HIPEC Surgery For Abdominal Cancers - Yale Medicine Explains

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STAGE FOUR CANCER HAS SPREAD FROM ITS ORIGIN TO OTHER PLACES IN THE BODY.
Stage four cancers can be quite serious. It's actually very hard to see that a patient has developed stage four cancer until it's quite often quite late. Compared to other stage four cancers, when abdominal cancer is spread to the lining, it becomes a much more serious problem. These cancers are sort of like glue and they actually cause blockages of the intestine or they can fill the abdomen up with a lot of fluid that causes a lot of distress, lots of symptoms, lots of problems for our patients.
PERITONEUM IS THE MEMBRANE LINING THE ABDOMEN, PELVIS, AND OTHER INTERNAL ORGANS.
The chemotherapy that is given through the IVs in the peritoneum very well and so, you can imagine that when the chemo is at such low doses, it's not as effective. Surgery removing these cancers is very precise.
CYTOREDUCTIVE SURGERY REMOVES CANCER FROM THE ABDOMEN.
The peritoneum, it's as thin as Saran wrap. You have to be very precise in being able to take this layer off you got to peel it off of the lining tissues and remove it off organs where it's really stuck. Sometimes we have to remove things like the ovaries, the uterus, the colon. We're trying to take out everything that is visible to make sure that we give our patients the best chance against this advanced cancer and we give a score called the CC score and really our goal is to get to what we call a CC 0, which means no visible tumor is left inside or a CC 1 where, if there is some cancer, it's only like a very thin layer such that the chemotherapy that we put inside will penetrate across the tumor and kill it.
HIPEC REMOVES THE REMAINING CANCER.
HIPEC is hypothermic intraperitoneal chemotherapy. It works in conjunction with the cytoreductive surgery where we remove the tumors, but then this hot chemotherapy works on the surfaces to kind of sterilize them. HIPEC has three components: It has heat, it has the chemotherapy and it has flow. We heat patients up to about 108 Fahrenheit but it's usually for a short period of time, so like about an hour and a half. This chemotherapy actually distributes inside these tumors and kills them, but it only works on the surface. So it actually doesn't penetrate very deep. So patients don't have the same side effects that you would get from, say, chemotherapy in the IV. It’s able to deliver high concentrations of chemotherapy, killing cancer cells right where they are without adding a lot of side effects to patients.
YALE MEDICINE ADVANCES CANCER CARE
Curing cancers like this, or at least helping make a big difference to cancers like this requires a group of very smart, dedicated, motivated people who are thinking very hard together and who are passionate about the same things. And I think I find that here at Yale. We built an excellent team of individuals that are here to take care of patients. We’re adopting novel technology, new therapies and I think our biggest goal
is to get novel therapies to our patients. I think it's a very interesting time where I feel like we can truly make a difference to our patients with peritoneal metastasis.
0:00 - Stage Four Cancer
0:41 - The Peritoneum
0:59 - Cytoreductive Surgery
1:46 - HIPEC
2:37 - Patient Approach