Cytoreductive surgery with HIPEC is a complicated procedure that is done by a mesothelioma doctor who specializes in surgical oncology. It is made up of two different surgeries. Usually, the whole process takes 10 to 12 hours. Before or after surgery, a patient may need intravenous or oral mesothelioma chemotherapy. What is HIPEC mesothelioma Cytoreduction surgery?
|What is HIPEC cytoreductive surgery for mesothelioma?|
Peritoneal mesothelioma can only be treated with surgery called cytoreductive surgery. It requires an invasive procedure to take out tumors in the abdomen. In the 1980s, Dr. Paul Sugarbaker, a world-famous oncologist, came up with the idea of combining cytoreduction with hyperthermic intraperitoneal chemotherapy (HIPEC) to help his patients live longer. Today, the best way to treat peritoneal mesothelioma is through cytoreduction surgery with HIPEC.
What is HIPEC surgery for mesothelioma cytoreduction?
cytoreductive surgery with hyperthermic intraperitoneal chemotherapy (HIPEC) is a type of mesothelioma surgery that is often recommended to peritoneal mesothelioma patients by their doctors.
Patients with peritoneal mesothelioma only have one surgery option that can cure them and lengthen their lives: cytoreductive surgery with HIPEC.
Cytoreduction surgery with HIPEC is a two-part process. In the first part, visible tumors in the abdomen are removed through invasive surgery. This is called debulking.
The second part is called hyperthermic intraperitoneal chemotherapy, or HIPEC. This is a process in which a warm chemotherapy agent is flushed through the abdomen.
In the 1980s, Dr. Paul Sugarbaker, an oncologist (a doctor who treats cancer), came up with HIPEC cytoreductive surgery. Dr. Sugarbaker, who is now retired, has used this two-step process to treat cancer patients over 1,500 times with success.
For peritoneal mesothelioma, cytoreduction with HIPEC is used
25% to 30% of people with peritoneal mesothelioma can be cured by cytoreduction surgery with HIPEC.
Studies have also shown that people who have had cytoreduction with HIPEC have a median survival time of 53 months. This is about four times longer than the average amount of time a person can expect to live without cytoreduction with HIPEC.
New research shows that sending a patient right away for cytoreduction with HIPEC is important for their long-term survival.
HIPEC helps people live longer after cytoreductive surgery
A 2019 study of more than 1,800 people who were treated for peritoneal mesothelioma with cytoreductive surgery and HIPEC found that the 5-year survival rate went from less than 10% to 50-90%.
Patients who got treatment right away lived an average of 3.2 more years than patients who didn't get surgery.
The researchers said that these kinds of delays happen often, especially in rural areas where there aren't as many options for health care. They came to the conclusion that patients should be sent quickly to a medical center that does cytoreduction with HIPEC so that they can make an informed choice about surgical treatment options.
The Sugarbaker Technique
Many doctors who treat mesothelioma call the method of using cytoreduction with HIPEC the Sugarbaker Technique in honor of the person who came up with it.
People with peritoneal mesothelioma are told that the procedure is the best way to treat it.
HIPEC-based mesothelioma cytoreductive surgery
Cytoreductive surgery with HIPEC is a complicated procedure that is done by a mesothelioma doctor who specializes in surgical oncology. It is made up of two different surgeries. Usually, the whole process takes 10 to 12 hours.
Patients with mesothelioma may need chemotherapy treatments through an IV or orally before or after surgery. When chemotherapy is given intravenously, there is a chance that it will cause bad side effects. This is less likely to happen if the solution is put directly on the abdomen (through a vein).
At the moment, the best way to treat peritoneal mesothelioma is through cytoreductive surgery with HIPEC.
Mesothelioma cytoreductive surgery is the first phase
The first step of HIPEC cytoreductive surgery is to use cytoreductive surgery, also called tumor debulking, to remove all visible tumors from the abdomen.
The extent of the surgery will depend on how far along the disease is and where the tumors are.
Before the surgery, the surgeons will talk about the chance that they will have to remove organs or parts of organs to get rid of the tumors.
Mesothelioma Hyperthermic Intraperitoneal
Chemotherapy is the second phase (HIPEC)
After the cytoreduction surgery is done and all of the visible mesothelioma tumors have been removed, the second part of the procedure, called HIPEC, will start.
