Traditional chemotherapy treatment involves the administration of anti-cancer drugs. Mesothelioma patients have two main methods of receiving this treatment. One such method, known as systemic therapy, introduces chemotherapy to patients in a pill form or through direct injection into a vein. Both forms allow the drug to enter the patient’s bloodstream and travel throughout the body, attacking cancer cells wherever they lie.
For mesothelioma, the second form of administration is used, where the drug is injected directly into the body cavity where the cancer resides. These drugs might be introduced either intrapleurally, through the chest cavity, or intraperitoneally, meaning they are injected into the abdominal region.
A new peritoneal mesothelioma option called Heated Intraperitoneal Chemotherapy (HIPEC) promises to change that however. HIPEC is the second stage of a treatment option that begins with surgery during which as much of the tumors growing in the mesothelioma patient’s abdomen as possible are removed.
Immediately following surgery, HIPEC commences in the form of an intra-abdominal lavage infused over one to two hours, made up of a chemotherapeutic agent in a sterile solution heated to between 111 degrees Fahrenheit and 114 degrees Fahrenheit. The intraperitoneal environment itself is maintained at a temperature between 107 degrees Fahrenheit and 109 degrees Fahrenheit. At the end of the perfusion interval, the solution is drained from the operation site.
Thereafter the perfusion is repeated once a week for three to four weeks, depending upon the attending oncologist’s preference.
The purpose of HIPEC is to eliminate those metastases too small to make surgical removal a viable option. The first procedure is done immediately following surgery in order to wash away any potentially metastatic cells dislodged from the primary tumors during surgery. Heating the chemotherapeutic agents allows them to penetrate tumors more effectively.
In traditional chemotherapy, chemotherapeutic agents are infused intravenously through a peripheral site that is generally far from the tumors they are treating. In HIPEC, however, chemotherapeutic agents are infused directly at the site of the mesothelioma tumors, increasing their concentration which makes them more effective. Additionally, HIPEC has been linked to fewer side effects than traditional peritoneal mesothelioma chemotherapies.
Unfortunately HIPEC is only effective with patients suffering from peritoneal mesothelioma and other abdominal cancers. Patients who have been diagnosed with pleural or pericardial mesothelioma will need to discuss other treatment options with their oncologists.