Hyperthermic intraperitoneal chemotherapy

Hyperthermic Intraperitoneal Chemotherapy (HIPEC) is a highly specialized treatment for cancer that has spread to the lining of the abdominal cavity, known as the peritoneum. This procedure combines surgery with heated chemotherapy. Unlike traditional chemotherapy that circulates throughout the body, HIPEC delivers heated chemotherapy directly into the abdominal cavity, targeting cancer cells with minimal exposure to the rest of the body. This article provides an overview of the procedure, its indications, benefits, and risks.

Procedure

The HIPEC procedure is performed in two main steps. First, the surgeon performs Cytoreductive Surgery (CRS) to remove visible tumors within the abdomen. This is a critical step to ensure that the chemotherapy can be as effective as possible. Following the surgical removal of tumors, the abdominal cavity is bathed with a heated chemotherapy solution. The heat increases the effectiveness of the chemotherapy by enhancing the absorption of the drugs by the cancer cells and making them more susceptible to the chemotherapy. The solution is typically circulated within the abdomen for 60 to 90 minutes.

Indications

HIPEC is primarily used to treat cancers that have spread to the peritoneal surface, such as:

• Colorectal Cancer
• Stomach Cancer
• Ovarian Cancer
• Certain types of Appendiceal Cancer
• Mesothelioma of the peritoneum
• Pseudomyxoma Peritonei

Benefits

The main benefit of HIPEC is its ability to directly target cancer cells in the abdomen with high doses of chemotherapy, while minimizing the systemic side effects typically associated with chemotherapy. This localized approach allows for higher concentrations of chemotherapy to be used, potentially improving the effectiveness of the treatment. Additionally, the heat used in HIPEC can help to kill cancer cells directly and make them more sensitive to chemotherapy.

Risks and Complications

As with any surgical procedure, HIPEC carries risks and potential complications. These may include:

• Infection
• Bleeding
• Complications from anesthesia
• Damage to abdominal organs
• Fatigue
• Nausea
• Chemotherapy-related side effects, although these are generally less severe than with systemic chemotherapy due to the localized nature of the treatment.

Recovery

Recovery from HIPEC can be extensive, often requiring a hospital stay of one to two weeks, followed by several weeks of recovery at home. The exact recovery time varies depending on the individual's overall health, the extent of the surgery, and how well they respond to the treatment.

Conclusion

HIPEC is a promising treatment option for patients with certain types of cancer that have spread to the peritoneum. By combining surgery with heated chemotherapy, HIPEC aims to improve survival rates and quality of life for these patients. However, it is important for patients to discuss the potential benefits and risks of this treatment with their healthcare provider to determine if HIPEC is the right option for them.

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