Targeting Tumors

HIPEC treatment for abdominal cancers is improving outcomes

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What if you could attack cancer cells without destroying healthy tissue?

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Treatment for cancer has long involved surgery, followed by chemotherapy or radiation. Over the years, physicians have developed more targeted therapies to destroy cancer more effectively while also reducing the damage treatment does to healthy tissue. One such procedure — called HIPEC (hyperthermic intraoperative peritoneal chemotherapy) — involves removing cancerous tumors and then pouring heated chemotherapy directly into the abdomen in the operating room.

Why heat? Because heating the chemotherapy improves the way cells absorb it. And because the toxic drugs aren’t circulating through the bloodstream, surgeons can use higher doses. For that same reason, side effects are minimized, unlike in IV chemotherapy.

Cleveland Clinic was the first in Northeast Ohio and one of few programs in the nation to use this tumor-specific targeting to deliver chemotherapy for abdominal cancers in 2009. They’ve treated around 100 patients with the technique since then.

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“A series of research studies have shown clear benefits for patients who have undergone surgeries involving HIPEC,” says surgical oncologist Sricharan Chalikonda, MD. “For the right patients, we are starting to see survival rates increase by years.”

Advanced surgical skills required

Before the HIPEC procedure, surgeons perform cytoreductive surgery, a complicated technique that destroys or removes all visible tumors within the abdomen. Depending on the size and location of the tumors, the procedure also may involve the partial removal of other organs, such as the small bowel, large bowel, spleen and uterus.

“Removing all visible disease is crucial to the patient’s prognosis for long-term survival, which also depends on the number of tumors within the abdomen and the cancer’s aggressiveness,” says Pedro Escobar, MD, head of Robotic Surgery in the Section of Gynecologic Oncology. Dr. Escobar operates with Dr. Chalikonda in some cases.

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Dr. Chalikonda is quick to point out that HIPEC is not right for all abdominal cancers. It is designed to treat advanced cancers such as colorectal, ovarian and gastric as well as appendix tumors that have invaded other organs but have not spread beyond the abdomen.

To learn more or for answers to any question about cancer, call the Cleveland Clinic Cancer Answer Line at 216.444.7923 or toll-free 866.223.8100. A cancer clinical nurse specialist is available Monday through Friday, 8:30 a.m. to 4:30 p.m.

Download a HIPEC Fact Sheet

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