Therapeutic Approach to Peritoneal Cancer with HIPEC: What You Need to Know

Therapeutic Approach to Peritoneal Cancer with HIPEC: What You Need to Know

Peritoneal cancer is a rare and serious type of cancer that affects the lining of the abdomen. This disease often originates from primary tumors, such as gastrointestinal cancers and ovarian cancer. Today, HIPEC (Hyperthermic Intraperitoneal Chemotherapy) is gaining attention as an innovative method for treating peritoneal cancer. In this article, we will discuss what the HIPEC method is, its advantages, and its place in the treatment of peritoneal cancer.

What is HIPEC?

HIPEC is a treatment method that involves the direct application of heated chemotherapy into the abdominal cavity during surgery. This procedure is typically combined with cytoreductive surgery (the removal of as much of the tumor as possible). HIPEC targets the microscopic tumor cells remaining after surgery and aims to reduce the risk of cancer recurrence.

How HIPEC Works

• Targeted Application: Since chemotherapy is applied directly to the abdominal cavity, systemic side effects are kept at a minimum.

• Hyperthermia: The high temperature of the chemotherapy enhances the damage to cancer cells.

• Sustained Effect: The drugs remain in the abdominal cavity for a long time, allowing them to work effectively.

Stages of HIPEC Treatment

HIPEC generally consists of two main stages:

1. Cytoreductive Surgery:

• The goal is to remove as much of the tumors inside the abdomen as possible.

• This stage can last for several hours, depending on the size and spread of the tumor.

2. HIPEC Application:

• Immediately after surgery, heated chemotherapy drugs are administered into the abdominal cavity via a pump system.

• The procedure typically lasts between 60 and 90 minutes.

Advantages of HIPEC

1. Localized Treatment Applying chemotherapy directly to the abdominal cavity reduces systemic toxicity and increases treatment effectiveness.

2. Effective in Destroying Cancer Cells Hyperthermic chemotherapy increases the sensitivity of cancer cells to the drugs.

3. Reduces the Risk of Recurrence When combined with cytoreductive surgery, HIPEC significantly reduces the likelihood of the cancer re-emerging.

Areas of Use for HIPEC

HIPEC is used in the treatment of various peritoneal malignancies, including:

• Peritoneal Carcinomatosis: Peritoneal spread originating from colorectal cancer.

• Ovarian Cancer: Stands out as an effective method in advanced-stage ovarian cancer.

• Mesothelioma: Yields promising results in the treatment of peritoneal mesothelioma.

• Gastrointestinal Stromal Tumors (GIST): HIPEC can also be used for these rare tumors.

Differences Between HIPEC and Traditional Chemotherapy

Feature	HIPEC	Traditional Chemotherapy
Application Method	Directly to the abdominal cavity	Intravenously
Side Effects	Localized, less systemic	Systemic, more pronounced
Effectiveness	Targets microscopic tumor cells	More generalized effect
Treatment Duration	Single session during surgery	Over weeks/months

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Risks of HIPEC Treatment

As with any medical procedure, HIPEC has some risks:

• Surgical Complications: Complications related to bleeding, infection, or anesthesia.

• Chemotherapy Side Effects: Symptoms such as nausea, vomiting, and abdominal pain.

• Long Recovery Process: The recovery period after cytoreductive surgery and HIPEC can last from a few weeks to several months.

Outcomes of HIPEC Treatment

Clinical Success Rates According to various studies, a significant improvement in both survival rates and quality of life has been observed in patients treated with HIPEC. For example:

• In cases of peritoneal carcinomatosis originating from colorectal cancer, survival rates have increased by 30-50%.

• In the treatment of ovarian cancer, the application of HIPEC has reduced the risk of recurrence by up to 40%.

Patient Experiences Many patients who have undergone HIPEC treatment have experienced a marked improvement in their quality of life and a reduction in symptoms.

Eligibility Criteria for HIPEC Treatment

HIPEC may not be suitable for every patient. Eligibility for treatment depends on the following criteria:

• Tumor Spread: The cancer must be confined to the abdominal cavity.

• General Health Status: The patient must be strong enough to withstand the surgery.

• Organ Function: Normal kidney and liver function are important.

The Future of HIPEC

New Technologies and Research

• More Precise Chemotherapy Drugs: Advanced drug technologies may increase the effectiveness of the treatment.

• Integration with Robotic Surgery: When combined with robotic surgical techniques, HIPEC can become even more minimally invasive.

• Personalized Treatment: Patient-specific HIPEC protocols can be developed through genetic analysis.

Global Applications HIPEC has started to be used more widely around the world. It is becoming a standard treatment protocol, especially in advanced medical centers.

Conclusion

HIPEC is a revolutionary method for treating peritoneal cancer. Its potential to improve patients' life expectancy and quality of life is significant, thanks to its localized chemotherapy application, hyperthermic effect, and combination with surgery. However, it is important to carefully evaluate the risks and eligibility criteria for this treatment. Patients and healthcare professionals can make the best treatment decision by comprehensively analyzing the advantages and disadvantages of HIPEC.

Keywords: HIPEC, peritoneal cancer, hyperthermic intraperitoneal chemotherapy, cytoreductive surgery, cancer treatment, ovarian cancer, colorectal cancer.