Hyperthermic Intraperitoneal Chemotherapy (HIPEC)
Novel Chemotherapy Treatment Advances Survivorship by Outsmarting Gynecologic Cancer
Play this video to learn how this rare heated chemo is becoming a new therapy for gynecologic cancers.
Gynecologic oncology specialists at University Hospitals Seidman Cancer Center are currently treating gynecologic cancer patients with a promising chemotherapy treatment called Hyperthermic Intraperitoneal Chemotherapy (HIPEC). HIPEC involves delivering chemotherapy in a novel way, and when used in combination with surgery, is becoming a promising treatment for gynecologic cancers. HIPEC has been used for several years in patients with other cancers, but oncologists at UH Seidman Cancer Center view it as the next step in advancing treatment of gynecologic cancers, including recurrent and new ovarian and certain high risk endometrial cancers.
Combination of HIPEC and Surgery Used to Treat Abdominal and Gynecologic Cancers
Hyperthermic Intraperitoneal Chemotherapy (HIPEC) is a type of hyperthermia therapy used in combination with surgery in the treatment of advanced abdominal cancers. HIPEC has been used for years in patients with colon, pseudomyxomas and appendiceal cancers, as well as mesothelioma -- cancers that in general are not responsive to chemotherapy. It is now being viewed as a promising treatment for advanced abdominal and gynecologic cancers, which are generally responsive to chemotherapy, including new and recurrent ovarian cancer and certain high-risk endometrial cancers.
HIPEC is delivered in the operating room immediately after cancer surgery to attack any remaining malignant cells and to delay or abate cancer growth. After a surgeon removes as much of the visible cancer as possible, a chemotherapy agent is heated and then circulated via a perfusion system throughout the abdominal cavity for up to 90 minutes. During this time, the agent penetrates diseased tissue and attacks the remaining cancer cells. After the chemotherapeutic agent is removed, the area is flushed with a sterile saline solution.
It can be either curative or palliative, depending on the type of tumor and how much of the tumor can be removed surgically. In cases where the tumor is completely removed, HIPEC also can be used to potentially prevent recurrence.
Advantages Over Traditional IV Therapy
There are many advantages of using HIPEC in place of traditional intravenous (IV) therapy, including:
- Improved survival rates for women with gynecologic cancer
- Targets hard-to-reach surfaces in the peritoneum
- Allows for a much higher dose of chemotherapy to permeate the cancerous tissue than IV chemotherapy, which circulates throughout the body and is diluted by the time it reaches the abdomen
- Delivers the chemotherapeutic agent only where it is needed - sparing healthy tissue and the rest of the body's exposure to treatment - to help reduce side effects such as hair loss
- Heating a chemotherapeutic agent enhances its effectiveness, increasing cancer cell responsiveness.
- One-time treatment delivered at the time of surgery
Data Shows Positive Outcomes for Patients Treated With HIPEC
HIPEC is showing promising outcomes for gynecologic cancer patients, though giving chemotherapy into the abdomen for women with ovarian cancer is not new. Traditionally, however, it has been given following surgery, was not heated and needed to be administered multiple times.
National data on the use of intraperitoneal chemotherapy (IP) to treat ovarian cancer is promising, showing that women with advanced ovarian cancer live an average of 1.5 years longer than women receiving traditional intravenous chemotherapy. Unfortunately, this type of therapy is complicated because it is delivered over multiple outpatient treatments and as a result, most women with ovarian cancer are not offered this therapy.
With HIPEC, in contrast, patients can be given the treatment at the time of surgery, eliminating multiple outpatient IP treatments and the complications associated with it.
Preliminary data has been very positive and HIPEC has proven to be a well-tolerated and effective treatment for gynecologic cancer. One study of patients with gastric cancer and peritoneal metastasis found that those who underwent surgery alone had a median survival rate of eight months. Of the patients who had surgery and HIPEC, 54 percent had a one-year survival rate; 42 percent a three-year survival rate; and 31 percent a five-year survival rate.
Investigating the Use of HIPEC as an Effective Treatment Option
Learn more about HIPEC research and clinical trials being conducted at UH Seidman Cancer Center.