All you need to know about
HIPEC

Hyperthermic intraperitoneal chemotherapy (HIPEC) is aprocedure where a chemotherapy solution is heated and delivered directly to the abdominal cavity during surgery.

The term “Intraperitoneal” means that the treatment is delivered to the abdominal cavity. The term “Hyperthermic Chemotherapy” means that the solution containing chemotherapy is heated to a temperature greater than normal body temperature.
While conventional chemotherapy circulates throughout the body in the bloodstream, HIPEC delivers chemotherapy directly to the cancer cells within the peritoneum (the lining of the abdomen). This increases efficacy of the treatment because the cells are subjected to higher doses of chemotherapy and the heated solution also improves the absorption of the drug by the tumor cells and destroys microscopic cancer cells that remain in the abdomen after surgery.Read More...

Before patients receive HIPEC treatment, the surgeon reduces or debulks the size of a tumor within the abdomen.

This is known as Cyto Reductive Surgery [CRS]. When the maximum number of tumours have been removed, a heated, sterilized chemotherapy solution is delivered to the abdomen to penetrate and destroy any remaining cancer cells. The solution is heated to the temperature of a warm bath approximately up to 41-42 degree Celsius [between 105 and 109 F]. It is then circulated throughout the abdomen for approximately 90 minutes. The solution is then drained from the abdomen, and the incision is closed. Read More...

This is a treatment option for people who have advanced spread of cancer within the abdomen, but no cancer outside the abdomen.

The entire procedure on the whole is a major surgical undertaking and the surgery takes place over a time frame of 8 to 10 hours.

Advantages

• Ensures delivery of higher doses of chemotherapy to the cancer cells
• Enhances and concentrates chemotherapy within the abdomen
• Reduces exposure of the rest of the body to chemotherapy
• Improved drug absorption by cancer cells
• Reduces some side effects of conventional chemotherapy
• Improves the survival for cancers which have spread to the lining of the belly.

Possible Side Effects of HIPEC Surgery

• CRS and HIPEC is a major operation and has sequelae associated with major surgery including possible need for ICU care, nutritional support, abnormalities in liver and kidney function and risk of bleeding and wound related issues
• Specific effects include alteration of blood parameters such as magnesium and other electrolyte levels
• Reduced production of platelets and white blood cells by the Bone marrow - Myelosuppression might also occur rarely.

Eligibility for HIPEC

• A good general condition without severe chronic illness
• Not have blocked intestines [bowel obstruction]
• Have a low peritoneal cancer index score (which estimates the amount of tumour inside the belly- the lower the index, the higher the likelihood that it can be completely removed and the higher the likelihood of cure]

Indications

HIPEC is indicated in Cancers such as:

• Ovarian Cancer
• Colon Cancer
• Pseudomyxoma peritonei
• Mesothelioma
• Appendiceal / Appendicular Cancer
• Gastric Cancer
• Primary Peritoneal Cancer

Pseudomyxoma peritonei

This is a peculiar disease where the abdomen is filled with jelly like material which is produced by a cancer of the appendix or ovary which has ruptured.

The belly swells up and there is extreme discomfort and difficulty in eating and digesting food and disturbances in emptying the bowel as well. The treatment of choice is surgery to remove the origin of the disease as well as all affected organs, which might include parts of the large or small intestine, stomach and uterus and ovaries. This is followed by HIPEC. This is one of the cancers where HIPEC has a very high rate of success. Read More...

Be sure to ask your Doctor about:

• Duration of Surgery and what the surgery involves
• Length of Hospital stay – In the ICU and then in the ward
• Possible sequelae and complications
• Chemotherapy after HIPEC
• Follow up after completion of treatment.

Also, in case of extensive spread of the disease detected before or during surgery, ask the doctor about the option of PIPAC (Pressurized Intra Peritoneal Aerosol Chemotherapy).

We perform HIPEC frequently for patients from all over India, the Middle east, Kenya, Tanzania, Uganda, Bangladesh and Myanmar. Our outcomes are excellent and in line with accepted world standards.