What is Hyperthermic Chemotherapy and Who Can Receive It?
Hyperthermic chemotherapy, also known as heated intraperitoneal chemotherapy (HIPEC), is a specialized treatment approach that combines the use of chemotherapy drugs with the application of heat to treat certain types of cancer. This procedure involves delivering heated chemotherapy drugs directly into the abdominal cavity, where they can directly target and destroy cancer cells.
The goal of hyperthermic chemotherapy is to increase the effectiveness of chemotherapy drugs by enhancing their penetration into the tumor tissue and improving their ability to kill cancer cells. The heat applied during the procedure helps to increase blood flow to the area, which in turn improves drug delivery and enhances the drugs’ cytotoxic effects. Additionally, the heat itself can directly damage cancer cells and make them more susceptible to the effects of chemotherapy.
Hyperthermic chemotherapy is primarily used to treat cancers that have spread to the peritoneal cavity, which is the space within the abdomen that contains organs such as the stomach, liver, and intestines. It is most commonly used for the treatment of peritoneal carcinomatosis, a condition in which cancer cells have spread to the peritoneum, the thin membrane that lines the abdominal cavity.
The procedure typically involves two main steps. First, the surgeon performs cytoreductive surgery, which involves removing visible tumors from the abdominal cavity. This step aims to remove as much tumor tissue as possible to reduce the tumor burden. After the surgery, the heated chemotherapy drugs are administered directly into the abdominal cavity. The drugs are heated to a temperature of around 41-43 degrees Celsius (105-109 degrees Fahrenheit) and circulated within the abdomen for a period of 60-90 minutes. This allows the drugs to directly target any remaining cancer cells and destroy them.
Hyperthermic chemotherapy can be administered using different techniques. One common method involves using a closed system, where the heated chemotherapy drugs are circulated within the abdominal cavity using a pump and a closed circuit. Another method involves open surgery, where the drugs are manually applied and circulated within the abdomen. The choice of technique depends on various factors, including the type and extent of the cancer, the patient’s overall health, and the surgeon’s preference and expertise.
Not everyone is a suitable candidate for hyperthermic chemotherapy. The procedure is generally reserved for patients with advanced or recurrent cancers that have spread to the peritoneal cavity. It is most commonly used for the treatment of cancers originating from the appendix, colon, stomach, ovaries, and mesothelioma, a type of cancer that affects the lining of the lungs, abdomen, or heart.
In addition to having cancer that has spread to the peritoneal cavity, patients must meet certain criteria to be eligible for hyperthermic chemotherapy. These criteria include good overall health, adequate organ function, and a performance status that allows them to tolerate the procedure. Patients with significant comorbidities or poor performance status may not be suitable candidates for this treatment approach.
Hyperthermic chemotherapy is a complex and specialized procedure that requires a multidisciplinary team of healthcare professionals, including surgeons, oncologists, anesthesiologists, and nurses. The success of the treatment depends on the expertise and experience of the team performing the procedure.
Like any medical procedure, hyperthermic chemotherapy carries certain risks and potential complications. These can include infection, bleeding, damage to surrounding organs, and adverse reactions to chemotherapy drugs. However, with proper patient selection and careful surgical technique, the risks can be minimized.
In conclusion, hyperthermic chemotherapy is a specialized treatment approach that combines the use of chemotherapy drugs with the application of heat to treat certain types of cancer that have spread to the peritoneal cavity. It aims to increase the effectiveness of chemotherapy drugs by enhancing their penetration into the tumor tissue and improving their ability to kill cancer cells. However, not everyone is a suitable candidate for this procedure, and patient selection is crucial for achieving successful outcomes.