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HIPEC Treatment Targets Tough Cancers by‘ Bathing ’Tumors in Chemo

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2019/09/04
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  HIPEC Treatment Targets Tough Cancers by‘ Bathing ’Tumors in Chemo
 
  Applying heated chemotherapy directly to cancer cells can help some patients with an aggressive form of the disease . 
 
  The biggest threat cancer poses happens when it spreads throughout the body . 
 
  Cancer that has spread to the lining of the abdominal cavity is particularly tricky . Once these advanced cancers have entered that area , they ’ re notoriously difficult to treat . Surgery alone is rarely successful , and traditional chemotherapy yields limited results . 
 
  But a treatment called HIPEC offers hope . 
 
  HIPEC , which stands for hyperthermic intraperitoneal chemotherapy , involves applying heated chemotherapy directly into the abdomen after surgery . 
 
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  “ For a number of different cancers , this seems to be our best opportunity to either cure or control the cancer much better than any other type of treatment , ” says Clifford Cho , M . D . , chief of hepatopancreatobiliary and advanced gastrointestinal surgery at Michigan Medicine . “ It ’ s something that has been around for a while but recently has started to pick up speed . ”
 
  Cho , who has trained in the procedure and recently introduced it at the University of Michigan Rogel Cancer Center , answered common questions about HIPEC : 
 
  How HIPEC treatment works
 
  What kinds of cancer can this procedure treat ? 
 
  Cho : This process addresses cancers that are grouped together under the term peritoneal surface malignancies , or PSM . This describes the way some cancers spread . It can encompass colon cancer , appendix cancer , mesothelioma cancer and adrenal cancer . 
 
  Mostly , we ’ re talking about intra-abdominal cancers that , for reasons that aren ’ t totally clear , sometimes metastasize not by getting into the bloodstream and going to different organs , but actually sort of spilling over into the abdominal cavity . 
 
  Surgery by itself has never worked well because it ’ s impossible to get rid of all of it . It ’ s just the nature of the way it spreads . It ’ s like trying to pull out dandelions ; you just can ’ t get them all . 
 
  But if you combine it with HIPEC , there is some evidence that it makes a big impact . 
 
  How do you know if you qualify for HIPEC ? 
 
  Cho : Some people have metastatic cancer that is spread in the body in the typical way , which is through the bloodstream . For those people , standard chemotherapy is by far the best . 
 
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  Some people have this pattern where the cancer is not so much inside the liver or inside the lungs or inside the bones , but it ’ s more inside the lining of the belly . We rely on CAT scans and MRI scans to show us the location and distribution of the tumors , which can help us decide if someone qualifies for HIPEC . 
 
  Now , some people have both ways of developing metastatic disease—through the bloodstream and into the abdominal cavity . For those people we are careful , because it ’ s hard to do both treatments concurrently . We have to make those decisions very carefully . 
 
  Can you describe the process ? 
 
  Cho : Assuming we go through the whole process and they ’ re good candidates , the operation itself can be very long . It really is driven more by how much tumor there is that we have to remove ( from the abdomen ) . Sometimes the removal of the tumor portion only takes a couple of hours , but sometimes that alone can take eight or nine hours . 
 
  After we remove all the tumors we can see , we fill up the belly with chemo . It ’ s heated chemo , so it penetrates the tissue.Basically , what we ’ re doing is bathing any leftover cancer cells in chemotherapy . This way , you get direct contact to the cancer cells with the chemo as opposed to when you give it traditionally through a port or through a vein . 
 
  Delivering the chemo this way also means that it does not get absorbed systemically . It goes right to where the tumor cells are and doesn ’ t have the kind of systemic side effects that we always worry about with traditional chemotherapy . 
 
  What should patients know before the operation prior to HIPEC ? 
 
  Cho : The challenge with this type of disease is that it is hard to know , even with a CAT scan , exactly what the operation is going to entail . 
 
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  Sometimes we must remove multiple organs—because many times it ’ s not just a big tumor but seeding of little tumor deposits throughout the abdominal cavity . You might not know what you will need to remove until you do the operation . 
 
  Also , because of the duration of the operation and how much tumor removal there is , oftentimes even if everything goes perfectly , people can be in the hospital for over a week . Usually the reason is because the bowel falls asleep , which is the natural response to a big operation . And because this is a bigger operation than most , that sometimes lasts longer . 
 
  Can HIPEC offer a second chance to some people who might otherwise be facing palliative care ? 
 
  Cho : Under the right circumstances , yes . This is a way of treating some tumors that are otherwise just inaccessible . 
 
  新闻来源网站 : 
 
  https : // healthblog . uofmhealth . org / cancer-care / hipec-treatment-targets-tough-cancers-by-bathing-tumors-chemo