HIPEC (Hyperthermic Intraperitoneal Chemotherapy) in India

HIPEC (Hyperthermic Intraperitoneal Chemotherapy) – Detailed Description

HIPEC (Hyperthermic Intraperitoneal Chemotherapy) is a specialized cancer treatment procedure that combines surgery with heated chemotherapy to treat certain cancers that have spread to the lining of the abdominal cavity (peritoneum). It is commonly used for selected patients with colorectal cancer, ovarian cancer, appendiceal cancer, pseudomyxoma peritonei, and peritoneal mesothelioma.

The main goal of HIPEC is to destroy remaining cancer cells inside the abdominal cavity after surgical removal of visible tumors. Unlike traditional chemotherapy, which travels throughout the bloodstream, HIPEC delivers heated chemotherapy medication directly into the abdominal cavity. The heat helps improve the effectiveness of certain chemotherapy drugs against cancer cells.

HIPEC is usually performed after a surgical procedure called Cytoreductive Surgery (CRS), in which the surgeon removes visible cancerous growths from the abdominal lining and affected organs when necessary.

Before treatment, doctors perform several diagnostic examinations, including CT scans, MRI, PET scans, blood tests, tumor marker tests, and sometimes diagnostic laparoscopy. These tests help determine the extent of cancer spread and whether the patient is suitable for the procedure.

How HIPEC Treatment Is Performed

HIPEC is generally performed under general anesthesia and involves the following steps:

1. Cytoreductive Surgery (CRS): The surgeon removes visible cancerous tumors from the abdominal cavity.

2. Preparation: After tumor removal, the abdominal cavity is prepared for chemotherapy circulation.

3. Heated Chemotherapy: Special chemotherapy medication is heated to approximately 41–43°C and circulated throughout the abdominal cavity.

4. Drug Circulation: The heated chemotherapy solution is circulated for a specific period, usually around 30–90 minutes, depending on the treatment protocol.

5. Removal of Medication: The chemotherapy solution is drained from the abdominal cavity.

6. Completion of Surgery: The surgeon completes the procedure and closes the surgical incision.

Types of Cancers Treated with HIPEC

• Colorectal Cancer: For selected cases where cancer has spread to the peritoneum.

• Ovarian Cancer: For certain advanced or recurrent ovarian cancers.

• Appendiceal Cancer: Particularly for selected appendiceal tumors and pseudomyxoma peritonei.

• Peritoneal Mesothelioma: A rare cancer affecting the abdominal lining.

• Gastric Cancer: In selected cases of stomach cancer with peritoneal involvement.

Benefits of HIPEC

• Delivers chemotherapy directly into the abdominal cavity.

• Helps destroy microscopic cancer cells remaining after surgery.

• Combines tumor removal with localized chemotherapy.

• Reduces exposure of the rest of the body to chemotherapy compared with systemic administration.

• May improve disease control in carefully selected patients.

• Can provide longer-term disease control for certain peritoneal cancers.

• Offers an additional treatment option for selected patients with abdominal cancer spread.

Recovery After HIPEC

Recovery after HIPEC can take several weeks because it involves extensive abdominal surgery and chemotherapy treatment. Patients usually remain in the hospital for monitoring and supportive care.

During recovery, doctors monitor blood counts, kidney function, liver function, digestive activity, and signs of infection. Patients may experience abdominal pain, fatigue, nausea, loss of appetite, or temporary digestive problems.

Nutritional support, pain management, wound care, gradual physical activity, and regular follow-up appointments are important parts of recovery.

Possible Risks and Complications

• Infection or bleeding.

• Delayed wound healing.

• Temporary or prolonged bowel problems.

• Kidney or liver complications.

• Low blood cell counts.

• Blood clots.

• Leakage from intestinal connections when bowel surgery is performed.

Additional Treatment

Depending on the cancer type, surgical findings, and pathology results, patients may require additional systemic chemotherapy, targeted therapy, immunotherapy, or regular cancer monitoring.

HIPEC (Hyperthermic Intraperitoneal Chemotherapy) is an advanced cancer treatment approach that combines cytoreductive surgery with heated chemotherapy delivered directly into the abdominal cavity. Careful patient selection, experienced surgical teams, and proper post-operative care are essential for achieving the best possible treatment outcomes.