The outlook for patients with advanced abdominal cancers is considerably more positive thanks to a treatment called heated intraperitoneal chemotherapy (HIPEC), performed at Froedtert Hospital, a leading center for HIPEC surgery in the Midwest.
HIPEC gives patients with stage IV appendix, colon or gastric cancer or mesothelioma a viable option — even people who have been told they have no options.
“We now know that patients with cancer that has not spread beyond the abdomen can achieve long-term control and possibly a cure,” said Harveshp Mogal, MD, surgical oncologist.
A two-part procedure, HIPEC combines surgery with heated, high-dose chemotherapy.
“After the peritoneum (abdominal membrane) is entered, we surgically remove every bit of visible tumor,” Dr. Mogal said.
“If the cancer is invasive, organs like the gallbladder or stomach may have to be removed or the lining of the peritoneum stripped.”
The incision is then closed temporarily, and catheters are inserted to circulate chemotherapy throughout the belly.
“The concentrated chemo is heated to about 106 degrees Fahrenheit for about 90 minutes,” Dr. Mogal said. “This kills any residual cancer left behind — nodules or microscopic cells we can’t see and remove — because heat is known to improve penetration to the cells.”
After the chemotherapy, the catheters are removed, and the abdomen is closed. The entire procedure can take up to 10 hours. HIPEC patients may need additional therapies to treat their cancer effectively.
“It’s very individualized,” Dr. Mogal said. “Data shows outcomes are better in places like Froedtert Hospital where we have significant HIPEC patient volume.”
Froedtert & MCW surgical oncologists have performed more than 250 HIPEC procedures since 2010. “We are unique in that we have four surgeons who are HIPEC-trained and a program dedicated to patients with peritoneal cancer, from the moment they come in the door throughout all their follow-up care,” Dr. Mogal said.