- May 20, 2019
- Posted by: Dr. Amit Gandhi
- Category: CANCER, Uncategorized
Cancer is a life-threatening disease and just like various other cancers, ovarian cancer is associated with high mortality rate across the world. In fact, as anticipated by the American Cancer Society in 2018, more than 20,000 women have been diagnosed with ovarian cancer and 14,000 among them died.
Though the mortality rate remains high, still scientists and medical experts are practicing advanced technologies and techniques in order to find a complete cure for ovarian cancer. With the ongoing treatment challenges, one of the treatment options has been able to make a remark to some extent. This treatment is applicable for ovarian cancer of all stages but has proven remarkable results for the newly diagnosed ovarian cancer.
This new and advanced treatment option for ovarian cancer is HIPEC and in this post, we will discuss the same.
Current Treatment for Ovarian Cancer
With a high mortality rate among various types of gynecologic cancers, ovarian cancer has become a leading cause of concern. Most of the patients are diagnosed with advanced stage ovarian cancer and the most effective treatment for this involves maximum debulking surgery followed by a series of chemotherapy.
For patients who are not suitable for primary surgery, primary chemotherapy is practiced, which is further followed by regular intervals of debulking after 3 sessions of chemotherapy. Despite this, for most of the cases, the outcome remains dismal for patients suffering from advanced stage ovarian cancer.
Intraperitoneal or regional chemotherapy theoretically leads to a decreased rate of systemic toxic effects and may enhance results by alleviating residual microscopic ailment more effectively as compared to intravenous chemotherapy. However, it may not result in 100% success and hence it becomes essential to practice, other advanced treatment option like HIPEC.
HIPEC Treatment for Ovarian Cancer
HIPEC is Hyperthermic Intraperitoneal Chemotherapy, which means practicing intraperitoneal chemotherapy during the surgical process offered under hyperthermic conditions. The process has a multifactorial rationale to be used under hyperthermic conditions when offering intraperitoneal chemotherapy.
For clinical hyperthermia, the temperature used is 41 Degree Celsius or more. Hyperthermia has a direct cytotoxic effect on the cancerous cells resulted from impaired DNA repair, induction of heat-shock proteins, denaturation of proteins, together that may serve as receptors to natural kill cells, inhibit angiogenesis and induction of apoptosis.
In addition to the intrinsic cytotoxic effect, hyperthermia releases synergy with some chemotherapeutic agents and boost tumor and peritoneal drug penetration.
Numerous centers across the world have used HIPEC to cure ovarian cancer. Initially, this treatment was developed to offer rare chemoresistant gastrointestinal malignancies. But now it is practiced at the time of surgery after completion of resection. During the process, tubing is placed in the abdomen and chemotherapy drugs are circulated at a hyperthermic temperature of 41Degree Celsius or higher. The process continues from 45-90 minutes and the tubing is then removed and the incision is closed.
What Statistical Data Says?
One study was conducted by van Driel to cure advanced stage ovarian cancer using HIPEC. Based on the implications, the study concluded that results obtained through HIPEC treatment are encouraging. However, still, the question remains on applying these results in everyday clinical practice.
Based on many retrospective data, it is suggested that using HIPEC treatment in women with recurrent ovarian cancer or newly diagnosed ovarian cancer is beneficial. A study from a team of experts from the Netherlands reported on stage 3 randomized trials where women with stage III newly diagnosed ovarian cancer was offered HIPEC at interval surgery after the process of neoadjuvant chemotherapy.
Moreover, the results confirmed that both OS and PFS were improved in women with newly diagnosed ovarian cancer using HIPEC treatment.
HIPEC Now – A Promising Treatment for Ovarian Cancer
As the results from various studies on HIPEC treatment for ovarian cancer and the NEJM study in particular reveal, it can be witnessed that numerous HIPEC programs are available across the country. However, you can expect success with these programs only if they are offered with experienced professionals having the clinical expertise needed to successfully perform cytoreductive surgery and safely administer HIPEC.
The success of HIPEC can be more promising for patients who have no or minimal residual disease after surgery. It is possible to achieve the desired results and more successful outcomes at high-volume centers with a proven track record and well-established program.