Certain cancers can spread throughout the abdomen, but there is hope to prolong survival in some patients offered by Dr. Carrie Luu, a SLUCare Surgical Oncologist at SSM Health St. Louis University Hospital.
It's giving patients with certain advanced abdominal cancers (and a grim diagnosis), more hope for a solution to in their fight against the toughest of cancers.
First, Dr. Carrie Luu offers cytoreduction, "the goal of that is to remove all cancers, all visible cancers by resecting them, by removing them." Cytoreduction is an extensive debulking procedure in which all visible tumor is removed—within the abdomen. The inner lining of the abdomen is also stripped or removed. When all tumors have been removed, a heated, sterilized chemotherapy solution is delivered to the abdomen to penetrate and destroy remaining cancer cells. The solution is heated to 106-107 degrees Fahrenheit, about the temperature of a warm bath. It’s circulated throughout the abdomen for approximately 90 minutes. The solution is then drained from the abdomen, and the incision is closed.
Then, a method called HIPEC. HIPEC is a newer regional treatment approach that allows surgical oncologists to deliver high doses of chemotherapy directly to the tumor(s), while sparing the rest of the body to harmful levels of toxicity. It is like a chemotherapy bath.
Hyperthermic intraperitoneal chemotherapy (HIPEC) – is making a tremendous impact in treating complex cancers that have spread to the abdominal cavity such as colon, appendiceal, ovarian, etc. It’s a last resort for patients who may have been told that no other treatment will work.
“This treatment in helpful in some types of cancer. Not all. Appendix cancer spread inside the abdominal cavity. Colon Cancer inside the abdominal cavity. Another common one is Peritoneum mesothelioma.”
HIPEC is a highly concentrated, heated chemotherapy treatment delivered directly to the abdomen during surgery. Unlike systemic chemotherapy delivery, which circulates throughout the body via the bloodstream, HIPEC delivers chemotherapy directly to cancer cells in the abdomen. This allows for higher doses of chemotherapy treatment. Heating the solution may also improve the absorption of chemotherapy drugs by tumors and destroy microscopic cancer cells that remain in the abdomen after surgery.
Although this surgery is not for everyone, it may prolong survival or quality of life compared to systematic chemotherapy alone.
HIPEC 1) allows for high doses of chemotherapy; 2) enhances and concentrates chemotherapy within the abdomen; 3) reduces the rest of the body’s exposure to the chemotherapy; 4) improves chemotherapy absorption and susceptibility of cancer cells; 5) reduces some chemotherapy side effects.
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