For Physicians: Cytoreduction and Hyperthermic Intraperitoneal Chemotherapy (HIPEC)

Hyperthermic Intraperitoneal Chemotherapy (HIPEC) is a technique used in combination with surgery to treat various gastrointestinal cancers, peritoneal mesothelioma and ovarian cancer that have spread to the lining of the abdomen.

Watch as Surgical Oncologist Nader Hanna, MD, meticulously removes all tumors from the stomach cavity, known as cytoreduction, before beginning the HIPEC process. Once all visible tumors are removed, the patient is connected to a series of catheters and a pumping device that bathes the entire abdominal cavity with the chemotherapy drugs for approximately 90 minutes.

“This treatment option is best for patients with advanced abdominal cancers, including cancers of the appendix, colorectal cancer, gastric cancer, ovarian cancer and peritoneal mesothelioma,” explains Dr. Hanna.

The University of Maryland Marlene and Stewart Greenebaum Cancer Center was one of the first medical centers in the nation to offer the HIPEC procedure, beginning in 2004.

The hyperthermic intraperitoneal chemotherapy is administered at high temperatures directly inside the body. The high temperature of the solution has been found to increase the drug's therapeutic effect. The fluid goes throughout the abdomen to treat any tumor cells that may remain after surgery. Both heat and direct contact with chemotherapy drugs kills the cancer cells. Once that is over, the surgical team inspects the inside of the body to be sure there are no visible tumors and no trauma.

Clinical studies have shown HIPEC to be significantly more effective than systemic chemotherapy alone for GI cancers that have spread in the peritoneal cavity. Combined with tumor removal, HIPEC can improve survival and quality of life for patients who would otherwise have few if any options. The technique has also been shown to reduce pain dramatically.