Over the past two decades, surgical oncologists have begun using an innovative treatment approach in advanced abdominal cancers that combines cytoreductive surgery—removal of visible tumor—with the application of chemotherapy directly to the affected area of the body. Traditional chemotherapy medications are given as an infusion through a vein.
This intraoperative chemotherapy procedure—known as HIPEC (hyperthermic intraperitoneal chemotherapy)—is given at the end of cytoreductive surgery. Once the visible tumors are removed, a heated sterile chemotherapy solution is continuously circulated throughout the abdominal cavity to kill any residual cancer cells that cannot be detected by sight.
This “chemo bath” continues for 90 to 120 minutes. The solution is then removed before the incision is closed.
“Applying the chemotherapy directly to the abdominal cavity at the time of surgery allows us to deliver a higher concentration of the drug that is better absorbed by the part of the body in need of treatment,” says Daniel Abbott, MD, a surgical oncologist with the University of Cincinnati Cancer Institute Comprehensive Gastrointestinal Cancer Center and assistant professor at the UC College of Medicine. “It is also thought to reduce the negative side effects of chemotherapy treatment to other, unaffected parts of the body by delivering it directly to the targeted area.”
Scientific literature also suggests that adding heat to chemotherapy may improve the drug’s ability to kill cancer cells without causing additional harm to healthy cells, Abbott notes.
“For those patients with resectable (surgically removable) peritoneal disease , cytoreductive surgery with HIPEC can be an extremely effective first-line treatment,” says Abbott, noting that the UC Health-based gastrointestinal cancer team offers HIPEC for appendix, colon, ovarian, peritoneal mesothelioma and certain gastric cancers.
The team has performed more than 300 HIPEC procedures over the last 15 years. Their results were published in the internationally recognized medical journal, Surgery, in October 2012. “We know thatpatients with low-grade tumors and those who have a complete (or near complete) cytoreduction benefit the most from this therapy and can live for 10 or more years after HIPEC.”
The HIPEC Procedure
During the HIPEC procedure, chemotherapy is heated to above body temperature and then applied directly to the abdominal cavity. This is done after—but in conjunction with—surgery to remove visible tumors. The surgical oncologist delivers the heated chemotherapy to the target area. A perfusionist then uses a specialized pump to continuously circulate the solution throughout the abdominal cavity for up to two hours to help eradicate any residual cancer cells that still exist.
Appointments & More Information
For appointments with UC Health surgical oncology, call 513-584-8900. To learn more about the UC Cancer Institute Gastrointestinal Cancer Team, visit uccancer.com/GI.