HIPEC Treatment in Bangalore

Hyperthermic intraperitoneal chemotherapy (HIPEC) has changed the lives of many patients. HIPEC is meant to cure patients who have lost hope. These are for those whose cancers have spread to the entire abdominal cavity and traditional treatment gives them less than 6 months of survival. 

 

About 50% of these patients can expect a cure with HIPEC. This is especially useful for cancers of the ovary, colon, and pseudo-myxoma peritonei. Dr. Sandeep Nayak is one of the leading surgical oncologist in Bangalore, India, with a reputation for excellence in both traditional and minimally invasive surgical treatment (laparoscopy & robotic surgery)of various cancers. 

 

He uses the most up-to-date diagnostic tools and surgical treatments to fight cancer, including hyperthermic intraperitoneal chemotherapy treatment in Bangalore. Some cases of HIPEC can be performed by laparoscopy (minimally invasive surgery). 

 

He and his team have successfully performed more than 50 hyperthermic intraperitoneal chemotherapy (HIPEC) surgeries in the past 5 years in Bangalore. 

 

Hyperthermic intraperitoneal chemotherapy (HIPEC) is one of the innovative cancer treatments. The term "hyperthermic" refers to a higher temperature. The term "intraperitoneal" refers to the area of your abdominal cavity. 

 

During your cancer surgery, HIPEC involves heating chemotherapy drugs and circulating them through your abdominal cavity (the area inside your abdomen). During treatment, your surgeon removes all cancer in a procedure called Cyto-Reductive Surgery (CRS) which is followed by HIPEC. It is important that all the cancer cells are removed which is medically called CC0. 

 

In this article, we will discuss more about hyperthermic intraperitoneal chemotherapy treatment.

Now, let’s know,

Which Cancers does HIPEC treat?

Dr. Sandeep Nayak, a seasoned cancer specialist in Bangalore, may use HIPEC to treat cancers of the abdomen or chest. HIPEC may also be used to treat:

  • Colorectal cancer can develop anywhere in the large intestine (colon) or the paths connecting the colon and anus (rectum).
  • Ovarian cancer affects the ovaries, which are responsible for producing eggs and female hormones.
  • Appendix cancer grows in the appendix, part of the colon and intestines.
  • Psuedo-myxoma peritonei is a Peritoneal cancer type of cancer that affects the cells that line the inside of your abdomen producing jelly-like material.
  • Gastric cancer, also known as stomach cancer, is a type of cancer that affects the inner lining of your stomach.
  • Mesothelioma is a cancer of the chest or abdomen lining caused by asbestos exposure.
  • Soft tissue sarcomas are cancers that develop in the body's connective tissues.

Who can Benefit from HIPEC?

Your doctor will consider the following factors when determining if you are a candidate for HIPEC: 

  • If you have any other medical issues.
  • The location of cancer in your abdomen.
  • Your general physical fitness.
  • Your surgical background.

Doctors typically use HIPEC for people who have advanced abdominal cancers. For severe abdominal cancers, traditional chemotherapy or radiation therapy is often ineffective. Before deciding about offering HIPEC as an option the doctor will give a score based on the CT scan, called PCI which can be from 1-39. Higher is score is worser. HIPEC is offered only if the score is within reasonable limits. 

Now, let’s discuss,

Procedure of HIPEC Treatment

Although the specific approach to HIPEC surgery varies by treatment centre, the general concept remains consistent. There are two stages of the procedure: Following cytoreductive surgery, heated chemotherapy is administered.

Stage 1: Cytoreductive Surgery 

Initially, surgeons perform cytoreductive surgery (CRS) to remove as much tumor growth from the abdominal cavity as possible. The goal is complete removal which is called CC-0. This can be done through open or laparoscopic surgery. Laparoscopic surgery patients are carefully chosen.

 

HIPEC without surgery is ineffective because chemotherapy drugs cannot penetrate deep into malignant tumors usually not more than 1-2 mm. Tumors are not always completely removed, and patients may need other treatments.

 

Stage 2: Chemotherapy Bath 

Any remaining cancer cells are eliminated with heated chemotherapy immediately after CRS to prolong survival and prevent cancer relapse. For a better effect, the chemotherapy drug is circulated at 42℃.

A multimodal treatment plan combining cytoreductive surgery (CRS) and hyperthermic intraperitoneal chemotherapy (HIPEC) has significantly improved peritoneal cancer and mesothelioma patient survival. 

