Hyperthermic intraperitoneal chemotherapy, or heated chemotherapy, is a relatively new form of chemotherapy used to treat rare cancers of the abdomen. This form of chemotherapy is considered to be more effective than traditional forms of chemo because it's conducted postoperatively and may produce fewer side effects than the traditional chemotherapy. Heated chemotherapy allows surgeons to destroy trace remains of the cancer directly after surgery, reducing the risk for further cancer growth. This new technique is hoped to one day be used to treat a variety of cancers, which might possibly lower cancer mortality rates and increase the rate of recovery.
Hyperthermic Intraperitoneal Chemotherapy
Most cancer treatments typically consist of radiation, chemotherapy and surgery, but heated chemotherapy involves the use of surgery and a heated chemotherapy drug directly after the procedure. This is done in hopes of increasing the effectiveness of the cancer drugs. After the surgery is complete, the area surrounding the tumor is flushed with the heated chemotherapy drug. The heat activates the drug’s potency while weakening the tumor’s ability to restore itself. Basically, it results in a higher concentration of the drug.
“It's called intraperitoneal hyperthermic chemotherapy. It works by flushing a heated chemotherapy drug through tissue surrounding a tumor immediately after the tumor's removed,” states an assistant professor of surgery at Wake Forest University Baptist Medical Center, Perry Shen. Dr. Shen goes on to say, "That hopefully provides kind of a mop-up or cleanup of any residual cancer cells left behind."
Although this technique seems simple, the results are drastic and the side effects are said to be far less than traditional chemotherapy. This method is a huge breakthrough because traditional chemotherapy does very little when used to treat advanced abdominal cancers. Doctors remain hopeful this treatment can be used for cancers in other areas of the body, as well as become a common, effective cancer treatment option.
How Does It Work?
The new heated chemotherapy procedure is conducted in two separate stages. First, surgery is conducted to remove as much of the cancer as possible. Second, while the patient remains in the operating room, a heated saline solution that has been combined with a chemotherapy drug is injected into the abdominal cavity. Due to research, scientists learned tumor tissue is more sensitive to heat than normal tissue, which makes the cancerous cells less resistant to chemotherapy treatment. By injecting the drug, it stays near the tumor instead of traveling to other areas of the body, which results in far fewer side effects than traditional chemotherapy.
Heat boosts the drug's potency and weakens the tumor's ability to repair itself. The targeted delivery means a higher concentration of the chemo reaches the cancer. "This procedure can provide them a longer-term survival than regular chemotherapy alone," says Dr. Shen.
What are the Benefits?
There are numerous benefits to using heated chemotherapy. Most chemotherapy requires multiple sessions over a prolonged period of time, but heated chemotherapy only requires one session. Because the chemotherapy comes into direct contact at a higher concentration with the cancer cells, the drug is more efficient at fighting the cancer. Plus, heat in general kills cancer. Heat even allows the tumor to become more penetrable, allowing the chemotherapy drug to fight the cells quickly and more effectively. Since the patient it anesthetized while undergoing heated chemotherapy, he won’t experience the nausea and vomiting side effects that are generally experienced with chemo.
Is It Effective?
Although heated chemotherapy is only now becoming a part of conventional medicine, it was originally pioneered by Paul Sugarbaker, M.D. of the Washington Cancer Center in the early 1980s. Dr. Sugarbaker knew cancer cells were more sensitive to heat, so he began combining chemotherapy with heat. This led to the discovery that the heat increased the effectiveness of chemotherapy. Over time, further studies were conducted to prove the effectiveness of this cancer treatment option.
Four separate studies have been conducted with the use of animals and the new chemotherapy technique. With all of the studies, it was evident the new treatment killed the cancerous cells and prevented the cancer from spreading to other areas of the body. Unfortunately, even with these results, the U.S. Food and Drug Administration (FDA) has yet to approve the treatment option. It’s hoped advancements can be made over the next few years, but it will be a difficult road. So far the treatment has only been used for rare cancers that are difficult to treat, such as appendiceal cancer. Because the cancers are rare, there are few people who have it and are willing to undergo clinical trials.
"The Challenge of Bringing Chemotherapy into Surgery" https://findarticles.com/p/articles/mi_m0FSL/is_6_80/ai_n8579090/
"New York Doctors Testing Heated Chemo for Rare Cancers" https://www.physorg.com/news155482238.html
"HIPEC Treatment" https://cancer.ucsd.edu/treatments/heated-intraperitoneal-chemotherapy/Pages/default.aspx
"Heated Chemo" https://www.sciencedaily.com/videos/2005/1205-heated_chemo.htm