HIPEC Infuses Heated Chemotherapy Directly into Patient's Abdomen during Surgery.
SARASOTA – Many challenging cancers that originate or spread in the abdomen often require a multi-modality treatment approach that includes surgery, chemotherapy and radiation.
Benefits of HIPEC
- Concentrated and targeted dose of chemotherapy.
- Deeper penetration of medicine thanks to high temperatures that cause blood vessels to expand.
- Side effects often reduced because the cancer-fighting agents don’t circulate throughout the whole body.
Cancers Treated with HIPEC
- Appendiceal (appendix)
- Peritoneal Mesothelioma
But an advanced procedure that bathes cancer cells in a concentrated solution of heated chemotherapy before patients ever leave the operating room is delivering a powerful one-two punch to cancers that often don’t respond well to repeated rounds of chemotherapy or other treatments.
Sarasota Memorial Hospital is the first medical center on the Suncoast and among a progressive group of leading cancer centers around the country providing Hyperthermic Intraperitoneal Chemotherapy (HIPEC), adding this modality to the many considered by the multidisciplinary tumor board that proactively reviews every patient’s treatment to ensure superior collaboration and coordination of care.
HIPEC is a treatment that, thanks to advances in surgical techniques and chemotherapy drugs, is now considered a potentially life-saving option for cancers once considered fatal. The most common forms of cancers that can be treated by HIPEC include appendiceal cancer, colorectal cancer, gastric/stomach cancer, ovarian cancer and peritoneal mesothelioma.
“HIPEC used to be a treatment of last resort, but has become an effective frontline therapy for challenging cancers that originate or spread in the abdominal cavity,” said Kenneth Meredith, MD, medical director of the gastrointestinal cancer specialty program at Sarasota Memorial’s Brian D. Jellison Cancer Institute. “It has proven especially beneficial, increasing survivability, for people with certain appendiceal and peritoneal mesothelioma cancers that do not respond well to systemic (intravenous) chemotherapy.”
Meredith began performing HIPEC procedures at Moffitt Cancer Center 13 years ago. Since joining Sarasota Memorial in 2014, he helped build its GI oncology program and bring effective new treatment options to the community.
HIPEC offers a range of benefits. For patients with early cancer and benign conditions, HIPEC can be used as a potential long-term cure; for those with incurable cancer, it can offer palliative therapy that extends a cancer patient’s quality of life.
On May 29, Meredith and partnering GI oncology surgeon Pedro Briceno, MD, performed the first HIPEC procedure at SMH, successfully treating a 58-year-old woman with an appendiceal mucinous neoplasm, a benign but aggressive tumor that can cause life-threatening obstruction.
Most HIPEC procedures are performed following an open cytoreductive surgery. But in this case, the SMH team performed the surgery and HIPEC laparoscopically through 10-millimeter incisions, first removing visible tumors and lesions from her body and then infusing a one-time, 90-minute dose of chemotherapy directly into the abdomen. The 108-degree chemo bath flushed the chemicals directly through her organs and across microscopic tumor cells that typically can’t be reached through traditional intravenous chemotherapy.
The minimally invasive approach allowed the patient to go home just 3 days after surgery, avoiding complications associated with open surgery, shortening her recovery period, and eliminating the need for intravenous chemotherapy.
“Without HIPEC, patients with this kind of aggressive tumor face multiple operations to manage the condition,” Meredith said. “In this particular case, we are happy to report that just one dose of chemotherapy during surgery was all that was necessary to penetrate and destroy remaining tumor cells.”
Cancer Institute specialists Beverly Long, MD, and Toni Kilts, DO, both gynecologic oncologists, are using HIPEC as part of a combination treatment for complex GYN cancers. Long lauded the arrival of the new procedure at the Jellison Cancer Institute She emphasized the importance of this novel treatment in helping her patients live with difficult gynecological cancers, particularly when combined with traditional modalities, such as interval debulking surgery.
“Ovarian cancer can be difficult to treat, especially for women with extensive abdominal disease that cannot be safely removed,” Long said. “But in a recent randomized trial, the addition of HIPEC helped these women live an average of one year longer than those who were treated with traditional chemotherapy.”
“Because HIPEC requires special equipment, surgical expertise, and a multi-disciplinary team, its use has been previously limited to large academic centers,” Long continued. “I’m excited that our team can offer this advanced treatment to patients in our own community.”
About Sarasota Memorial Health Care System
Led by the 9-member, publicly elected Sarasota County Public Hospital Board, Sarasota Memorial is a regional medical center offering Southwest Florida’s greatest breadth and depth of care, with more than 1 million patient visits per year. Sarasota Memorial’s 839-bed, acute-care hospital has been recognized consistently as one of the nation’s best, with superior patient outcomes and a complete continuum of outpatient services. In the past several years, the Hospital Board has invested more than $250 million in the developing Cancer Institute to provide the community it serves with access to advanced, comprehensive cancer care.
About the Brian D. Jellison Cancer Institute
Sarasota Memorial's Brian D. Jellison Cancer Institute is committed to providing our community and visitors with convenient access to comprehensive, coordinated and collaborative cancer care. Cancer Institute services cover the entire continuum of oncology care — from prevention, screening and diagnosis to treatment, clinical trials, and lifetime follow-up, survivorship care and support. At the heart of the program is the Cancer Institute's 8-story oncology tower, set to open in Fall 2021 on the hospital's main campus. Along with our new Radiation Oncology Center off University Parkway, the tower is part of the institute’s expanding center of excellence designed to offer world-class cancer care close to home for area residents.