HIPEC – Hyperthermic Intraperitoneal Chemotherapy.
The term “Intraperitoneal” means that the treatment is delivered to the abdominal cavity. The term “Hyperthermic Chemotherapy” means that the solution containing chemotherapy is heated to a temperature greater than normal body temperature.
Some cancers have a tendency to spread to the inner lining of the abdomen called the peritoneum. Cancers mainly from the appendix and ovary can produce a substance called mucin that can spread and form jelly like substances in the abdomen. When such a thing happens it is called “Pseudomyxoma Peritonei”. Certain other cancers such as cancers from the colon (intestine) or stomach or the peritoneum itself can form multiple nodules on the inner lining of the abdomen.
When this happens, surgery may not be able to remove all the nodules from the abdomen and despite numerous recent advances in chemotherapy, the overall chance of chemotherapy being curative and effective is still low n these situations.
How HIPEC Works?
Before HIPEC is administered, the surgeon–using standard surgical methods–will remove all visible tumors that can be removed throughout the peritoneal cavity. This is known as cytoreductive surgery. Following cytoreductive surgery, in the operative setting the surgeon will administer HIPEC treatment.
Chemotherapy solution is a liquid chemical solution that kills cancer cells. Higher concentrations of the chemotherapy solution can be used when it is given directly into the abdomen, so chemotherapy given this way is more effective at killing cancer cells in the abdomen than chemotherapy that is given through a vein. The chemotherapy solution is heated to a temperature higher than normal body temperature (hyperthermic) as it is thought to be more effective in killing cancer cells.
Chemotherapy given this way also causes fewer side effects than chemotherapy given through a vein because of something in the body called the “peritoneal-plasma barrier” that prevents the high concentrations of chemotherapy solution from reaching the blood stream.
This procedure is done so that the chemotherapy can reach more places in the abdomen while the abdomen is still open for surgery (it can be swished around and circulated inside the abdomen to reach more areas where cancer cells that are not visible to the naked eye may be hiding).
In some cases the chemo is circulated through tubes in the abdomen after the abdomen has been closed (closed technique).
This type of chemotherapy is best at killing cancer cells that are too small to be seen with the naked eye- these include cancer cells that may have been released from larger tumors during the surgery or cells that have been released if the appendix has perforated or ruptured. Peritoneal chemotherapy prevents these cells from being left behind to form new cancerous tumors in the abdomen.