioma Patient
"Extremely communicative and helped my dad get an appointment...." see more
Sunni H. - Loved One of a Mesothelioma Patient
"Danielle DiPietro was an invaluable resource for me. Her sug...." see more
Deborah C. - Spouse of a Mesothelioma Patient
"I was very grateful and appreciative of Dr. Smart from The M...." see more
Kimberlin C. - Spouse of a Mesothelioma Patient
"In January of 2016, my husband was diagnosed with peritoneal...." see more
Gloria R. - Spouse of a Mesothelioma Patient
PIPAC is a mesothelioma treatment that delivers chemo directly to the abdomen using a pressurized aerosol. This means the chemo drug is turned into a fine mist.
Key Facts About PIPAC
PIPAC, which stands for pressurized intraperitoneal aerosolized chemotherapy, is a newer treatment for mesothelioma. Researchers are currently studying the new treatment to see how well it works. Doctors are hopeful PIPAC can help people with peritoneal mesothelioma. This type of mesothelioma affects the lining of the abdomen.
PIPAC for mesothelioma uses a special delivery method to treat the cancer. First, the chemo is placed directly into the abdomen. Second, a pressurized aerosol mist helps the mesothelioma chemotherapy reach more of the cancer cells.
The PIPAC procedure delivers the chemo mist throughout the abdominal cavity. This intraperitoneal chemotherapy allows the medicine to reach more of the affected areas. It may be more effective than traditional chemo for peritoneal mesothelioma.
Preparing for PIPAC is like preparing for mesothelioma surgery. You’ll undergo tests and talk to your doctors, who will tell you how to prepare. During the procedure, you’ll be asleep under anesthesia. The doctors will make small incisions in your abdomen to insert the tools needed for PIPAC.
Steps of a PIPAC Procedure
The delivery of chemo takes about 30 minutes. With prep, the procedure itself and post-procedure monitoring, the whole process takes about 60 to 90 minutes.
You’ll likely stay in the hospital for a few days after PIPAC. Recovery will depend on your overall health and how your body responds to the mesothelioma treatment. Your doctor will give you specific instructions for recovery.
Get answers about treatment, top doctors, and clinical trials from the nation’s most trusted mesothelioma resource.
Get Your Free GuidePIPAC surgery offers several potential benefits for people with peritoneal mesothelioma. It’s a targeted approach that delivers chemo directly to the abdominal lining. This can potentially reduce side effects compared to traditional chemo.
Chemo is usually given through the bloodstream via an IV, which can cause whole-body or systemic side effects. Applying chemo directly allows higher doses to reach cancer cells and limits side effects in the rest of the body.
PIPAC’s Benefits for People With Mesothelioma
These benefits may significantly improve the lives of people with mesothelioma. The success of PIPAC for mesothelioma patients is promising, offering hope for improved outcomes.
Side effects of PIPAC may include pain and fatigue. While PIPAC is designed to target mesothelioma cells, it can still affect healthy tissues.
Pressurized Intraperitoneal Aerosolized Chemo Side Effects
Rare but serious side effects, such as infection, can also occur. It’s important to discuss all potential side effects with your doctor. Early detection of side effects ensures your doctor can take steps to minimize or treat them.
Your doctor will work with you to create a plan to manage any PIPEC side effects that arise. Managing side effects is an important part of PIPAC treatment.
Tips for Managing PIPAC Side Effects
Patients should report any side effects to their doctor promptly. Early intervention can help manage side effects more effectively.
Mesothelioma patients who are eligible for PIPAC are in relatively good overall health. PIPAC is a major procedure, and your peritoneal mesothelioma doctor will determine if you’re a good candidate.
PIPAC is still under investigation in clinical trials in the U.S. Each trial has its own rules about who can participate. These rules are called eligibility requirements. In general, you must be physically able to undergo the procedure and tolerate the chemo.
PIPAC is available through mesothelioma clinical trials. Your cancer center or a Patient Advocate can tell you about available trials in your area or nearby states. Your doctor can refer you to a mesothelioma specialist who can evaluate you for a clinical trial.
This procedure isn’t widely available at peritoneal mesothelioma treatment centers yet. These trials test how well PIPAC works and who it helps the most.
Connect with top-rated doctors specializing in mesothelioma treatment, who will personalize treatment options based on your diagnosis.
