Hot Chemotherapy (HIPEC)

What is Hot Chemotherapy (HIPEC)?

In recurrent or suitable advanced-stage cancers, the process of applying a certain amount of cancer drug to the abdomen after all visible tumors are removed by surgery for a certain period of time by heating with special medical devices and washing the inside of the abdomen is defined as hot chemotherapy.

Is Hot Chemotherapy (HIPEC) a New Hope for the Treatment of Advanced Stage Cancer Patients?

The progression and behavior of some cancers are now better understood. Hot chemotherapy has also become standard practice, as it significantly prolongs the life span for suitable cancer types.

To Whom Is Hot Chemotherapy (HIPEC) Applied?

Hot chemotherapy is applied to many different types of cancer. Hot chemotherapy treatment can be applied in ovarian cancer, colorectal cancer, peritoneal cancers, some stomach cancers, and appendix cancers, which are stage 4 when first diagnosed or recurred, and are thought to be limited to the abdomen and can be completely removed.

What are the Benefits of Hot Chemotherapy (HIPEC) Treatment for the Patient?

In patients receiving standard chemotherapy for cancer treatment, their treatment can be started a few weeks after their wounds heal and surgery. However, the application of hot chemotherapy is different. Hot chemotherapy is applied during surgery in tumors that are shrunk to 2 mm and are invisible during surgery and cannot be surgically removed. In this way, it is aimed to eliminate the tumors. This is one of the important gains of the hot chemotherapy application for the patient.

How is Hot Chemotherapy (HIPEC) Applied?

Before the application of hot chemotherapy (HIPEC), the patient is evaluated and his/her suitability for this treatment is evaluated. Afterward, the appropriate dose of chemotherapy drug is determined according to the tumor type of each patient. After all the tumors that have spread into the abdomen are removed by surgery, the prepared chemotherapy drug is released into the abdomen with the help of a special machine and the drug is circulated in the abdomen for about an hour. After the completion of this procedure, the patient is taken to an intensive follow-up and treatment program.

How Effective Is Hot Chemotherapy (HIPEC) in Ovarian Cancer?

In recent studies, there is a 5-year life expectancy that reaches 52 percent in ovarian cancers with appropriate cleaning surgery with hot chemotherapy added. In tumors with better behavior, good chemotherapy sensitivity, and spread to fewer organs, this rate can reach up to 80% for 5 years.

How Effective Is Hot Chemotherapy (HIPEC) in Peritoneal Cancer?

In the case of intra-abdominal cancer called malignant mesothelioma, if appropriate and clean surgery and hot chemotherapy can be applied, 5-year life expectancy can be up to 40 percent. The average life expectancy in these patients is 6-12 months with standard treatments.

How Effective Is Hot Chemotherapy (HIPEC) in Appendix Cancer?

5-year life expectancy is 80-90% with clean surgery and hot chemotherapy to be applied in intra-abdominal diffusion of appendix cancers with good behavior, and 5-year life expectancy in appendix cancers with worse behavior is around 50%. If left without hot chemotherapy, the 2-year life expectancy in these patients is very low.

How Effective Is Hot Chemotherapy (HIPEC) in Colon Cancer?

Studies conducted on this subject show that while the average life expectancy in colorectal cancers with intra-abdominal diffusion is 6-12 months with standard treatments, a 5-year life expectancy increases to around 40 percent with a very clean surgery and hot chemotherapy to be performed in selected appropriate cases. 

How Effective Is Hot Chemotherapy (HIPEC) in Stomach Cancer?

Although studies on hot chemotherapy in stomach cancer have not yet been fully clarified, it has been determined that general life expectancy can be increased by at least 12 more months with hot chemotherapy in well-selected cases.

Are There Any Side Effects of Hot Chemotherapy (HIPEC)?

Hot chemotherapy, like other treatment methods used in cancer treatment, has some side effects. Some side effects such as loss of bone marrow function, kidney failure, liver poisoning, lung failure, psycho-neurological disorders, heart, brain, and lung disorders, and clotting in the main vessels can be observed.

In Which Situations Is Hot Chemotherapy (HIPEC) Not Applied?

It is accepted that hot chemotherapy is not effective in cancer patients with distant metastases that are not confined to the abdomen. Therefore, the HIPEC procedure cannot be used for this group of patients.

In Which Cancers Is Hot Chemotherapy (HIPEC) Effective?

In peritoneal cancers such as colorectal cancer, ovarian cancer, appendix cancer, some stomach cancers, and malignant mesothelioma, almost complete tumor removal is performed by surgery. Small tumor cells that are invisible to the naked eye are poisoned and destroyed by chemotherapy.

Is Cancer Staging Performed on Hot Chemotherapy (HIPEC) Patients?

This procedure is applied only in diffuse tumors that are determined to be stage 4, have not metastasized to different organs, and are limited to the abdomen. For this reason, there is no need for additional cancer staging in patients who have been given hot chemotherapy.

Is Systemic Chemotherapy Also Applied After the Operation to Hot Chemotherapy (HIPEC) Patients?

In this regard, the condition of the patient and the disease is the determining factor. Systemic chemotherapy can also be applied after the application of hot chemotherapy in tumor types that are thought to recur rapidly or early, although it generally depends on the type of tumor.

Do Microscopic Tumor Cells Disappear with Hot Chemotherapy (HIPEC)?

Yes, studies have shown that the greatest effect of hot chemotherapy is that it traps or destroys the remaining invisible small tumors and cells.

What are the Most Common Problems After Hot Chemotherapy (HIPEC)?

Generally, patients who will receive HIPEC treatment are patients who have undergone previous surgery and have received long-term chemotherapy in a debilitated condition. There are serious complications of a very heavy surgery and subsequent hot chemotherapy due to general anesthesia and multiple organ removals to be performed. Internal or external sutures, wound dehiscence, bleeding, lung, liver, kidney, bone marrow failures, and severe intra-abdominal adhesions are the most common problems. Therefore, determining whether patients will survive such a process is the most important step before the procedure.