Every patient battling cancer in the abdomen should ask their doctor about HIPEC, or hyperthermic intraperitoneal chemotherapy, an advanced procedure that combines cancer surgery and chemotherapy. Its results are more powerful than either option alone.
Despite the new chemotherapy options available and the improvements in treatments experienced by patients, the overall chance of chemotherapy being curative is still low, and side effects are difficult for the patient to endure. However, HIPEC can help cancer patients whom tumors are confined to the peritoneal cavity.
“Intraperitoneal” is the term used to describe the placement of treatment within an abdominal cavity, while “Hyperthermic Chemotherapy” means that the solution containing chemotherapy is heated to a temperature greater than normal body temperature.
Before HIPEC is administered, the surgeon’s work will involve removing visible tumors throughout the peritoneal cavity. This is known as cytoreductive surgery. Following this process, the surgeon will administer the HIPEC treatment.
The procedure is divided into three stages:
- Exploration: Here the surgeon will open the abdomen evaluate the peritoneal cancer.
- Debulking: In the debulking, or cytoreduction, phase of the procedure the surgeon will remove the visible tumor implants. However, even when all of the visible tumor is removed it is possible for microscopic cancer cells to still remain. The final stage of the procedure is meant to eliminate those cells.
- Chemoperfusion: Here the abdominal cavity is rinsed with a heated chemotherapy solution. Unlike systemic chemotherapy that is delivered in the blood stream, throughout the whole body, the chemotherapy in the HIPEC procedure is largely isolated in the peritoneal cavity. Therefore, a much higher concentration of chemotherapy can be utilized, while the toxicity and side-effects associated with systemic chemotherapy are minimized.
Which cancers can be treated with HIPEC?
- Certain types of ovarian cancer.
- Certain sarcomas, which affect muscles, tendons, nerves, blood vessels and other connective tissues.
- Gastric (stomach) cancer.
- Mesothelioma, which forms in the thin abdominal tissue called the mesothelium.
- Peritoneal carcinomatosis, which affects the abdominal cavity lining called the peritoneum.
Benefits of HIPEC
- HIPEC allows for a higher concentration of chemotherapy to be delivered into the abdomen more effectively and safer than standard chemotherapy, which is delivered intravenously.
- This type of chemotherapy is best at killing cancer cells that are too small to be seen with the naked eye.
- Chemotherapy delivered through HIPEC causes fewer side effects than intravenous chemotherapy. This is because the high concentrations of chemotherapy solution are unable to cross what is known as the peritoneal plasma barrier.
- Experts say that pairing surgery and HIPEC together may be more beneficial than chemotherapy alone.
Risks and side effects of HIPEC
A benefit of HIPEC therapy is that it focuses high-dose chemotherapy directly to areas affected by the cancer itself. Unlike conventional chemotherapy, HIPEC minimizes medication exposure to the rest of the body. This means the common side effects of chemotherapy – like hair loss, nausea, diarrhea, and changes to the skin or nails are generally avoided.