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Team of medical experts from Hiranandani Hospital led by Dr Sanket Mehta, oncosurgeon, successfully completed an operation on a patient was suffering from advanced stage of colorectal cancer. Surgery was performed with the help of combination of cytoreductive surgery and heated chemotherapy bath called Hyperthermic intraperitoneal chemotherapy (HIPEC).
This advanced technique for the treatment of colorectal cancer was used for the first time, at comprehensive Cancer Care Centre under the Aegis of International Oncology Services at Dr L H Hiranandani Hospital, Powai on 28 yr old young Pankaj Jaiswal.
The procedure is expected to relieve patients suffering from advanced stage of abdominal cancers like ovarian cancers, pseudomyxomas (cancers arising from the appendix), mesothiliomas and primary peritoneal cancers. These are critical conditions where traditional treatment methods have not yielded good results. The average duration of the cytoreductive surgery and HIPEC is about 12 to 14 hours. However, it depends upon the extent of the disease.
The concept of this treatment is that all visible tumour that has spread to the peritoneum is first completely removed by a special and aggressive type of surgery called as cytoreductive surgery (CRS). Following this, the microscopic disease that may still be left behind after this extensive surgery is eradicated by a heated chemotherapy bath, called as HIPEC. In HIPEC, a high dose of chemotherapy is circulated within the abdominal cavity using a special closed circuit mechanism and a machine called the HIPEC machine.
The machine helps to maintain a high temperature and flow rate for the high dose chemotherapy to ensure increased penetration of the chemotherapy into the cancer cells, uniformly within the abdominal cavity so that all cancer cells are destroyed. Moreover, the chemotherapy given during HIPEC does not circulate through the rest of the body and hence the usual side-effects of chemotherapy are avoided. The machine has been specially imported from France by Dr Sanket Mehta, oncosurgeon, International Oncology Services at Hiranandani Hospital, Powai, since it is not currently available in India.
“Before approaching us, the patient was counselled that the only treatment available was palliative chemotherapy, which would decrease the symptoms and control the disease for a short period but long-term survival was not possible. However, since the patient was in very good general condition we started with an aggressive type of chemotherapy involving three types of chemotherapy drugs that gave a good response, which is an encouraging sign in these types of patients. After careful evaluation, he was taken up for a surgery where we removed all the disease and then administered a heated chemotherapy bath directly into the abdomen, which is called as HIPEC using a special machine that delivers this chemotherapy at high concentration, high flow rate and a high temperature,” informed Dr Sanket Mehta.
Dr Mehta is hopeful that the combination of this aggressive surgery and HIPEC can in fact offer patients a potential chance of long-term survival.
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