HIPEC: Finding the Best Patients for Hot Chemo


BALTIMORE, Md. (Ivanhoe Newswire)— HIPEC, or hot chemo, is a treatment for advanced abdominal cancers. It’s a life-saving option for some patients, but in others, doctors have to stop surgery because of complications. Researchers are now working to determine which patients may be at a higher risk of an aborted procedure.

For newlyweds Brittany and Ryan Little their first- year anniversary gift is priceless, Brittney is still here. At just age 27, doctors diagnosed the chronic pain in Brittney’s abdomen as PMP, an advanced type of appendix cancer. It was the last thing either expected.

“We had just gotten married in August, you know, four months earlier,” Ryan Little recalled.

“It just, it didn’t feel real,” Brittney Little shared.

Doctors recommended surgery, followed by internal chemotherapy known as HIPEC or Hot Chemo. Doctors surgically remove the tumor, and then bathe the abdominal cavity in heated chemotherapy.

“That was pretty much my only option at that time, because of the extent,” explained Brittney.

Doctor Kate Baron and her colleagues are trying to determine which patients do best with HIPEC. In up to thirty percent of the cases surgeons begin the procedure and have to stop.

“It’s a very dramatic situation because aborted surgery itself doesn’t have any benefits for patients but can lead to complications or even delay other treatments like chemotherapy,” Elaborated Ekaterina “Kate” Baron, MD, a surgical research fellow at the Institute for Cancer Care at Mercy.

(Read Full Interview)

Baron’s study found screening for elevated tumor and inflammatory markers in addition to imaging could help doctors plan before HIPEC surgery. For Ryan and Brittney no amount of planning could prepare them for their first big challenge

“Well, I guess when they say in sickness and in health, I didn’t quite think a sickness would come that quick after marriage,” recalled Brittney.

“Our future didn’t end; it just changed a little bit,” Ryan shared.

Getting better, and stronger a day at a time.

HIPEC has several advantages for patients. It’s only one treatment done immediately after surgery, so it doesn’t require several trips back for treatment. It also allows for a higher concentration of chemotherapy to be delivered into the abdomen.

Contributors to this news report include: Cyndy McGrath, Executive & Field Producer; Kirk Manson, Videographer; Roque Correa, Editor.

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REPORT:    MB #4796

APPENDICEAL CANCER: The appendix is a thin pouch that is attached to the large intestine and sits in the lower right part of the stomach. Appendix cancer, which is exceedingly rare, occurs when cells in the appendix change and grow significantly. The tissue growth formed from the cells is called a tumor. There are four types of tumors that can develop in the appendix: carcinoid tumors, mucinous neoplasms, appendix adenocarcinoma, and goblet cell carcinomas/adenocarcinoids. The following treatments may be considered for appendix cancer. Surgery like an appendectomy, Hemicolectomy, Cytoreductive surgery, and a Peritonectomy, chemotherapy and Hyperthermic intraperitoneal chemotherapy (HIPEC)

(Sources: https://www.hopkinsmedicine.org/health/conditions-and-diseases/appendix-cancer)

HYPERTHERMIC INTRAPERITONEAL CHEMOTHERAPY: HIPEC is one potential option for advanced-stage appendix cancer. Before patients receive HIPEC treatment, doctors perform cytoreductive surgery to remove visible tumors within the abdomen. Cytoreductive surgery is accomplished using various surgical techniques. Once as many tumors as possible have been removed, the heated, sterilized chemotherapy solution is delivered to the abdomen to penetrate and destroy remaining cancer cells. HIPEC is a treatment option for people who have advanced surface spread of cancer within the abdomen, without disease involvement outside of the abdomen.

(Source: https://hipectreatment.com/appendix-cancer/)

PREDICTING AN ABORTED HIPEC PROCEDURE: Aborted Hyperthermic Intraperitoneal Chemotherapy (AHIPEC) is a common, unsuccessful outcome of curative cytoreductive surgery (CRS)/HIPEC. Ekaterina Baron, MD., Surgical Oncologist at the Institute for Cancer Care at Mercy Medical Center lead a study about predicting aborted HIPEC procedures which can help surgical oncologists improve patient selection for the treatments. The study was focused on finding the tools that can be applied before surgery to identify the best kinds of dates for a procedure and avoid unnecessary surgery in other patients. The first thing they found was that appendiceal tumors can have different histological subtypes and the preoperative factors that are associated with an aborted procedure can be different among these subtypes. It allows surgeons and patients to think more realistically about sedation, performing additional tests, like diagnostic laparoscopy, taking additional imaging or sometimes just wait a little bit to see how the tumor will behave.

(Sources: Ekaterina Baron, MD., Surgical Oncologist at the Institute for Cancer Care at Mercy Medical Center, https://consultqd.clevelandclinic.org/direct-pacemaker-monitoring-via-smartphone-enables-high-rates-of-transmission-success/)




If this story or any other Ivanhoe story has impacted your life or prompted you or someone you know to seek or change treatments, please let us know by contacting Marjorie Bekaert Thomas at mthomas@ivanhoe.com

Doctor Q and A

Read the entire Doctor Q&A for Ekaterina Baron, MD, Surgical Oncology, Institute for Cancer Care

Read the entire Q&A