The following steps make up the HIPEC procedure:
Through the closed or partially closed incision, the doctor puts a saline solution in the area of the abdomen.
The solution is used to flush out the abdomen.
A solution for chemotherapy is heated to 108 degrees Fahrenheit and added to the saline that is already being used to flush the area.
The surgeon massages the abdomen to make sure that the heated chemotherapy is spread out evenly.
Doctors use a heated chemotherapy agent for mesothelioma to make the drugs work better and get into the cancer cells better. "Hot chemotherapy" is another name for HIPEC.
It is thought that this heated chemotherapy treatment is better at treating peritoneal mesothelioma than chemotherapy given through a vein.
This process also reduces the amount of chemotherapy that gets into the bloodstream, which makes the side effects of chemotherapy treatments given through an IV less severe.
When Does HIPEC treatment for mesothelioma Take Place?
This process usually takes between 60 and 90 minutes, but it depends on the person.
If you have been diagnosed with mesothelioma and are looking into treatment options, our free Questions to Ask Your Doctor Checklist can help you get ready for your next appointment.
Mesothelioma Cytoreductive HIPEC Surgery's Pros
The Annals of Translational Medicine looked at medical data and found that cytoreductive surgery and HIPEC treatment have made peritoneal mesothelioma patients 50% more likely to live longer overall. A 2019 study found that survival rates went up by as much as 90%.
Because of this, medical centers started using the procedure to treat other kinds of cancer, such as cancers of the digestive tract.
HIPEC cytoreductive surgery has been used to treat, among other things:
Gastric cancer (stomach cancer) Ovarian cancer
Due to the way the concentrated one-time dose of chemotherapy drugs work, patients get the benefit of chemotherapy for staying alive without getting sick, throwing up, or losing their hair.
Mesothelioma cytoreductive HIPEC has risks and side effects
Because this surgery is so invasive and takes so long, complications are a big part of how well patients do during and after cytoreductive surgery and HIPEC treatment.
Some things that can go wrong are:
The blood clots. Digestive problems Heart attack Infection
Bleeding inside Death
Even though only a small number of patients report getting sick after surgery, it is important to be aware of the possible problems that could arise.
Some things that could go wrong with cytoreductive surgery and HIPEC are:
Easy to bleed and bruise Changes in blood pressure and heart rate Constipation
I am sick and tired.
Loss of hunger and weight gain Less resistance to getting sick
Most of the time, the high-temperature dose of chemotherapy given during the HIPEC procedure causes the bowels to move more slowly and causes the number of white blood cells and platelets in the blood to rise.
Even though some of these side effects can be serious, they usually go away within a few hours of the procedure.
Cytoreduction and HIPEC Side Effects: How to Cope?
Even when they aren't as bad as the effects of systemic chemotherapy, the side effects of cytoreduction with HIPEC can be unpleasant (a chemotherapeutic drug injected into a vein or given orally).
Read on to find out about common side effects and how to deal with them.
Overall, patients can expect to feel tired after surgery because their body is healing from a complex procedure. Patients will get better over time depending on how much they do every day and how much rest they need.
Loss of hair is another common side effect, but it only lasts for a short time and can be managed with good nutrition and time.
C.Loss of Hunger
One of the most common side effects is losing your appetite, which you can deal with by eating more small meals.
D.Sickness and Pain
The procedure can also cause nausea and pain, but these side effects can be managed with the help of medicines.
There are other risks, like bleeding, infection, and bad reactions to general anesthesia, that come with any major surgery. Most of the time, these side effects are not too bad and can be treated in the hospital.
HIPEC mesothelioma cytoreduction: who qualifies?
Even though surgery with HIPEC and cytoreduction is the best way to treat peritoneal mesothelioma, not everyone can have it.
Before someone is chosen to take part in the treatment, a number of things must be taken into account.
The patient's health at the start is the most important qualification factor. The surgery takes 10 to 12 hours, so the patient must be in good health overall.
The patient's stage of peritoneal mesothelioma is another thing to think about. The treatment will only be offered to people with early-stage peritoneal mesothelioma.
