September 2008
Patients in the advanced stages of ovarian cancer have new hope in a technique now offered at Northside Hospital in Atlanta. The hospital has expanded its cancer care program with the addition of hyperthermic intraperitoneal chemoperfusion (HIPEC).
Until recently, treatment options for patients with advanced cancer of the ovary included surgery and conventional chemotherapy. Now, surgeons can dramatically improve the odds for these patients by combining surgery with heated chemotherapy.
“The five-year survival rate for ovarian cancer is not much better now than it was 25 years ago,” said Dr. Benedict Benigno, Director of Gynecologic Oncology and world-renowned cancer surgeon, who recently introduced HIPEC at Northside Hospital.
Performed immediately following surgery, HIPEC delivers heated chemotherapy into the abdominal cavity, where it can penetrate diseased tissue directly. After the surgeon removes as much visible cancer as possible, the heated chemotherapy is circulated throughout the abdomen in an effort to kill the remaining cancer cells. The heated chemotherapy is circulated for 90 minutes and then removed, and the abdomen is flushed with a sterile saline solution.
Because conventional chemotherapy is usually administered intravenously, it circulates throughout the body and is diluted by the time it reaches the abdomen. With HIPEC, the chemotherapy is given directly into the abdomen, which allows a much higher dose of chemotherapy to permeate the diseased tissue than could be accomplished by conventional chemotherapy administration.
HIPEC is useful, not only in newly diagnosed patients, but also with patients that have a recurrence that can be surgically removed. However, HIPEC is not appropriate for everyone. Patients should be healthy enough to withstand a lengthy operation. Because of extreme shifts of fluid, there is a higher risk of pulmonary edema and these patients must have cardiac clearance prior to surgery.
HIPEC has been used for many years in patients with colon and pancreatic cancer as well as mesothelioma, but only recently has been used for ovarian cancer. According to Dr. Benigno, the ovary is the only organ in the body that has its functioning cells facing the interior of the abdominal cavity. Long before the cancer forms, the cells are detached from the ovary and can implant on the surfaces of the diaphragm and bowel. Because of this, HIPEC is an ideal treatment in select patients with ovarian cancer.
