Cancers that originate in the abdomen and spread throughout the peritoneal cavity used to be universally fatal, says surgeon Fabian Johnston, M.D., M.H.S. Surgically removing the many metastatic sites seemed like an impossible task, and systemically delivered chemotherapy doesn’t penetrate deep enough into the peritoneal lining.
However, hyperthermic intraperitoneal chemotherapy, or HIPEC, is a technique that has been slowly gathering steam over the past few decades. It involves flooding the cavity with a warm chemotherapy solution, catching errant malignant cells and small, imperceptible tumors.
To perform HIPEC, Johnston and the surgical team first perform a complete cytoreduction of all visible disease throughout the entire abdomen, checking for evidence of lesions on the diaphragm, liver, bladder, bowel and paracolic gutters. The next step is to fill the peritoneal cavity with a chemotherapeutic solution heated to the temperature of a warm bath, and allow it to circulate up to 90 minutes.
The treatment can be an option for patients with appendiceal, colon, ovarian, gastric or primary peritoneal cancers.