BENGALURU: Peritoneal surface malignancies are considered to be an enigma and one the most difficult to treat cancers. They are a group of advanced stage cancers that develop on the lining of the abdomen, called the peritoneum.
These cancers in which there is a high incidence of peritoneal deposits can arise form colorectal cancer, ovarian cancer, gastric cancer, biliary tract cancers, pancreatic cancer and breast cancer. It is one of the most dreadful cancers as it is rapidly progressing leading to severe pain, fluid in abdomen, blockage of intestines and very poor quality of life. Unfortunately the only treatment option available to them was palliative chemotherapy. Even chemotherapy has been found ineffective as the drug was not able to reach the peritoneal cavity. In order to combat these unique cancers, conventional cancer treatments is not sufficient. Therefore peritoneal cancers were considered a death sentence by the oncologists as cure was not possible.
For the first time in cancer history, thanks to a new breakthrough surgical technology in the form of Hyperthermic intraperitoneal chemotherapy (HIPEC) and Pressurised Intraperitoneal Aerosol Chemotherapy (PIPAC), there is now hope for curing these patients. The premise of this breakthrough treatment is that the traditional chemotherapy is ineffective as the drug is not able to reach the peritoneal cavity. Now with advent of HIPEC and PIPAC the chemotherapy is directly applied to the peritoneal cavity leading to cancer being melted away.
Studies have shown that this new revolutionary treatment has shown dramatic response which was never seen till now. It is truly heartening to see improved survival in patients.
Manipal Hospitals, Bengaluru which pledges for a ‘Cancer Less Future’ has recently started the Manipal Centre of Excellence for Hyperthermic intraperitoneal chemotherapy (HIPEC) and Pressurized Intraperitoneal Aerosol Chemotherapy (PIPAC). Manipal comprehensive cancer centre has an established HIPEC and PIPAC program since 2010 and is the number one referral centre for peritoneal cancer treatment in Asia. The surgical oncology team of Dr Somashekhar, Dr Shabber Zaveri and Dr Ashwin Rajagopal are experts in performing complex abdominal surgery for peritoneal cancers and have performed over 300 surgeries. Chairman, Manipal Comprehensive Cancer Centre, Manipal Health Enterprises
What is HIPEC?
Hyperthermic intraperitoneal chemotherapy (HIPEC) is a highly concentrated, heated chemotherapy treatment that is delivered directly to the abdomen during surgery. Unlike systemic chemotherapy delivery, which circulates throughout the body, HIPEC delivers chemotherapy directly to cancer cells in the abdomen. Heating the solution may also improve the absorption of chemotherapy drugs by tumors and destroy microscopic cancer cells that remain in the abdomen after surgery. A specially trained surgeon first performs complex Cytoreductive surgery which typically lasts for 7-8 hours.
Advantages
Allows for high doses of chemotherapy
Enhances and concentrates chemotherapy within the abdomen
Minimizes the rest of the body’s exposure to the chemotherapy
Improves chemotherapy absorption and susceptibility of cancer cells
Reduces chemotherapy side effects
What is PIPAC?
PIPAC is pressurised intraperitoneal aerosol chemotherapy. It is the newest method of giving chemotherapy to patients with advanced abdominal cancer. In PIPAC, chemotherapy vapour is generated using a special device called ‘Capnopen’. This procedure is performed through laparoscopy where the pressure in the abdominal cavity is raised. The combined effect of this increased pressure and vaporized chemotherapy, increases the drug concentration in the cancerous tissue.