CRS/HIPEC is one of the most complex surgeries performed for abdominal cancers. CRS/HIPEC is short for cytoreductive surgery and hyperthermic intraperitoneal chemotherapy. You can learn more about this treatment here.
Preparing physically, emotionally, and logistically can make treatment smoother and can significantly support recovery. Preparing well can reduce stress, improve recovery, and help patients and caregivers feel more in control. CRS/HIPEC is a major step and a hopeful one.
And you don’t have to do this alone. The Abdominal Cancers Alliance community, survivors, and specialists are here to support you every step of the way. This guide walks patients and caregivers through practical steps to take in the weeks and days leading up to surgery.
Understanding the Procedure
First and foremost, it’s important to understand what CRS/HIPEC is and why it’s used. Cytoreductive Surgery (CRS) removes visible cancer from the abdomen. HIPEC delivers heated chemotherapy directly into the abdominal cavity to kill microscopic cancer cells. Together, these treatments can extend survival, reduce recurrence, and improve quality of life for many patients with peritoneal surface malignancies. Peritoneal surface malignancies, also termed peritoneal metastases or peritoneal carcinomatosis, represent a stage when cancers have spread within the abdominal cavity.
What to Expect Immediately After Surgery
CRS/HIPEC recovery looks different from other surgeries. Following surgery, most patients spend time in the ICU (intensive care unit), have temporary tubes and drains, and are encouraged to start walking even before they feel ready. These steps are normal and important parts of recovery.
It’s normal for caregiving to be intense during the first 2-to-4 weeks at home. Preparing in advance makes that period easier. Battling cancer is tough, but you don't have to do it alone.
Building your Caregiving Team
Recovering from cancer treatment requires support. And recovering from major surgery, such as CRS/HIPEC, is no exception. Asking for that support can be hard, but it is necessary. And know that most people want to be able to support you, and you can help them by asking for specific things. As you prepare and plan for treatment, it will help to identify:
​Your primary caregiver who will help with:
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Transportation to the hospital
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Keeping track of medication
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Hydration and meal reminders
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Household tasks (laundry, pet care, transporting children, yard work)
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Emotional support
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Communication with the care team
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Identifying backup helpers
​Consider recruiting friends or family for small tasks such as:
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Running errands
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Meal delivery
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Cleaning
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Staying with the patient for a few hours while the primary caregiver rests
Pre-Surgery Physical Preparation
Patients who build strength and optimize nutrition beforehand often have smoother hospital stays and recoveries.
Nutrition - Aim for balanced meals with adequate protein. If appetite is low, use nutrient-dense snacks and shakes. Work with a Registered Dietitian (RD) if possible.​
Dietary supplements - Ask your doctor about taking supplements before surgery that may help prepare your body, such as vitamins. And discuss all herbal or other dietary supplements that you take, as many (such as garlic, ginseng, turmeric, St. John’s wort supplements) should be stopped at least two weeks before surgery.
Hydration - Proper hydration before surgery helps prevent complications after surgery.
Activity - Light exercise, even gentle movement or activity, helps to improve circulation, reduce risk of blood clots, support lung health, and build stamina for recovery. Walking daily - even short distances - is beneficial.
Caffeine - Reducing caffeine intake prior to treatment will help prepare the body to go at least several days following surgery with no caffeine. Weaning the body off of caffeine intake can help manage caffeine withdrawal symptoms.
Alcohol - Avoid alcohol for at least two weeks before surgery unless your team gives different guidance.
Smoking - If you smoke, stop smoking (including vaping) as early as possible and at least two weeks before surgery to reduce complications.
Pre-Op Medical Requirements
It is important to make sure that you are well and strong enough to undergo treatment. Your care team may schedule several tests to help evaluate your health heading into surgery:
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Bloodwork
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Imaging
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Nutritional evaluation
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Cardiac clearance
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Anesthesia evaluation
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Instructions about current medications (e.g., blood thinners, diabetes meds)
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Follow instructions closely. Medication adjustments are common before major surgery.
Important Pre-Surgery Medication & Treatment Considerations
Some medications, supplements, and cancer treatments must be stopped weeks before CRS/HIPEC to reduce surgical risks. Always review everything you take with your care team, including supplements and over-the-counter products.
Getting Your Home Ready
Recovery from CRS/HIPEC takes a long time, and most of that time will be spent at home. Small preparations can go a long way to helping you feel ready to return home and reduce stress after being discharged from the hospital. Ultimately, that can help make your recovery more successful!
Choose a comfortable space on a main floor with:
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Pillows
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Blankets
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Easy access to the bathroom
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A place to keep medications, water, and snacks
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A chair that’s easy to get into and out of
Stock the Kitchen, gather foods that are:
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Gentle on the stomach
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High in protein
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Easy to prepare
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Available in small portions
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Examples may include: yogurt, eggs, soups, soft fruits, protein shakes, crackers, nut butters.
