HIPEC Heated Chemotherapy

Hyperthermic intraperitoneal chemotherapy / HIPEC treatment (also referred to as “heated chemotherapy“) is the name of an innovative method of therapy, developed for treating carcinomas that have metastasized into the abdominal cavity (i.e. ovarian and intestinal cancers, etc.). It helps combat these kinds of metastases and has been shown to significantly prolong patients’ lives.

What is HIPEC?

During heated chemotherapy a highly-concentrated warmed up chemotherapy solution is introduced directly into the abdominal cavity immediately following a cytoreductive surgery. Unlike traditional chemotherapy agents, which circulate through the blood, HIPEC affects the malignant cells in the abdominal cavity directly. This allows for treatment with higher doses. Heating the solution to 42°C is done to improve its absorption by tumour cells and facilitate the destruction of microscopic cells remaining following the surgery.

How does HIPEC Treatment Work?

Before performing the HIPEC, a surgeon will perform a cytoreductive operation, during which he will resect any visible abdominal masses). Once this stage is complete a heated sterilized chemotherapy solution (42°C) is introduced into the abdominal cavity. It is left in the abdomen for 90 minutes.

Heated chemotherapy is indicated for advanced superficial cancers (carcinomatosis) limited to the abdomen. It is performed immediately following surgery in order to destroy all remaining malignant cells, including those that cannot be visualized.

Benefits of Heated Chemotherapy

• Heating the solution to 42°C makes it more effective at destroying cancerous cells without damaging the surrounding healthy tissue.
• HIPEC doses can be a lot more concentrated than during traditional chemo as the solution is not absorbed by the body in the same way. It also does not cause side effects common to traditional methods of chemotherapy.
• 90% of the solution remains within the abdominal cavity, so it is less toxic for the patient.
• Minimal damage to healthy tissue.
• Improved susceptibility of cancer cells.
• Performed once during surgery (as opposed to lengthy treatment courses)
• Can be used to treat both adults and children

Indications

• Certain types of ovarian cancer (presently this is one the most common indications for HIPEC)
• Soft tissue sarcomas
• Wilms tumour
• Abdominal tumours
• HIPEC therapy has been shown to be twice as effective in treating children with DSRCT (desmoplastic small round cell tumor) compared to traditional chemo
• Colorectal cancer (most common indication)
• Peritoneal mesotheliomas
• PMP (pseudomyxoma peritonei)
• Appendiceal mucinous adenocarcinomas

The following diagnostic procedures are required before heated chemotherapy can be scheduled:

• Radiological imaging (CT/MRI/PET-CT scan of chest, abdomen and pelvis)
• Histopathologic study
• Tumour marker levels analysis (CEA, CA 19-9, CA 125)
• You will also be asked to provide a medical summary detailing all treatments (including, if applicable, radiotherapy) that you’d undergone in the past.

Cost of Treatment

Heated chemotherapy cost includes 5 days of hospitalization. You should be able to travel home 15 days after the procedure. Presently HIPEC treatment is available in 3 Israeli medical centers: Assuta Hospital, Chaim Sheba Medical Center and Herzliya Medical center