Receiving a diagnosis of metastatic abdominal cancer can be devastating and can also require patients and families to make challenging decisions about treatment options amid the confusion of the diagnosis.
Patients do have options and can benefit from HIPEC surgery, a specialized treatment that incorporates the use of surgery and the application of heated chemotherapy to the abdominal cavity.
Although daunting, patients and families can thrive and conquer this type of treatment with the right information. In this blog, we'll talk about understanding of HIPEC, the HIPEC Procedure, and treatment expectations pre and post HIPEC.
What is HIPEC?
One term people often hear when dealing with cancer is HIPEC and they may not understand what it means.
HIPEC Medical Definition
HIPEC means Hyperthermic Intraperitoneal Chemotherapy.
Going word by word:
The first word, hyperthermic, means 'high heat.'
The second part of the word, intraperitoneal, describes the abdominal cavity.
The last word, chemotherapy, is the course of cancer-treating drugs.
So HIPEC treatment is the course of high-heat cancer-treating drugs in the abdominal cavity that is given post-cancer surgery.
What is HIPEC Surgery?
If you want to know what HIPEC surgery entails, it is a form of targeted cancer treatment for particular cancer types that metastasize inside the peritoneal cavity.
In the process, all detectable cancerous growths are excised. Following that, a heated solution of chemotherapeutic agent is perfused into the peritoneal cavity to kill any residual cancerous cells that are too small to be seen. Since the chemotherapy is localized to the site, it can kill cancerous cells that are adjacent to the chemotherapy solution while keeping chemotherapy exposure to the rest of the body at a minimum.
Why is HIPEC Surgery Performed?
HIPEC surgery aims to address the spread of cancer on the peritoneum.
After the removal of larger tumors, small cancer cells may still be present in the body that were too small to be seen. These cells may later grow to be larger and cause the spread of cancer to the body again.
To treat the small cancerous cells, the HIPEC process targets the peritoneum directly with heated chemotherapy to remove the cancerous cells that may be present and remain.
Which Cancers Can Be Treated with HIPEC?
HIPEC is not a universal treatment for all cancers. It is only suggested to treat some abdominal cavity cancers.
The following is a list of cancers where HIPEC treatment could be an option:
Appendix Cancer
Some types of appendix cancers can spread to the abdominal cavity. These cases can benefit from HIPEC.
Colorectal Cancer
In some cases, HIPEC can be used to treat peritoneum spreading colorectal cancer.
Ovarian Cancer
HIPEC can be a part of the treatment of advanced ovarian cancer for some women.
Peritoneal Mesothelioma
HIPEC treatment shows the most promise for this rare cancer of the abdominal lining.
Stomach Cancer
HIPEC treatment can be an option for some cancers of the abdomen.
HIPEC is only appropriate for some types of cancer based on how aggressive the cancer is and how healthy the patient is overall.
How Does the HIPEC Procedure Work?
The HIPEC procedure is conducted in three steps.
Step 1: Cytoreductive Surgery
This step involves the removal of all remaining tumors in the abdominal cavity.
Surgical staff will remove all visible cancerous tissue to achieve a maximal reduction.
Step 2: Hyperthermic Chemotherapy
Now, a heated chemotherapy solution is circulated throughout the abdominal cavity.
The solution is maintained at a higher temperature to help chemotherapy permeate the tissues and potentially improve the cytotoxicity to the neoplastic cells.
The chemotherapy solution can reach marginally resectable areas.
Step 3: Surgery Completion
Once the chemotherapy is done, the abdominal cavity is washed, and the remainder of the surgery is completed.
Patients are then monitored in the recovery unit.
What Are the Benefits of HIPEC Surgery?
One reason HIPEC is popular is that it can provide localized treatment.
HIPEC surgery has several potential benefits:
- Chemotherapy can be delivered directly to the tumor
- The chemotherapy is delivered in a relatively larger concentration
- The rest of the body is exposed less to chemotherapy when it is administered via HIPEC
- HIPEC can treat cancer cells that are too small to be detected
- HIPEC may have a positive impact on the prognosis of select patients
Results are unique to each individual so it is possible that a patient may be of the same condition and have completely different responses to HIPEC.
What Are the Risks and Side Effects of HIPEC?
HIPEC has all the common risks of any major surgical procedure.
Potential complications:
- Infection
- Excessive bleeding
- Blood clots
- Intestinal issues
- Transient tiredness
- Nausea and vomiting
- Slow healing
The surgical procedure's complexity, the patient's overall health and condition, and the cancer's severity and stage all determine the risk level.
Medical experts assess the risks and benefits of the patient before prescribing HIPEC.
Recovery After HIPEC Surgery
HIPEC surgery involves a longer recovery period compared to standard surgical procedures.
Hospital Stay
Most patients need to stay in the hospital for post-operative monitoring, pain management, and recovery assistance.
Returning to Daily Activities
It may take several weeks and, in some cases, months to recover fully, given the health condition and the complexity of the surgery. Activity levels should be increased gradually and in accordance with what the doctor recommends.
Follow-Up Care
HIPEC treatment requires several post-operative visits. These visits provide in-person assessments and other imaging and laboratory evaluations to assess recovery and to check for any tumor recurrences.
Who is a Good Candidate for HIPEC?
HIPEC is not suitable for all patients with abdominal cancer.
When determining the appropriateness of HIPEC, doctors commonly account for the following, among other factors:
- Cancer type
- Stage of the disease
- Patient's overall health and fitness
- The patient's ability to undergo major surgery
- Anticipated treatment outcome
HIPEC can only be considered after an extensive work-up by a qualified cancer specialist.
Conclusion
HIPEC targets certain cancers in the abdominal cavity that have metastasized. HIPEC uses a unique combination of surgery and heated chemotherapy.
HIPEC is tailored to carefully selected patients. It removes the visible tumors in the abdominal cavity and targets cancerous cells that are left over after the tumor has been removed. Not all patients are suitable for HIPEC and other options should be evaluated.
Dr. Pooja Babbar, one of the best oncologists in Gurgaon is an abdominal cancer expert and will provide all the care requirements you need. If you are interested in HIPEC treatment for yourself or a loved one, schedule a consultation with Dr. Babbar.