Prepare Mobility Supports, some patients benefit from:
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A walker
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Shower chair
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Raised toilet seat
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Get non-slip bath mats and remove throw rugs and trip hazards
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Install grab bars or handles in the bathroom as balance and/or strength may be limited
Packing for the Hospital
Must-Haves
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Insurance card and ID
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List of medications
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Phone & charger
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Glasses/hearing aids
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Advance directive (optional but recommended)
Comfort Items
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Lip balm (hospital air is dry)
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Slip-proof slippers
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Shower sandals
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Light robe
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Personal pillow (optional)
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Headphones or earplugs
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A good book (or two) for positive distraction
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A notebook for instructions or journaling
What Not to Bring
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Valuables
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Large electronics
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Heavy clothing
The hospital will provide basic toiletries.
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 Black Over-Ear Headphones |
 Purple Knit Beanie |
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Planning ahead by creating an advance directive or will is one of the most meaningful ways to ensure your wishes are understood and respected—no matter what the future holds. An advance directive allows you to outline your healthcare preferences and designate someone you trust to make medical decisions on your behalf if you’re unable to do so. A will helps clarify how you’d like your personal affairs handled. While these conversations and documents can feel overwhelming, taking this step can provide peace of mind for both you and your loved ones, helping reduce uncertainty during difficult moments.
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You don’t need to have everything figured out to get started. Begin by reflecting on what matters most to you, talking openly with your family and care team, and exploring trusted resources that guide you through the process. Many advance directive forms are free and available by state, and legal aid organizations may offer low-cost or pro bono assistance. By putting your wishes in writing, you’re taking an active role in your care and creating a valuable gift of clarity and comfort for the people who support you.
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Use this guide to take the first steps toward creating an advance directive or will:
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Reflect on what matters most to you, including your healthcare preferences and personal values.
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Choose a trusted person to serve as your healthcare proxy or medical decision-maker.
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Talk with your loved ones about your wishes so they understand your goals for care.
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Ask your healthcare team questions about treatment preferences, comfort care, and future planning.
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Complete an advance directive form for your state.
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Consider creating or updating your will with a legal professional if possible.
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Keep copies of your documents and share them with your proxy, family members, and care team.
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Review and update your plans as needed, especially after major life or health changes.
Helpful Resources
These trusted organizations can help guide you through advance care planning:
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Advance Directives (Free State Forms & Guidance)
• CaringInfo (National Hospice and Palliative Care Organization) – State-specific advance directive forms and
easy-to-follow instructions
https://www.caringinfo.org
• Prepare for Your Care – Step-by-step guidance, videos, and printable forms
https://prepareforyourcare.org
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Legal Support for Wills & Estate Planning
• Legal Aid / Legal Services Corporation – Find low-cost or free legal help in your area
https://www.lsc.gov
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• American Bar Association Free Legal Answers – Ask basic legal questions online
https://www.freelegalanswers.org
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Conversation Starters
• The Conversation Project – Tools to help you talk with loved ones about your wishes
https://theconversationproject.org
Emotional & Mental Preparation
CRS/HIPEC brings understandable stress - for both patients and loved ones. Common feelings before surgery may include: Anxiety, Worry about outcomes, Fear of pain or complications, Sadness or frustration, Concern for family members. These feelings are normal!
Consider some helpful strategies:
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Write down questions for your surgeon and nurses.
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Practice relaxation exercises or gentle breathing.
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Ask about speaking to a social worker or counselor.
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Connect with survivors or support groups as this is helpful for both patients and caregivers.
Remember: you are not alone. This surgery is performed safely every day in experienced centers!
Setting up an Advanced Directive or Will
Conversations to Have Before Surgery
With Your Surgical Team
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What should I expect during the first 24–48 hours after surgery?
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Will I have drains, an epidural, or a catheter?
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How will pain be managed?
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When will I start eating again?
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What is the plan for physical therapy?
With Your Family
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Who will stay with the patient in the hospital?
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Who will handle updates to extended family?
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What responsibilities need to be covered at home?
With Your Employer
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Discuss leave of absence
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Ask for documentation in advance, including preparing for Family Medical Leave as applicable
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Understand short-term disability options
Caregiver-Specific Preparation
As noted throughout this guide, caregivers play a crucial role in helping the patient through treatment. While you don’t need medical training, understanding a few basics ahead of time can reduce stress, improve safety, and help you feel more confident as a caregiver.
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Start with the basics:
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How to help with walking
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When to encourage hydration and meals
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Signs of dehydration
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When to call the care team
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How to track bowel movements and symptoms
Prepare for your own well-being, because caregiving is rewarding but demanding:
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Arrange time to rest
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Accept help from others
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Use checklists or apps to track medications
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Communicate openly about needs
A Practical Checklist: Preparing for CRS/HIPEC
2–4 Weeks Before Surgery
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Build strength with gentle activity
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Focus on nutrition and hydration
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Meet your surgical and anesthesia teams
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Finalize caregiving support
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Arrange time off work
1 Week Before Surgery
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Prepare your home recovery space
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Stock food and supplies
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Confirm logistics for the hospital
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Review medication instructions
1 Day Before Surgery
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Follow pre-op diet instructions
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Pack lightly
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Practice calming strategies
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Arrange transportation
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