HIPEC surgery in Iran, also known as heated or hyperthermic intraperitoneal chemotherapy, is the process of heating chemotherapy drugs and delivering them into the abdominal cavity. This treatment is often combined with cytoreductive surgery and is an effective approach for peritoneal mesothelioma. In fact, HIPEC surgery in Iran is an innovative and complex procedure used to treat colorectal cancer which has spread to the lining of the abdomen (peritoneum).
Some types of cancers are very difficult to treat. Cancer that has spread to the lining surfaces of the peritoneal (abdominal) cavity from primary colorectal cancer, ovarian cancer, gastric cancer, appendiceal cancer or from mesothelioma and pseudomyxoma peritonei–known as peritoneal carcinomatosis–are such cancers.
Despite numerous recent advances in chemotherapy, the overall chance of chemotherapy being curative is still low, and the side effects are difficult for the patient to endure. However, when these cancers are confined to the peritoneal cavity, Hyperthermic Intraperitoneal Chemotherapy (HIPEC) becomes an option for candidate patients.
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.
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.
The procedure has two phases: Cytoreductive surgery followed by heated chemotherapy.
Phase I: Surgery
First, doctors perform cytoreductive surgery to remove as much tumor growth as possible from the abdominal cavity.
HIPEC without surgery is ineffective because the chemo drugs cannot penetrate deep into cancerous tumors. In some cases, complete removal of the tumors is impossible and patients may need to explore other treatment options.
Phase II: Chemotherapy Bath
Mesothelioma doctors any remaining cancer cells with heated chemotherapy immediately after surgery to extend survival and prevent cancer recurrence.
The usual chemotherapy drugs, including carboplatin, cisplatin, doxorubicin, gemcitabine and pemetrexed, have all been used for heated chemotherapy. Instead of injecting these drugs into your blood, doctors deliver them directly to the chest or abdomen.
How the HIPEC machine works?
. Doctors insert catheters into the abdominal cavity and connect them to the perfusion system, which heats the chemotherapy solution and pumps it to and from the body.
. As the solution flows through the machine, a heating element raises it to between 105 and 109 F. Cancer cells start to die when heated to around 104 F, while normal cells can survive up to 111 F.
. A doctor massages the abdomen by hand to ensure the solution is fully mixed. This step helps the drugs reach remaining cancer cells.
. The chemotherapy drugs flow between the patient and perfusion system for about one hour.
. When the chemotherapy bath is finished, doctors drain the medicated solution from the body.
. The cavity is later rinsed with only a saline solution before the catheter is removed and incision is closed.
The entire procedure, including surgery and HIPEC, may take between six and 18 hours to complete because surgery times vary. The more the cancer has spread within the abdomen, the longer surgery will take.
. Best survival rates of any peritoneal mesothelioma treatment
. Fewer side effects than traditional chemotherapy
. Safe delivery of higher drug doses than systemic chemotherapy
. Local application means more cancerous cells than normal cells are exposed to the drugs, which prevents resistance to chemotherapy.
. Wound infections
. Urinary tract infections
. Blood clots
. Bowel obstruction
. Disruption of normal bowel motility (which reduces appetite)
. Fistula (a connection between the skin and intestines)
. Myelosuppression (bone marrow produces fewer platelets and blood cells)
As with any aggressive treatment, not all patients are eligible for HIPEC treatment.
Peritoneal mesothelioma patients must:
. Be healthy enough for surgery
. Not have heart disease or other serious chronic conditions
. Not have more than one bowel obstruction or partial obstruction
. Have a low peritoneal cancer index score (which estimates tumor growth and tumor spread).
. Have an epithelial cell type (other cell types are carefully considered)
Doctors look for patients who are otherwise healthy except for their cancer diagnosis. They conduct assessments to determine a patient’s overall health, which they call performance status.
The most common tumors treated by HIPEC are:
. Colorectal cancers
. Appendix tumors such as
. pseudomyxoma peritonei
. low-grade appendiceal mucinous neoplasm
Other cancers treated by HIPEC are:
. Adrenal cancer
. Ovarian cancer
. Liver cancer
. Pancreatic cancer
After HIPEC surgery, you should expect a recovery time of several months. Your treatment team will go over everything you need to know about the recovery process, including how to care for your incision wounds and encourage healing.
The most challenging aspect of recovery is fatigue. It will likely take two to three months until you begin to feel back to normal. Until then, it is important to stay active (within your limits) and maintain good nutrition.