Dr. Melanie Ongchin, surgical oncologist at the UPMC Hillman Cancer discusses the use of an innovative surgery known as HIPEC to treat peritoneal carcinomatosis, a rare type of cancer that can develop when gastrointestinal or gynecologic cancers spread.
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– [Tonia Caruso] This podcast is for informational and educational purposes only. It is not medical care or advice. Clinicians should rely on their own medical judgments when advising their patients. Patients in need of medical care should consult their personal care provider. It’s an innovative surgical approach to a rare form of cancer. Welcome to the UPMC HealthBeat Podcast. I’m Tonia Caruso, and joining us right now is Dr. Melanie Ongchin from the UPMC Hillman Cancer Center. Doctor, thanks so much for joining us.
– Tonia, thank you. I appreciate the time.
– UPMC is always on the forefront of innovation and especially when it comes to surgery and cancer surgery. Let’s talk about the work that you do when it comes to the rare forms of cancer.
– One of the more rare forms of cancer that we treat here at UPMC is called peritoneal carcinomatosis, which, again, is a cancer that has seeded the abdominal cavity. These are situations that are very difficult to treat and very difficult to cure. However, we have pioneered and really brought to the forefront a procedure called Hyperthermic Intraperitoneal Chemoperfusion, or HIPEC for short. The goal is to remove any gross visible tumor that the patient has within their abdominal cavity.
– What exactly does the surgery entail?
– The surgery is quite extensive. It is a lengthy procedure, but again, as a surgeon, our goal is to leave the patient as cancer-free as possible. We open the belly, we take out any gross visible disease, and we heat the abdomen and treat it with heated chemotherapy. The goal, again, is to prolong the patient’s overall survival, as well as to leave them symptom-free from any preoperative manifestations of their cancer.
– And, really, patients from all over come to you for this procedure.
– Absolutely. Though this is a rare phenomenon of any GI cancer, we are a very high referral center. So over the years, we’ve really grown our HIPEC program. We’ve educated the nurses as well as the OR staff, and we really work as a team approach to treat every patient. Again, even though it is rare, we do one of the highest volume number of cases in the country.
– And surgery really is key in most cases when it comes to treating cancers of the GI system.
– Absolutely. I believe surgery is a curative option for many of our patients.
– So what are some of the most common GI cancers?
– So we treat all GI cancers, including stomach cancer, liver cancer, pancreas, colon cancers. There are abdominal sarcomas, which are soft tissue tumors that occur in the abdomen.
– Are there common symptoms for most of these GI cancers? And if so, what are some of these symptoms?
– Some of the more common symptoms are abdominal pain and changes in their bowel habits. Additionally, some of these patients complain of unexplained weight loss, or changes in their body habitus, such as increasing bloating, sensations, or distension of their belly. Other common symptoms are yellowing of their skin, or jaundice. Those are some of the more common immediate responses that prompt the patient to go to the emergency room or see their primary care doctor, where they’re further worked up for their cancer.
– Right. And let’s talk about when a patient does come in. And you’re the surgeon, you’re almost like the first line of defense, but there are lots of people at the table, working with the patient, working with the patient’s PCP, in planning for treatment. And let’s talk about that and talk about some of the people who are at the table working with you.
– Any patient who comes in with a cancer diagnosis, we truly approach every case and every patient in a multidisciplinary fashion. We work very closely with their primary care doctors, their cardiologist, as well as our medical or radiation oncologists. we come up with a collaborative plan, so that we’re able to provide the best care for these patients. In light of the COVID-19 crisis, we have worked even closer with these outlying physicians to provide care closer to home while maintaining the surgical options here in Pittsburgh.
– So, doctor, even as cases of COVID-19 emerged in our region, for the most part, you kept patients coming in for treatment. Why is that? Why was that so important?
– Any patient who has cancer, we truly feel that early diagnosis is key to better outcomes. So we really try to avoid canceling cases or procedures if absolutely necessary. Office appointment or follow-up visits, if they were unable to be done in person, we adopted a telemedicine or video visit application to be able to perform follow-up and routine visits while patients were able to stay at home.
– Right. And what do you want to say to patients about the safety precautions in place at all of the Hillman Cancer Center locations? I believe UPMC has done a great job as far as providing appropriate PPE and instructions, as well as changes in policy to provide safety for both the staff as well as physicians and patients.
– And so, and before a patient even receives a procedure, they are offered testing of COVID-19.
– Correct. All patients, as well as visitors, now are screened before entering the building. Patients who are scheduled for surgical procedures are also tested for COVID-19, as we know that patients who have the virus and undergo any surgery are at increased risk for complications and poor outcomes. So we do take every precaution necessary preoperatively to ensure that our patients are having surgery in a timely manner, as well as in a safe manner. I would like patients to understand that UPMC, as well as our surgical oncology division, has taken every precaution to provide the best and safest care for these patients and to be able to provide it in a timely manner.
– Well, doctor, such great information. We thank you so much for spending time with us today. We appreciate it.
– Thank you again.
– And thank you for joining us. I’m Tonia Caruso. This is UPMC HealthBeat.
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The UPMC Hillman Cancer Center provides world-class cancer care, from diagnosis to treatment, to help you in your cancer battle. We are the only comprehensive cancer center in our region, as designated by the National Cancer Institute. We have more than 60 locations throughout western Pennsylvania and Ohio, with more than 200 oncologists. Our internationally renowned research team is striving to find new advances in prevention, detection, and treatment.