 

Cancers of the abdomen and chest (thorax) can be treated with this procedure. When used on the chest, the method is referred to as HITOC; however, the principle remains the same. This procedure can be done in some patients via laparoscopy, reducing trauma and improving recovery.

Chemotherapy Bath

How Does HIPEC Machine Work?

  • Surgeons place tubes into the abdominal cavity and connect them to the perfusion system, which heats and pumps the chemotherapy solution throughout the abdominal cavity. The chemotherapy does not enter the rest of the body. So, the side effects are usually limited to the abdomen. A heating element raises the temperature of the solution as it flows through the machine to around 40oC to 42oC. When heated to this temperature, cancerous cells start dying, whereas normal cells can sustain up to 43.9oC.
  • The doctor massages the abdomen or mixes the liquid to ensure the solution is mixed thoroughly. This step aids in delivering the drugs to the remaining cancer cells. This process takes about 60 to 90 minutes to complete. Afterward, the medicated solution is drained from the body. Before the catheter is removed and the incision is closed, the cavity is rinsed with only a saline solution to clear all the drugs.
  • Depending on the amount of cancer, the entire procedure, including CRS and HIPEC, could take anywhere from 6 to 12 hours to complete.

Recovery after HIPEC

  • HIPEC is a major procedure; Though most patients are discharged by 7-10 days in our cases, full recovery takes time. You should expect to take 3 months to recover.
  • Our oncology experts will review everything you need to know about recovery, including how to care for your incision wounds and promote healing.
  • Fatigue is the most challenging aspect of recovery. It will most likely take two to three months to feel normal again. Until then, it is critical to stick to the nutrition guidelines and stay active.
  • You may not be eating well for a few months as the intestines would have been affected by HIPEC. Our dieticians will give you instructions on how to manage your diet.

PIPAC: For Stage 4 Colon, Ovarian, and Peritoneal Cancers

HIPEC and PIPAC are two novel techniques for administering chemotherapy to patients with peritoneal carcinomatosis that have been shown to improve survival and quality of life.

 

When deciding whether to use one technique or the other, there are various factors to consider. It should always be a multidisciplinary team of cancer surgery experts who determines the best treatment for each patient, taking into account each case's unique characteristics and personal circumstances.

 

Peritoneal pseudomyxoma, mesothelioma, carcinoma of gastric origin, ovarian cancer, and colon cancer are among the five types of peritoneal carcinomatosis that the HIPEC technique aims to treat. 

 

PIPAC is also used to treat peritoneal carcinomatosis, but only in advanced stages of cancer when CRS & HIPEC surgery is not an option. It then serves as a palliative measure, enhancing the person's quality of life. 

A tumor in the peritoneum or metastasis of tumors of gastrointestinal (colon), gynecological (ovary), or any other organ of the abdominal area (liver, appendix, pancreas) can cause treated peritoneal carcinomatosis.

Let’s look at the,

Benefits of HIPEC

Compared to traditional chemotherapy, HIPEC has several advantages, including:

  • Fewer toxic side effects exist because 90% of chemotherapy drugs remain in the abdomen.
  • Chemotherapy with higher doses and heat can kill more cancer cells.
  • Instead of multiple treatment sessions over several weeks, only one treatment session is required.

Possible Risks Associated with HIPEC

Many patients tolerate HIPEC well. However, the specific risks will vary depending on the surgery required to remove your cancer and the drugs used in conjunction with HIPEC treatment. It is best to speak with your surgeon about this.

Although HIPEC is effective in many patients, there is a chance that it will not eliminate all cancer cells or that cancer will return. 

Frequently Asked Questions

You will need to stay in the hospital after treatment to recover. The hospital stay usually lasts four to fourteen days. You may not be able to take nutrition by mouth during your initial recovery, depending on the extent of your surgery. Nutrition can be given intravenously (IV) or through a feeding tube. We will provide you clear instructions at the time of discharge. 

Peritoneal cancer can be treated with cytoreductive surgery (CRS) and hyperthermic intraperitoneal chemotherapy (HIPEC). On the other hand, patients experience postoperative pain. This is very well managed by the anaesthesia and pain management team. Most of our patients experience acceptable amount of pain.

Patients with abdomen and chest cavity cancers may benefit from HIPEC treatment. It may be your primary treatment option. Alternatively, it may be used with other cancer treatments such as targeted therapy or chemotherapy.

Researchers are still studying the benefits of HIPEC. HIPEC isn't used as frequently as other cancer treatments. HIPEC's benefits are limited to certain cancers and may not be appropriate for everyone.

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