Why ‘Hot Chemo’ Can Be More Effective Than IV Against Cancer

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While traditional chemotherapy drips intravenously into the body to circulate and attack deadly cancer cells, a faster, a more effective way of helping people with some cancers is now available at the Hartford HealthCare Cancer Institute.

Called Hyperthermic Intraperitoneal Chemotherapy (HIPEC), the treatment is designed for people with cancers of the appendix, colon and ovaries, as well as mesothelioma and pseudomyxoma.

“With HIPEC, we can deliver heated chemotherapy directly into the patient’s abdominal cavity, where it circulates and bathes the tissue and organs as it target cancer cells,” said Dr. Bret Schipper, director of surgical oncology at the Cancer Institute and specially-trained in HIPEC. “It’s a highly effective and efficient way to kill cancer cells and microscopic tumors that have metastasized or attached themselves to the surface of the abdominal wall or abdominal organs.”

The effectiveness of HIPEC – underscored in a recent study in the New England Journal of Medicine about its use with ovarian-cancer patients — is based on the type of chemotherapy that is used and the delivery method, Dr. Schipper said. He added that:

  • HIPEC can deliver a higher concentration of chemotherapy than the traditional intravenous (IV) approach, without compromising safety.
  • The high temperature of the medicine delivered with HIPEC increases its effectiveness, leading to more cancer cell death.
  • HIPEC-delivered chemotherapy causes patients fewer side effects than standard IV treatment because the medication does not circulate throughout the body.

“In the study from the Netherlands, researchers found that patients treated for their advanced ovarian cancer with HIPEC lived an average of 12 months longer than those who did not have HIPEC,” Dr. Schipper said.

HIPEC can be used with chemotherapy or in place of it, Dr. Schipper said. But instead of multiple treatments as with IV chemotherapy, HIPEC is delivered in a single, 90-minute session. Heating the medication, he noted, may improve absorption by the tumors, destroying more cancer cells in the process.

“First, the surgeon removes any visible tumors in the patient’s abdominal cavity in the operating room. Then, the heated chemotherapy is delivered directly into the abdomen to destroy any remaining cancer cells or tumors that are too small to be seen,” he said. “After the treatment, the abdomen is drained and the surgeon closes the incision.”

Patients need to have Stage IV abdominal cancers to be considered for HIPEC treatment. The surgical oncology team reviews imaging, pathology and medical history to determine whether a patient is a good candidate for the procedure.

“These are often patients who are told no other treatment will work because their cancer is complex and advanced,” Dr. Schipper said. “HIPEC gives many a new option to consider.

For more information about HIPEC at The Hartford HealthCare Cancer Institute, which offers HIPEC at Hartford and St. Vincent’s hospitals, click here or call Marlene Silvis, nurse navigator, at 860.972.5764.

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