Checking to see if the cancer has reached vital organs shows that it hasn't spread too far. If it has, it can have a big effect on how well the HIPEC cytoreductive surgery works and how well the patient can get better.
If you or someone you care about has been diagnosed with mesothelioma, our Patients Advocates can help. They can tell you about the latest treatments and help you get money to pay for medical bills.
Recuperation from HIPEC Cytoreductive Mesothelioma Surgery
People who have had cytoreduction surgery with HIPEC can expect to feel better after the treatment in about two to three months.
Recovery from the HIPEC Cytoreductive Hospital Stay
The first step in getting better is to stay in the hospital for a short time, either at a cancer center for mesothelioma or at another hospital.
The next step in getting better for patients is getting out of the hospital. They will then go home to continue getting better.
Cytoreductive Recovery at Home for HIPEC
For at least the next two to three weeks, patients will continue to heal at home with light activity and a lot of rest.
Due to the location of the surgery, the digestive system is put under a lot of stress, and some patients will need an IV to get the nutrients they need for a good recovery.
Getting Better After mesothelioma Cytoreductive Surgery
Research has shown that after about 4 months, patients should feel mostly back to normal. The same research shows that between 8 and 12 months, a patient's quality of life improves by a lot.
For the best chance of getting better, patients should:
1.Keep your diet healthy
Good nutrition helps the body heal itself and is a big part of getting better after a procedure. After HIPEC cytoreductive surgery, doctors should talk to their patients about a diet plan.
Most of the time, walking and doing easy things around the house are good ways to get moving. When you get up and walk, your lungs will expand and blood will flow from your legs to your heart. This can help you avoid infections and other problems after surgery.
Dr. David Sugarbaker's contributions to the treatment of mesothelioma
Dr. David Sugarbaker, one of the most well-known experts on mesothelioma, died on August 29, 2018. He was 65 years old. He was known for having a lot of knowledge and coming up with new ways to treat patients, like multimodal therapy. During his 25 years at Brigham and Women's Hospital in Boston, he built his reputation. There, he improved the extrapleural pneumonectomy and was the first to use a multimodal treatment approach. His work as an innovator in surgery helped lower the number of people who died during surgery, helped many patients live longer, and brought the community closer to finding a cure. David Sugarbaker, who was just named director of the Lung Institute at Baylor College of Medicine, is a well-known expert on mesothelioma because he was born with it and lived with it his whole life.
He is known for finding specific gene ratios in tumors caused by this disease linked to asbestos. This helped researchers learn more about the disease and its different clinical subtypes. His work has led to personalized treatments for each patient instead of the ineffective "one size fits all" method. He was one of ten children who grew up in Jefferson City, Missouri, and listened to their father talk passionately about the need to help people with cancer. Sugarbaker started the International Mesothelioma Program (IMP) in Boston in 2002. He has turned the things he learned as a child into a career that has helped people with this deadly disease get better care. In 2014, he moved from Boston to Texas to build a Lung Institute, which will include a Mesothelioma Research Institute that will help find a cure.
He thinks that in the next ten years, he will be able to find the right mix of patients and treatments that will lead to a cure, which is his holy grail. Sugarbaker thinks that improving the quality of life is the key to finding a cure for mesothelioma. He is inspired by the stories of his patients who have been able to live longer and better lives. He is often the main speaker at cancer seminars, and he was even in an episode of "Boston Med" on ABC in which a patient was being treated. His peers and patients see him as a leader in the field, and his father's stories still inspire him.
Dr. Paul H. Sugarbaker's contributions to the treatment of mesothelioma
Dr. Paul H. Sugarbaker is a retired mesothelioma specialist from the Washington Cancer Institute. He specialized in using cytoreductive surgery with intraperitoneal and systemic chemotherapy to treat peritoneal mesothelioma cancer.
In 1993, he started
the Foundation for Applied Research in Gastrointestinal Oncology (FARGO) to support research, education, and patient care in the field of gastrointestinal oncology. He has written more than 780 scientific and scholarly articles, books, and reports. He also co-wrote "Update on Chemotherapeutic Agents Used for Perioperative Intraperitoneal Chemotherapy," which was published in The Oncologist. Through his research and analysis of past patients, he continues to share his knowledge and help make progress in how to treat cancer.