CRS/HIPEC is one of the most aggressive abdominal cancer therapies available, but also one of the best options for many patients! CRS/HIPEC is short for cytoreductive surgery and hyperthermic intraperitoneal chemotherapy. You can learn more about this treatment here.
Recovery for this treatment is significant and is not a straight line. You will have good days and hard days, and that’s normal. What matters is steady, gradual progress and a strong support system. This guide walks you through what to expect from the moment you wake up after surgery through your return home and long-term healing.
Trust the Process
CRS/HIPEC recovery can be long and challenging, but patients consistently regain strength, independence, and quality of life. Your care team, caregivers, and the Abdominal Cancers Alliance community are here to support you every step of the way.
If you're recovering now: Keep walking. Keep hydrating. Keep nourishing your body. Celebrate progress.
You’re healing!
What to Expect When You Wake Up After Surgery
When you first wake up, you may notice several tubes, lines, or devices attached to you. These are normal, proactive, and temporary. They were placed intentionally to keep you safe and support your body as it begins healing.
Common tubes and equipment may include:
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IV lines that provide fluids, medications, and nutrition before you can eat or drink enough.
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Nasogastric (NG) Tube (sometimes also referred to as a feeding tube) that provides bowel rest and is removed once bowel function returns, and may be used to provide nutrition and medication.
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PCA Pump or Epidural: Patient-Controlled Analgesia allows you to press a button for pain relief. An epidural may also help manage pain during the early recovery period.
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Surgical drains remove fluid from the surgical area to prevent infection and complications.
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Vital signs monitoring equipment tracks heart rate, blood pressure, oxygen, and breathing.
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Foley Catheter: Helps track urine output while your body stabilizes after surgery.
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Chest Tube: Used only when needed, often after large resections, to maintain proper lung expansion.
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Ostomy: Sometimes an ostomy is needed to protect you during the initial 2 months of recovery after surgery. Your care team will help you understand, manage, and adjust to the ostomy during your hospital recovery. You will also be set up with home visiting nurses to help with ostomy care during the first few weeks of recovery at home following discharge.
These supports are not signs that something went wrong. They are carefully planned parts of CRS/HIPEC recovery and come out gradually as this support is no longer needed.
Will I Be in Pain?
Pain is expected after a surgery of this scale, but it is manageable.
Your care team uses multimodal pain management, which may include:
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Nerve blocks
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Epidural anesthesia
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Non-opioid medications (acetaminophen, anti-inflammatories, neuropathic pain meds)
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Limited, intentional opioid use
This approach controls pain while reducing sedation, nausea, constipation, and prolonged hospital stays. Most patients notice steady improvement day by day.
When Can I Eat Again?
Early return to nutrition is a key part of recovery. A typical path looks like the following:
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Clear liquids as bowel function begins returning
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Full liquids
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Soft foods
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Regular diet, as tolerated
Your care team will guide you. It’s common for appetite to be low - even for weeks - so small, frequent meals and hydration are essential.
If needed, temporary nutrition support (like a feeding tube or TPN) may be used until you can consistently take in enough calories.
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How Long Until I Can Go Home?
You are ready for discharge once you meet most of the following:
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You can move around safely: Walking independently or with a walker is important for both safety and preventing complications.
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You’re eating and drinking enough: You don’t need to be eating a full diet, just enough to sustain healing at home.
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Bowel and bladder function have returned: Passing gas and having bowel movements show that your digestive system is recovering.
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Symptoms are controlled with oral medications: Pain, nausea, and bowel function must be manageable without IV support.
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Drains are often removed based on output. Depending on the level of output, patients may be discharged with a drain still in place - this is very normal! Drains are then removed at a later postoperative outpatient visit.
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For some patients, a discharge to a rehab facility may be required depending on the level of fitness prior to surgery.
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No signs of infection: Incisions should look healthy, and your vital signs should be stable.
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You and your support system feel comfortable: Going home is the beginning of the longer healing phase.
Enhanced Recovery After Surgery (ERAS)
CRS/HIPEC centers typically follow ERAS guidelines to improve outcomes and support smoother recovery.
Key ERAS components:
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Early ambulation - getting out of bed on postoperative day 1
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Early oral nutrition - even small sips improve healing
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Minimizing IV fluids - to prevent swelling and bowel dysfunction
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Removing drains and tubes early and intentionally
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Multimodal pain control - minimizing opioids when possible
Benefits of ERAS for CRS/HIPEC patients:
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Faster return of bowel function
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Shorter hospital stays
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Fewer complications
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Improved quality of life during recovery
What Happens After I Leave the Hospital?