Find Your DoctorPIPAC and HIPEC deliver chemo to the abdomen in slightly different ways. HIPEC uses a liquid, while PIPAC uses an aerosol mist.
Both PIPAC and HIPEC have potential benefits and drawbacks. HIPEC for mesothelioma is a more established treatment. PIPAC is newer and is still under investigation.
| Key Differences | PIPAC | HIPEC |
|---|---|---|
| Temperature | Room Temperature | Heated |
| Delivery Method | Aerosol (mist) | Liquid |
| Timing | Can be repeated multiple times | Typically done once during surgery |
| Number of Treatments | Multiple treatments may be possible | Sometimes doctors repeat the procedure |
The cost of PIPAC varies. Cost depends on many factors, including where you receive treatment and your insurance coverage. Certain clinical trials may cover this new treatment. Talk to your doctor and insurance provider for more information.
No, PIPAC isn’t a cure for mesothelioma. It’s a treatment that may help control this cancer and improve symptoms.
The number of PIPAC sessions needed varies. Your doctor will determine the best treatment plan for you.
Insurance coverage for PIPAC isn’t guaranteed. Check with your insurance provider to see if it’s covered. A clinical trial may cover the cost of PIPAC.
Yes, PIPAC may be combined with other treatments, such as surgery or traditional chemotherapy. It may also be combined with NIPEC for mesothelioma, which is another type of intraperitoneal chemo. Your doctor will decide what is best for your situation.
Stay up-to-date on treatment, research, clinical trials, doctors and survivors
The information on this website is proprietary and protected. It is not a substitute for professional medical advice, diagnosis or treatment. Any unauthorized or illegal use, copying or dissemination will be prosecuted. Please read our privacy policy and terms of service for more information about our website.
This website and its content may be deemed attorney advertising. Prior results do not predict a similar outcome.
The Mesothelioma Center’s claim as the most trusted resource is based on our more than 150 5-star Google and BBB reviews. Our organization also helps more than half of all mesothelioma patients annually diagnosed.
Your web browser is no longer supported by Microsoft. Update your browser for more security, speed and compatibility.
If you are looking for mesothelioma support, please contact our Patient Advocates at (855) 404-4592
The Mesothelioma Center at Asbestos.com has provided patients and their loved ones the most updated and reliable information on mesothelioma and asbestos exposure since 2006.
Our team of Patient Advocates includes a medical doctor, a registered nurse, health services administrators, veterans, VA-accredited Claims Agents, an oncology patient navigator and hospice care expert. Their combined expertise means we help any mesothelioma patient or loved one through every step of their cancer journey.
More than 30 contributors, including mesothelioma doctors, survivors, health care professionals and other experts, have peer-reviewed our website and written unique research-driven articles to ensure you get the highest-quality medical and health information.
My family has only the highest compliment for the assistance and support that we received from The Mesothelioma Center. This is a staff of compassionate and knowledgeable individuals who respect what your family is experiencing and who go the extra mile to make an unfortunate diagnosis less stressful. Information and assistance were provided by The Mesothelioma Center at no cost to our family.LashawnMesothelioma patient’s daughter
Selby, K. (2026, February 9). PIPAC for Mesothelioma. Asbestos.com. Retrieved February 27, 2026, from https://www.asbestos.com/treatment/chemotherapy/pipac/
Selby, Karen. "PIPAC for Mesothelioma." Asbestos.com, 9 Feb 2026, https://www.asbestos.com/treatment/chemotherapy/pipac/.
Selby, Karen. "PIPAC for Mesothelioma." Asbestos.com. Last modified February 9, 2026. https://www.asbestos.com/treatment/chemotherapy/pipac/.
Karen Selby is a registered nurse and Board Certified Patient Advocate at The Mesothelioma Center with more than 30 years of experience in oncology and thoracic surgery. She worked as an operating room nurse in thoracic surgery at the University of Maryland for 6 years, assisting with surgeries such as lung transplants, pneumonectomies and pleurectomies. She later served as regional director of the tissue procurement program at the University of Florida. Karen joined The Mesothelioma Center in 2009, providing patients with personalized support and resources.
Our fact-checking process begins with a thorough review of all sources to ensure they are high quality. Then we cross-check the facts with original medical or scientific reports published by those sources, or we validate the facts with reputable news organizations, medical and scientific experts and other health experts. Each page includes all sources for full transparency.
Please read our editorial guidelines to learn more about our content creation and review process.
