City of Hope now is one of a handful of hospitals offering a “hot” new treatment option that could increase survival for some patients.

Heated chemotherapy sits ready for infusion into a patient. (Photo courtesy of Belmont Instrument Corporation)

Advanced colorectal cancer can spread to the inner lining of the body cavity, or peritoneum, and that makes successful treatment difficult. Chemotherapy given through a vein often can’t completely destroy these tumors because not enough of it reaches the cells in the peritoneum. This means that once cancer has spread to this area, it can keep growing.

A new technique, though, takes chemotherapy right to the cells. With heated intraperitoneal chemotherapy, or HIPEC, physicians pump a warmed chemotherapy solution into the body cavity and circulate it for up to two hours. This bathes the peritoneum with powerful anticancer drugs warmed to 108 degrees Fahrenheit — a move that increases the drugs’ potency.

The procedure, done in combination with surgery, scavenges and destroys remaining cancer cells that linger after surgery.

Physicians note that HIPEC also lets them directly expose a tumor to higher doses of chemotherapy — 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 Oncologic Surgery and a member of the surgical oncology team specializing in HIPEC treatment.

According to Ellenhorn, the procedure helps ensure tumor cells take up more chemotherapy while at the same time lessening exposure to the rest of the body, which dramatically reduces side effects and pain.

HIPEC also may be an option for patients with other types of metastasized abdominal cancer such as ovarian cancer, appendix tumors and mesothelioma, a cancer most commonly caused by exposure to asbestos.

Results of early clinical trials are promising; HIPEC appeared to increase survival times by months and, in some cases, years.

Clinical studies also have shown that patients whose colorectal cancer returns 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.”