Colon and Rectal Surgery Peritoneal Disease

What is HIPEC Surgery?

Hyperthermic or heated intraperitoneal chemotherapy (HIPEC) surgery is a two-step procedure that can treat certain cancers in the abdomen, including peritoneal cancer. In this procedure, cancerous tumors are surgically removed, then heated chemotherapy drugs are applied directly into the abdomen to eliminate any remaining cancerous cells. This is a treatment offered by surgeons in the Washington University colon and rectal surgeons in St. Louis, an institution known for its development and adoption of new, effective procedures.

Peritoneal Cancer Treatments

Peritoneal cancer is a rare form of cancer that forms in the peritoneum, a thin tissue that lines the abdominal wall and covers most of the organs located in the abdomen. When the cells of the peritoneum mutate or cancer from somewhere else in the body spreads to the peritoneum, peritoneal cancer can occur.

Each case of peritoneal cancer is unique, so treatment programs have to be determined based on the specific development and symptoms of the cancer.

Treatments for peritoneal cancer include:

  • Surgery: This procedure for peritoneal cancer, called cytoreductive surgery, removes any tumors on the peritoneum and nearby abdominal organs.
  • HIPEC: Hyperthermic (or heated) intraperitoneal chemotherapy, also called HIPEC, is a heated chemotherapy applied directly inside the abdomen. After surgery to remove all visible tumors, HIPEC may eliminate any remaining cancerous cells.
  • Chemotherapy: These are drugs taken orally or by injection, also used to target peritoneal cancer cells.

Washington University colon and rectal surgeon Sean Glasgow, MD, has established a successful peritoneal cancer program. Dr. Glasgow has partnered with surgical oncologist Beth Helmink, MD, PhD, to continue growing the peritoneal disease program. The team offers the most advanced treatments for peritoneal cancer, including cytoreduction with HIPEC, which involves removing all visible tumors before applying chemotherapy directly to the peritoneal cavity to kill any remaining cancer.

HIPEC – How does it work?

HIPEC surgery delivers high doses of chemotherapy into the abdomen to treat cancer that has spread in this region. Abdominal cancers that have spread to or began in the peritoneum can be difficult to treat through traditional chemotherapy. As an alternative option, HIPEC surgery can be a more effective treatment.

HIPEC surgery involves two stages:

  1. Cytoreductive surgery is the first stage. While the patient is under anesthesia, a surgeon will make an incision in the patient’s abdomen to view cancerous tumors and diseased tissue.
  2. The second stage is the HIPEC procedure. After removing all visible tumors and diseased tissue, the surgeon inserts a catheter containing chemotherapy drugs that are applied into the abdominal cavity. A perfusion machine heats and distributes the chemotherapy through the abdomen for one to two hours. Remaining chemotherapy is drained from the abdomen before it is rinsed with a salt solution and the incision is closed.

The amount of time the surgical procedure takes can vary based on how much cancer has spread throughout the abdomen. Advanced cancer may therefore take longer to treat.

After treatment, a hospital recovery period is necessary for healing. Typically, this stay lasts four to 14 days. Recovery may also require other clinical interventions, such as tube-administered nutrition.

Benefits of HIPEC

HIPEC surgery can be more effective than traditional therapy because it inserts high doses of chemotherapy directly into the abdomen, an area that traditional methods of chemotherapy cannot reach as effectively. As an innovative procedure, HIPEC can improve long-term health outcomes after surgery. It also provides an alternate treatment option for patients diagnosed with inoperable or advanced stage cancer.

HIPEC offers other advantages over traditional chemotherapy, including:

  • Decreased toxic side effects, since 90% of the chemotherapy drugs are retained in the abdomen.
  • A more intense dose of chemotherapy, which may destroy more cancer cells.
  • Only one treatment session, instead of multiple sessions conducted over several weeks.

Section of Colon and Rectal Surgery

Surgeons Dr. Glasgow and Dr. Helmink are both experts in their field, and the pioneering treatment programs at Washington University are being applied directly to patients seeking care at Washington University School of Medicine. Because no experience of cancer or other peritoneal disease is exactly alike, the physicians at Washington University work with each patient to find the most effective treatment program. Peritoneal cancer specialists at Washington University and the Siteman Cancer Center provide personalized treatment based on the needs of each patient.

Contact Washington University Colon and Rectal to learn more about HIPEC as an option for treating peritoneal cancer.