We all know the fear and shock that comes from hearing from a doctor that a loved one has cancer that has spread throughout the abdominal cavity, that is, inside the stomach. However, with the advancement of medical science, there are now treatments that can give hope even in such difficult cases. Today, we are going to talk about one such special, advanced treatment. This is called HIPEC.
Simply put, what is HIPEC?
The word HIPEC stands for Hyperthermic Intraperitoneal Chemotherapy . Although the name sounds a bit complicated, what happens in this is very simple. Let's break down these words and understand them.
- Hyperthermic - means "heated" .
- Intraperitoneal - means "within the abdominal cavity." Simply put, the peritoneal cavity is the empty space inside our abdomen where organs like the liver, stomach, and intestines are located.
- Chemotherapy - refers to drugs that are given to destroy cancer cells, as we all know it, "chemo".
HIPEC is a treatment method in which heated chemo drugs are injected directly into the patient's abdominal cavity after surgery, and the inside is thoroughly washed out, destroying cancer cells. Just like we wash a sink with soap, this method uses heated chemo to destroy even the smallest cancer cells that may be left inside the stomach.
What types of cancer is this treatment suitable for?
HIPEC treatment is usually used for cancers that have spread (metastasized) to the abdomen from elsewhere in the body. It is also used for some cancers that start in the abdomen itself.
| Types of Cancer Considered for HIPEC Treatment | |
|---|---|
| Cancer that has spread to the abdominal cavity from other organs: | |
| Adrenal cancer | Appendix cancer |
| Colorectal cancer | Liver cancer |
| Ovarian cancer | Stomach cancer |
| Cancers that develop within the abdominal cavity: | |
| Primary peritoneal cancer | Peritoneal mesothelioma |
| Pseudomyxoma peritonei | |
Important: HIPEC treatment does not completely cure cancer. However, it can help patients live longer, reduce symptoms, and live a better life . Your doctor will explain to you in detail whether this treatment is right for you and what the pros and cons are.
How do you prepare for this major surgery?
This is a very intense, complex treatment. Therefore, it is very important to prepare yourself as best you can, both physically and mentally, before it happens. Your medical team will help you with this. The following things may be important in preparing:
- If you smoke, stop it completely .
- Stopping alcohol use.
- Breathing exercises using a special device (incentive spirometer) to strengthen the lungs.
- Join a support group for cancer patients or seek the help of a psychologist.
How is the entire treatment process?
HIPEC is the second part of a two-part procedure. The entire procedure can take between 5 and 10 hours.
First step: Cytoreductive Surgery (CRS)
The first step is surgery. You are anesthetized, meaning you are completely asleep. The surgeons open your abdominal cavity and remove all visible cancerous tumors and diseased tissue .
Step Two: HIPEC Treatment
HIPEC treatment is used to destroy very small cancer cells that are not visible to the naked eye after cancer tumors have been removed surgically.
1. Catheterization: Surgeons insert several tubes (catheters) into your abdominal cavity. These tubes are connected to a machine that heats the chemotherapy drugs.
2. Giving heated chemo: The machine heats the chemo drugs to about 41-42 degrees Celsius (108°F) and pumps them into the abdominal cavity through the tube.
3. Chemo delivery: The medical team will then slowly rotate your body from side to side, ensuring that the heated chemo solution reaches every corner of your abdominal cavity. This will take anywhere from 30 minutes to 2 hours.
4. Chemo removal: After the prescribed time, the chemo fluid pumped into the abdominal cavity is completely withdrawn. The area is then rinsed again with saline to clean it.
5. Suturing the wounds: Finally, all the incisions made for the surgery are sewn closed.
What are the special advantages of HIPEC treatment?
When systemic chemotherapy is given through a vein, it travels throughout the body with the blood. However, because of the membrane barrier called the peritoneum that surrounds the abdominal cavity, it is difficult for the chemotherapy drugs to enter the abdominal cavity properly.
But in HIPEC treatment, because we administer the chemo directly into the abdominal cavity, it can bypass that barrier and go to where the cancer cells are and destroy them.
Other advantages:
- A very powerful chemotherapy treatment: Because the drugs are heated, they have a greater effect on cancer cells. Also, because they hit the cancer cells directly, they are more effective in killing cancer cells.
- Fewer rounds of treatment: There is no need to give multiple rounds of chemotherapy like regular chemotherapy. This treatment can be completed in a single surgery.
- Reduced side effects: Since chemo drugs are mainly confined to the abdominal cavity, side effects that affect the whole body (hair loss, excessive vomiting) that occur with regular chemotherapy treatments may be reduced.
What happens after treatment? How long does it take to recover?
Depending on your condition after HIPEC treatment, you may need to stay in the intensive care unit (ICU) for a few days. You may also be connected to a ``ventilator'' machine to help you breathe.
Because this treatment uses strong chemotherapy drugs, you may be given nutrition through a feeding tube until your bowel function returns to normal.
The following side effects may occur during recovery:
- Filling the stomach
- Constipation or diarrhea
- Fatigue
- Nausea and vomiting
- Pain at the surgical site
- Body swelling (due to the saline used in the treatment)
It can take about 4 to 12 weeks to fully recover. This includes one to two weeks in the hospital.
When you need to talk to the doctor urgently
If you develop any of these symptoms after returning home, you should call your doctor immediately .
- If the fever is higher than 38.3°C (101°F)
- Nausea and vomiting that don't stop
- Excessive swelling, redness, or pus around the surgical wound
- If the pain is getting worse
These can be signs of infection or a wound that is not healing properly, so it is important to seek treatment quickly.
Take-Home Message
- HIPEC is a special, advanced treatment for cancer that has spread to the abdominal cavity.
- Here, visible cancer cells are first removed through surgery, and then heated chemotherapy drugs are used to destroy invisible cancer cells.
- Although this is not a treatment that completely cures cancer, it greatly helps extend the patient's life and reduce symptoms.
- This is a very complex surgery, and recovery takes several weeks.
- If this treatment is suggested to you or someone close to you, it is very important to have an open and thorough discussion with your doctor about its benefits, risks, and outcomes.
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