If you’re exploring treatment options for cancer of the abdominal cavity, you may have come across a procedure called HIPEC. The Peritoneal Surface Malignancy Program at Tufts Medical Center was started by surgical oncologist, Martin Goodman, MD and was the first program in Boston to offer this procedure. We asked Dr. Goodman to answer some frequently asked questions about HIPEC and the steps involved.
What is HIPEC?
Cytoreductive surgery with hyperthermic intraperitoneal chemotherapy (HIPEC) is an innovative procedure used to treat cancers that have spread to the surface of the abdominal cavity, such as appendiceal cancer, pseudomyxoma peritonei, colon cancer, gastric cancer, ovarian cancer, and peritoneal mesothelioma.
Cytoreductive? What does that mean?
During the procedure, all visible tumors are surgically removed, leaving only microscopic cancer cells behind. In the process of removing the tumors, it is sometimes necessary for other organs to be partially or completely removed. The removal of an organ is only performed if the tumor cannot be separated from the organ’s surface. Organs that may be removed include the omentum (fatty layer that surrounds organs and absorbs tumor cells), gallbladder, spleen, part of the small or large intestine, and the peritoneum (membrane that lines the abdominal cavity and covers the abdominal organs). The cytoreductive procedure is followed by hyperthermic intraperitoneal chemotherapy (HIPEC), which aims to destroy any remaining microscopic cancer cells.
So, the HIPEC portion of the procedure actually removes the cancer? How is this done?
Then, a heated chemotherapy solution is delivered directly into the abdominal cavity to kill any microscopic cancer cells. Only a small amount of the chemotherapy is absorbed, so higher doses can be used without the systemic side effects that can occur with traditional chemotherapy. The chemotherapy solution used during the procedure is heated to between 107.6°F – 109.4°F (42-43°C), with a goal of eliminating any remaining cancer cells while preserving the healthy ones. This temperature is selected because cancer cells die at approximately 104°F (40°C), while normal cells die at approximately 111.2°F (44°C).