Hyperthermic intraperitoneal chemotherapy (HIPEC)
What is HIPEC?
HIPEC stands for Hyperthermic intraperitoneal chemotherapy (HIPEC). It is a highly determined, heated chemotherapy treatment. HIPEC delivered to the abdomen in surgery. Unlike general chemotherapy delivery, which circulates throughout the body. HIPEC delivers chemotherapy to cancer cells in the abdomen. This allows for higher doses of chemotherapy treatment. Heating the solution may also progress the incorporation of chemotherapy drugs by tumors. It destroys microscopic cancer cells that stay in the abdomen after surgery.
How Does It Work?
Before patients get HIPEC treatment, doctors do cytoreductive surgery to remove detectable tumours within the abdomen. Cytoreductive surgery is accomplished using different surgical techniques. Once as numerous tumours as probably have been detached, the heated, sterilized chemotherapy solution is delivered to the abdomen to penetrate and destroy left cancer cells. The solution is 41 to 42 degrees Celsius, on the temperature of a warm bath. It’s distributed throughout the abdomen for about 1 ½ hour. The solution is after that drained from the abdomen and the incision is stopped. After the process, patients are mandatory to spend an average of 2 weeks in the hospital. Nurses monitor very important signs throughout the patient’s stay. Make sure that no post-surgical complications occur.
- Enhances and concentrates chemotherapy within the abdomen.
- Allows for high doses of chemotherapy.
- Minimizes the rest of the body’s exposure to the chemotherapy.
- Reduces chemotherapy side effects.
- Improves chemotherapy incorporation and susceptibility of cancer cells.
Almost all the abdominal cancers increase to peritoneal surface (a layer which covers abdominal structures). In spite of numerous latest advances in chemotherapy, once cancer gets spread to these structures, it is measured “not curable” for a long time. And the side effects of chemotherapy are complicated for the patient to bear. On the other hand, when these cancers are confined to the peritoneal cavity, Hyperthermic Intraperitoneal Chemotherapy (HIPEC) becomes a choice for candidate patients. Hyperthermia pump which perfusates chemotherapy mixed fluid into the abdominal cavity around 41-43 degree centigrade temperature over 60-90 minutes. Hyperthermia helps to kill the microscopically add to cancer cells after total removal of visible cancer from the abdomen. Before HIPEC is administered, the surgeon will remove all visible tumors that can be removed throughout the peritoneal cavity. This is known as Cytoreductive Surgery.
Following cytoreductive surgery, in the operative setting, the surgeon will manage HIPEC treatment.
CANCER IN WHICH HIPEC IS USEFUL
- Pseudomyxoma Peritonii.
- Recurrent ovarian cancer.
- Advanced ovarian cancers.
- Stomach cancer.
- Colorectal cancers with peritoneal spread.
The greatest advantage of HIPEC is seen in pseudomyxomaperitonei, colorectal cancer, and mesotheliomas. When treated with intravenous chemotherapy alone, these patients survive for a few months to a couple of years. Cytoreductive surgery and HIPEC has shown to prolong survival in these cancers. Its role in ovarian and stomach cancer is under examination but more and more centres are using it for treatment since the outcomes are promising.
After HIPEC is systemic (intravenous) chemotherapy required?
After HIPEC in low-grade appendicular cancers, pseudomyxomas, and low-grade mesotheliomas, further chemotherapy may not be needed. In all other cases, it is essential to give advance intravenous chemotherapy.
Dr. Amol Dumre is experienced surgical oncologist and also the best HIPEC Surgeon in Pune. He has more than decades of the journey as a Cancer Specialist in Pune. He has done a fellowship in different cancer surgeries. He treated cancer patients with great success. To Know more about Hipec and Cytoreductive surgery. Read Article.