Surgical oncologist administers ‘hot chemotherapy’ regimen

colon cancer

It’s the kind of story made for TV: A woman with a life-threatening case of colon cancer comes to Inova for cutting-edge treatment that delivers a one-two punch to her disease, beating back tumors and returning her to better health.

With the arrival of surgical oncologist Lana Bijelic, MD, in 2015, Inova Schar Cancer Institute became the only center in Northern Virginia to offer the innovative “hot chemotherapy” technique, recently featured on an episode of the medical drama “The Good Doctor.” Known as HIPEC, or heated intraperitoneal chemotherapy, the treatment — administered during extensive surgery to remove all visible tumors — bathes any remaining tumor cells in the abdominal cavity with high-concentration chemotherapy warmed with a special device.

And although Dr. Bijelic says reality may be a bit more complex than what’s depicted on a TV series, the bottom line is the same: The treatment offers certain patients the possibility of a cure or far better outcome than standard therapies alone.

“These are advanced, aggressive cancers and I wish I had a magic wand and could say they would all go away and never come back, but it’s a lot tougher than that,” explains Dr. Bijelic, Medical Director of Surgical Oncology at Inova Schar, slated to open in April. “But HIPEC is something that has changed options and outcomes for many patients. For some, it’s the difference between having a chance of being cured or dying of their disease.”

Elite medical training required

HIPEC was developed about 30 years ago. Within the last five years, however, an increasing number of healthcare centers across the United States offer the technique. HIPEC can be used for advanced abdominal cancers such as those starting in the appendix, colon and ovaries, but it takes a specially trained surgeon to employ this technique. During a lengthy operation called cytoreductive surgery, HIPEC  circulates throughout the abdomen for up to 90 minutes.

“It treats tumors that have spread to the inner lining of the abdominal cavity — which, for a long time, was really considered to be off-limits for surgeons,” Dr. Bijelic explains. “The chemo is given directly into the abdominal cavity because we’re able to achieve higher concentrations at the surface where cancer cells stick. It’s heated because some scientific data says chemo drugs may be more effective at higher temperatures.”

Dr. Bijelic “feels very happy with the outcomes” she and her team have seen among Inova Schar patients undergoing HIPEC, numbering more than 100 each year. ABC7-WJLA recently profiled a colon cancer patient of Dr. Bijelic’s where the woman crediting HIPEC for saving her life.

“I was so glad she was willing to share her story because there’s still a lack of awareness, even among some doctors, in terms of the risks and benefits of HIPEC,” Dr. Bijelic says. “If the patient had followed the advice she’d gotten somewhere else, she never would have gotten the procedure.”