Recovery is a Process, Not a Moment!
Healing from CRS/HIPEC will take several weeks and even months. Most patients regain independence gradually and measure progress in ways that matter to daily life, such as:
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Walking farther and more comfortably
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Spending meaningful time with family
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Participating in meals, activities, and hobbies
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Increasing stamina for self-care
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Returning to work or light responsibilities
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Needing fewer naps or rest periods
It is a common feeling that you may feel more comfortable in the hospital because doctors and nurses are readily available at a moment's notice to support you and offer care. It is common to feel anxiety when you go home because now you and your support team at home are doing many of the things the nurses helped you with. It's ok to have those feelings and feel free to reach out for help. Progress is often two steps forward, one step back, and that’s okay!
Most hospitals have a "global period" that provides care (such as visits and/or addressing specific needs/conditions resulting from surgery) for when things come up after the patient has been discharged from the hospital, often for up to 90 days after major surgery. Patients and caregivers are encouraged to reach out to their hospital or nurse.
The Alliance’s Patient and Caregiver Network is also always here for support, to ask questions, or check in, when you are recovering at home.
If You Feel Something, Say Something!
Managing Blood Clot Risks
Early walking and movement are essential to reduce the risk of blood clots and support healing. Your team will guide you even when movement feels difficult. You may also be prescribed medications to help prevent blood clots. Injectable medicine like Lovenox (and its generic name, enoxaparin sodium) are easy to administer at home by the patient or a caregiver.
The Most Important Patient-Led Recovery Activities
Walking / Light activity is essential for:
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Preventing blood clots
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Restarting bowel function
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Building stamina
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Improving appetite and sleep
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Gradually increase distance daily
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Follow lifting and movement restrictions such as no bending, lifting, or twisting
Managing Symptoms Early - Common symptoms during CRS/HIPEC recovery:
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Fatigue
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Appetite loss
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Digestive changes
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Mild nausea
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Sleep disruption
These usually improve over time. Contact your care team if symptoms suddenly worsen.
Emotional & Mental Health - The emotional side of CRS/HIPEC recovery is as important as the physical side. Many patients experience:
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Anxiety or fear
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Frustration with slow progress
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Changes in mood
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Postoperative “brain fog”
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Grief related to temporary loss of independence
It’s important to:
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Accept help from family or caregivers
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Seek support from mental health professionals when needed
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Connect with survivor communities
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Celebrate small victories
Diet and Nutrition After You Leave the Hospital
Staying hydrated prevents fatigue, nausea, constipation, and dizziness - all common postoperative challenges. Aim for small sips throughout the day.
Eating Small, Frequent Meals: Appetite may be low, so nutrient-dense small meals help you get enough calories. Tips include:
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Eating every 2–3 hours
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Choosing soft, easy-to-digest foods
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Incorporating protein for healing
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Working with a Registered Dietitian when possible
Many care teams recommend aiming for about 60 grams of protein per day during recovery, often through small, frequent meals and protein-rich snacks.
Specific Postoperative Situations
Bowel Obstruction
After extensive abdominal surgery, temporary bowel sluggishness is normal. Signs of obstruction require prompt medical attention, but many do not require surgical intervention and resolve with conservative management.
TPN (Total Parenteral Nutrition)
If your body needs extra nutritional support, TPN may be used for a short period. It is safe, controlled, and monitored closely.
Chest Tubes
These may be placed during surgery and typically come out within a few days. Their removal usually provides immediate comfort.
Surgically Induced Menopause & HRT
Women who have ovaries removed may enter sudden menopause. Symptoms can include:
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Hot flashes
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Mood changes
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Sleep issues
Hormone Replacement Therapy (HRT) or non-hormonal strategies can help manage these changes. Discuss options with your oncology and gynecology teams.
Your Support System Matters
Full recovery from CRS/HIPEC is not something you do alone. Patients will need help with:
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Rides to appointments
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Meal preparation
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Hydration reminders
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Medication organization
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Household tasks
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Emotional support
Many caregivers find it helpful to track symptoms, meals, hydration, and walking progress.
When to Call Your Care Team
Caregivers should call the care team if the patient has:
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Prolonged elevated temperature (up to 100.4 degrees F), or any sign of a fever (100.4 degrees F and above)
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Worsening pain or swelling
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Signs of dehydration (dark urine, dizziness)
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New or concerning bowel changes (diarrhea, constipation, changes in stool color or consistency)
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