When advanced colorectal cancer spreads to the inner lining of the body cavity, treatment can become difficult. City of Hope now is one of a handful of hospitals offering a “hot” new treatment option that could increase survival for these patients.
Chemotherapy drugs given through the veins often do not reach sufficient levels inside of the body cavity to be effective at eliminating tumors. This means cancer that has spread, or metastasized, to the peritoneum is free to grow unchecked.
|Gastrointestinal cancer surgeons can now use heated chemotherapy to boost treatment of colorectal cancer that has spread to the body cavity. (Photo ©2005 Philip Channing)|
With heated intraperitoneal chemotherapy, or HIPEC, physicians pump a warmed solution of chemotherapy into the body cavity and circulate it for up to two hours, bathing the peritoneum with powerful anticancer drugs. The physicians warm the solution to 42 degrees Celsius (108 degrees Fahrenheit) because it increases its potency.
The procedure, which takes place in combination with surgery, scavenges and destroys microscopic residual cancer cells that linger after surgery.
In addition, HIPEC allows for higher doses of chemotherapy to come into direct contact with the tumor — doses too high for patients to tolerate otherwise.
“In select patients who have been able to have all or the vast majority of their tumor removed, HIPEC can provide lasting tumor control,” said Joshua Ellenhorn, M.D., chief of the Division of General and Oncologic Surgery and a member of the surgical oncology team specializing in HIPEC treatment.
According to Ellenhorn, the procedure improves drug uptake by tumor cells while also lessening exposure to the rest of the body, reducing side effects of chemotherapy and pain dramatically.
HIPEC also may be an option for patients with other types of metastasized abdominal cancers such as ovarian, appendiceal, mesothelioma and primary peritoneal tumors as well as pseudomyxoma, an unusual tumor that produces a mucous-like substance.
Results of early clinical trials are promising; HIPEC appeared to increase median survival times by months and, in some cases, years. Clinical studies also have shown that patients whose colorectal cancer recurs within the abdomen benefit from surgery followed by HIPEC.
Said Ellenhorn: “Surgical [tumor removal] with HIPEC is a promising treatment regimen for patients who have no other effective treatment options.”