Hyperthermic Intraperitoneal Chemotherapy (HIPEC)

Hyperthermic Intraperitoneal Chemotherapy (HIPEC) is a cutting-edge cancer treatment that holds promise for peritoneal mesothelioma patients.

HIPEC, short for Hyperthermic Intraperitoneal Chemotherapy, is a revolutionary cancer treatment that involves the delivery of heated chemotherapy drugs directly into the abdominal cavity. This procedure, often referred to as hyperthermic chemotherapy, is typically performed following cytoreductive surgery (CRS), a procedure aimed at removing tumors and lesions. While HIPEC has gained recognition as a standard of care for peritoneal mesothelioma, it is also employed in the treatment of ovarian cancer, colon cancer, gastric cancer, and appendiceal cancer.

How HIPEC Works

HIPEC’s primary objective is to eliminate any residual cancer cells that may remain after surgery. Peritoneal mesothelioma primarily affects the lining of the abdomen (peritoneum), making it challenging for traditional chemotherapy to effectively target tumors. HIPEC circumvents this challenge by delivering heated chemotherapy directly to the affected area, akin to a “chemo bath.” The heat aids in the absorption of chemotherapy drugs by cancerous tissue, while the direct contact ensures a focused attack on mesothelioma cells.

Benefits

Hyperthermic Intraperitoneal Chemotherapy offers a multitude of advantages, including:

• Precise Chemo Delivery: HIPEC enables the precise application of concentrated chemotherapy, maximizing its effectiveness.
• Extended Life Expectancy: When combined with surgery, HIPEC has been associated with improved life expectancies ranging from approximately 4 to 8 years for peritoneal mesothelioma patients.
• Prevention of Recurrence: HIPEC specifically targets any remaining cancer cells post-surgery, reducing the risk of recurrence.
• Fewer Side Effects: Compared to intravenous chemotherapy, HIPEC tends to result in fewer side effects due to localized drug delivery.
• Symptom Alleviation: HIPEC can alleviate mesothelioma-related symptoms, significantly enhancing the quality of life for patients.

HIPEC Surgery

HIPEC surgery is a two-step procedure designed to tackle peritoneal mesothelioma:

1. Tumor Removal (CRS): Surgeons aim to surgically remove visible tumors during cytoreductive surgery. However, microscopic cancer cells may persist.
2. Heated Chemo Application (HIPEC): Following tumor removal, heated chemotherapy drugs are introduced directly into the abdominal cavity. This combination of CRS and HIPEC aims to eliminate remaining cancer cells and prevent recurrence.

Heated Chemotherapy Wash

HIPEC is administered using a specialized perfusion machine that heats and circulates chemotherapy drugs into the abdominal cavity, a process typically lasting 1 to 2 hours. Unlike traditional intravenous chemotherapy, HIPEC delivers chemotherapy directly to the site of cancer, ensuring better cell kill rates while sparing healthy cells.

Temperature Control in HIPEC The effectiveness of HIPEC relies on precise temperature control:

• Cancer cells are eliminated at around 104°F, while healthy cells succumb at 111.2°F.
• The HIPEC chemo fluid is heated to a temperature ranging from 104°F to 109°F.
• This temperature range ensures cancer cell destruction while minimizing harm to healthy tissue.

Patient Recovery After CRS + HIPEC

Recovery times following CRS and HIPEC can vary among patients. Typically, patients spend 7 to 12 days in the hospital for monitoring after the procedure, with fatigue potentially lasting for 2 to 3 months post-procedure. Recovery experiences differ, so patients should consult their care team to gain a better understanding of what to expect.

Benefits of HIPEC in Mesothelioma

Research has shown that HIPEC can offer substantial benefits to mesothelioma patients, including extended life expectancies and improved quality of life. Studies indicate that peritoneal mesothelioma patients treated with HIPEC plus CRS may achieve life expectancies ranging from 4 to 8 years, with some patients surpassing these expectations. Additionally, HIPEC can provide symptomatic relief, enhancing the overall quality of life for individuals battling mesothelioma.

Extending Survival

HIPEC, when combined with CRS, has demonstrated remarkable success in extending survival rates for peritoneal mesothelioma patients, with some patients achieving:

• Median overall survival of 67 months.
• 1-year survival rate of 83%.
• 3-year survival rate of 62%.
• 5-year survival rate of 52%.

Potential Side Effects

While HIPEC can be highly effective, it also carries risks and potential side effects, including bleeding, blood clots, digestive issues, fatigue, and more. However, recent studies have indicated that the complication rate associated with CRS and HIPEC is relatively low compared to other surgical procedures. Patients should engage in open discussions with their mesothelioma specialists to gain insights into potential side effects specific to their circumstances.

Eligibility for HIPEC

Determining eligibility for HIPEC involves a thorough evaluation by medical professionals, taking into consideration a patient’s overall health and individual factors. Patients should consult with a specialist to understand their eligibility. If deemed ineligible for HIPEC, alternative mesothelioma treatments may be explored to improve the prognosis.

Hyperthermic Intraperitoneal Chemotherapy (HIPEC) represents a beacon of hope for peritoneal mesothelioma patients, offering extended life expectancies, reduced side effects, and potential relief from mesothelioma symptoms. While it is a specialized treatment, its impact on survival rates and quality of life cannot be understated. Patients are encouraged to consult with mesothelioma specialists to determine if HIPEC is a suitable part of their treatment journey.