A 32-year-old mother of two small children, who was recently diagnosed with metastatic stomach cancer, underwent surgery using Hyperthermic Intraperitoneal Chemotherapy (HIPEC) at The Mount Sinai Medical Center.
The surgery, which took place on Thursday, July 26th is a breakthrough in cancer treatment at Mount Sinai, giving a heated form of chemotherapy to the patients during surgery directly into the abdomen while in the operating room.
Dr. Daniel Labow, Assistant Professor of Surgery and Surgical Oncology at The Mount Sinai Medical Center was the lead surgeon. Mount Sinai is one of a few places around the country that can perform this groundbreaking treatment. “Gastric cancer is very aggressive and with heated chemotherapy you get a better penetration of the chemotherapy locally in the peritoneal cavity, where systemic or traditional chemotherapy is ineffective,” says Dr. Labow.
According to Dr. Labow, the patient had debulking surgery to remove all visible malignant tissue around her belly. Once all visible cancer was removed, the heated chemotherapy was instilled. Four tubes were then placed in the abdomen—two to instill the heated chemotherapy and two to drain it. The new HIPEC technology by Thermasolutions allowed the heated chemotherapy to bathe all of her internal organs to kill any microscopic cancer cell that remained in the abdomen. The heated chemotherapy saturated the once cancer stricken area for 60-90 minutes before being drained. The entire surgery lasted 10 hours.
This new technology produced by Thermasolutions heats chemotherapy to 105 degrees Fahrenheit/ 41 degrees Celsius. Surgery with HIPEC helps doctors to remove the cancer and treat it aggressively while minimizing the negative effects of high doses of intravenous chemotherapy, while extending the patient's life. “We know in peritoneal cancer intravenous chemotherapy is ineffective. This is a new aggressive way to treat cancer, with a multi-prong approach,” said Dr. Labow.
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. During the HIPEC procedure, the surgeon will continuously circulate a heated sterile solution--containing a chemotherapeutic agent--throughout the peritoneal cavity, for a maximum of two hours. The HIPEC procedure is designed to attempt to kill any remaining cancer cells. The procedure also improves drug absorption and effect with minimal exposure to the rest of the body. In this way, the normal side effects of chemotherapy can be avoided.