Advanced Therapy for Abdominal Cancers

HIPEC is a specialized cancer therapy in which the abdominal cavity is filled with heated chemotherapy drugs that treat abdominal cancers at the end of surgery to remove tumors. HIPEC is an innovative method of delivering chemotherapy directly into the abdomen and offers renewed hope for people with difficult-to-treat abdominal cancers that are often not detected until later stages. Our experts are available to answer questions and navigate the patient referral process. Please send an email to HIPEC@utsouthwestern.edu to let us know how we can help you.

Conditions We Treat With HIPEC

At UT Southwestern, we use HIPEC to treat several types of abdominal cancer, such as:

• Appendiceal cancer
• Colorectal cancer
• Desmoplastic small round cell tumors, which typically occur in children, teens, and young adults
• Malignant ascites
• Ovarian cancer
• Peritoneal mesothelioma
• Primary peritoneal cancer
• Pseudomyxoma peritonei (cancerous growth that typically begins in the appendix)
• Stomach cancer (gastric cancer)
• Other locally advanced cancers in the abdomen

Treatment with HIPEC

First, our surgeons remove visible abdominal tumors in a procedure called cytoreductive surgery, also known as “debulking surgery.” After tumor removal, a hot chemotherapy solution, heated to about 107 degrees Fahrenheit, is pumped into the abdominal cavity, where it gently circulates for 90 minutes. This helps to kill or sterilize any remaining cancer cells or very small tumors that the surgeon cannot see. The operation takes 6 to 9 hours, and the average hospital stay after the procedure is seven to 14 days.

HIPEC offers several benefits for people with abdominal cancers:

• HIPEC has fewer side effects than traditional chemotherapy because the anticancer medications don’t travel throughout the entire body.
• HIPEC provides a more concentrated dose of chemotherapy than traditional chemotherapy.
• Heating the chemotherapy solution allows the anticancer medications to penetrate deeper into the targeted tissue by expanding blood vessels for greater absorption.
• HIPEC is a single treatment provided in the same procedure as surgery to remove visible tumors, rather than multiple treatments over several weeks.

Who Is HIPEC For?

Unfortunately, not all patients with peritoneal cancer can undergo HIPEC surgery or experience the benefits this treatment can offer. Patients who wish to undergo HIPEC should consider several factors, including:

• Origin of the peritoneal cancer: Where did the peritoneal cancer start (primary peritoneal cancer versus secondary)?
• Extent of the disease: Peritoneal cancer index (PCI) is a score surgeons use to assess the extent of cancer in the peritoneal cavity. In general, a high PCI score means a worse prognosis, with exceptions for low-grade cancers such as pseudomyxoma peritonei.
• Patient performance status: HIPEC can be a very long, extensive, and complex surgery. Patients must be in good physical condition to tolerate the surgery and regain full recovery. Age alone might not be a limiting factor for HIPEC – “physiological age” is more important than “calendar age,” as we have safely performed HIPEC on otherwise fit and healthy patients over 70 years old.
• Cancer outside of the abdominal cavity: Chemotherapy used in HIPEC can treat cancer only inside the abdominal cavity, where the chemo can touch the surface of the cancer. If there are visible cancers outside of the abdomen (for example, in the lungs, bones, or brain), HIPEC is usually not considered.

Other areas where HIPEC cannot treat include cancer inside the abdominal organs, such as the liver and pancreas.

The goal of HIPEC is to control symptoms, prevent cancer from returning, and, in some cases, even cure the cancer.

HIPEC is a complex procedure. Talk with our doctors about the risks, benefits, and recovery.