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HIPEC

Hyperthermic Intraperitoneal Chemotherapy - abbreviated as HIPEC, is a procedure that takes place while in surgery. Hyperthermic chemotherapy means that the chemo drugs that are used are heated, and intraperitoneal dictates that the chemotherapy is administered directly into the abdomen.

 

Before the HIPEC is administered, cytoreductive surgery (CRS) is being done which is the resection of tumours within the abdominal cavity, with the aim of removing all disease that can be seen with the naked eye. Thereafter, with the help of a specialised machine, the chemotherapy drug will be heated before being administered directly into the abdominal cavity. This will help to target the microscopic diseases and cells that may be still lingering within the abdominal cavity. Owing to the peritoneal-plasma barrier, a high dose of chemotherapy drugs can be delivered with less systemic toxicity. This heated temperature of 40 degrees celsius is optimal as it increases the drug penetration and provides a synergistic effect with the intraperitoneal chemotherapy.

 

Conventionally, it has been thought that peritoneal metastases (where the primary cancer has spread to the peritoneum) have poor prognosis as it is considered advanced stage cancer, where chemotherapy and surgery are largely ineffective modes of treatment. But with the introduction of CRS HIPEC over the years, there is an improvement in the patients’ prognosis.

One thing to note is that not all patients are fit for CRS HIPEC. There are a few criterias:

  • Patients who are medically fit for surgery and anaesthesia

  • Patients’ primary tumours are within the ovary, colon or appendix, and shows no evidence of disease in other organs outside the abdominal cavity

  • Patients’ primary tumour is from the peritoneum

If you are a patient or a loved one of a patient who is considering CRS HIPEC, feel free to contact us and book a teleconsultation with Dr Melissa Teo or Dr Grace Tan.

A few of the benefits of CRS HIPEC over the conventional treatment of surgery and chemotherapy would be:
 

  • Increase in chances for long-term survival

    • According to the studies done, CRS HIPEC is effective in extending chances for long-term survival in patients with previously-deemed untreatable cancers. This is owing to the surgery being done in two parts - first to remove the resectable tumours (CRS), and next to administer heated chemotherapy (HIPEC) directly to the affected area.

  • Even distribution of higher concentrations of chemotherapy

    • As the chemotherapy will be administered directly into the abdominal cavity, it is able to be distributed to hard-to-reach areas, and there will be an even distribution

  • Increased effectiveness

    • As the HIPEC administered is heated at 40 degrees celsius, it helps to enhance the penetration into the tissues and increases effectiveness in killing the cancer cells within the peritoneum

  • Minimised undesirable side-effects of chemotherapy

    • There is a minimisation of the undesirable side-effects of chemotherapy as the body is not fully exposed to the chemotherapy unlike conventional methods