From the 2009 meeting of the Society of Gynecological Oncology an abstract showing that as few as 20% of patients make it all the way through a protocol of intraperitoneal chemotherapy for ovarian cancer. Two years ago we had a "back to the future" moment when it was revealed that intraperitoneal chemotherapy was superior to regular chemo in patients successfully treated surgically for ovarian cancer. The idea is that giving chemo directly to the abdominal cavity allows a higher concentration of medicine to reach the area at greatest risk for disease down the road which would lead to better outcomes. Surgeons implant catheters at the time of surgery for primary ovarian cancer that allow the medical oncologist to deliver chemo directly to the abdominal cavity. My experiences with this technique mirror the results reported now at the conference: patients go to the ICU patients get infections patients can't eat for weeks due to nausea. We are happy with the results now: no relapses yet. But still it's an uphill battle getting there. The larger problem is asking why patients with ovarian cancer tend to do so poorly compared with patients with other types of malignancy. The answer has been that they tend to have a higher stage at diagnosis than patients with other tumor types so the current approach of giving chemotherapy in the abdominal cavity ("intraperitoneal treatment" we call it) makes sense. http://www.medpagetoday.com/MeetingCoverage/SGO/12798