Surgery is a common treatment for many people with cancer. But sometimes surgery alone cannot completely treat tumors. When that is the case, doctors combine it with other treatments like chemotherapy and/or radiation.
A specialized procedure called cytoreductive surgery-hyperthermic intraperitoneal chemoperfusion (CRS-HIPEC) combines surgery with heated chemotherapy to treat advanced cancers in the abdomen.
What Is CRS-HIPEC?
Cytoreductive surgery (CRS) is a complex operation in which doctors remove all visible tumors within the abdomen. Immediately following surgery, doctors deliver heated chemotherapy solution (HIPEC) directly into the abdomen to kill any remaining tumor cells.
In traditional chemotherapy, anti-cancer drugs are given to patients by mouth or intravenously (IV). With HIPEC, the chemotherapy is delivered directly into the abdomen.
When Is CRS-HIPEC Used?
Doctors use CRS-HIPEC to treat advanced cancers that are confined to the abdominal cavity.
It is most commonly used for:
- Appendix cancer
- Colorectal cancer
- Malignant peritoneal mesothelioma
- Ovarian cancer
The procedure is used only in certain circumstances. Determining factors include the patient’s overall health, the extent of the disease, how much of the tumor can be removed surgically, the primary site of the tumor, and the aggressiveness of the cancer. CRS-HIPEC is more effective against low-grade (less aggressive) tumors with limited spread in the abdomen that can be completely removed surgically.
“We have to be able to remove all the disease to maximize the benefits of CRS-HIPEC,” says M. Haroon Choudry, MD, a surgical oncologist at UPMC Hillman Cancer Center.
How Does the HIPEC Treatment Work?
Before tarting HIPEC treatment, surgeons perform CRS, also known as debulking. They remove as much of the tumor as possible from its primary location and surrounding areas.
“The duration and extent of the operation is determined by the amount of tumor that has spread within the abdomen,” says Dr. Choudry.
After the debulking procedure, HIPEC treatment begins. During the treatment:
- Surgeons insert two tubes into the abdomen – one to deliver the heated chemotherapy solution and one to circulate the fluid out.
- The solution — heated between 41 and 42 C — circulates in the abdomen for 100 minutes.
- After washing put the chemotherapy solution, surgeons remove the tubes and temperature probes, and close the abdominal incisions.
Dr. Choudry says recovery from CRS-HIPEC treatment depends on the amount of cancer you have and extent of the operation. Surgerys can last between four and 12 hours, followed by a hospital stay of 10 to 14 days. Recovery can take about two months.
“Heat has been used as a treatment strategy against cancers for a long time,” says Dr. Choudry. “Heat can directly kill cancer cells and improve the delivery and efficacy of chemotherapeutic drugs. A combination of heat and chemotherapy is an effective treatment for advanced cancers of the abdomen following optimal surgery.”
For more information on HIPEC, contact UPMC Hillman Cancer Center at 1-877-731-6794.
Editor's Note: This article was originally published on , and was last reviewed on .