HIPEC 'warm chemotherapy' for advanced cancer patients

Thanks to scientific research, we now know more about the progression of some types of cancer. In appropriate cases in advanced stage cancer patients where the cancer recurs, a certain amount of cancer drug is heated with special medical devices and given into the abdomen. This method is called "Hyperthermic Intraperitoneal Chemotheraphy" (HIPEC).

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Before the application of hot chemotherapy (HIPEC), evaluations are made to determine whether the patients are suitable for this treatment. 


If it is found to be suitable, the appropriate dose of chemotherapy drug prepared in varying doses according to the tumor type of each patient is determined. 


All tumors that have spread into the abdomen are removed with surgery. 

Then, the prepared chemotherapy drug is emptied into the abdomen with the help of a special machine. The drug is expected to circulate in the abdomen for close to an hour. 


After this process is completed, the patient is taken to an intensive follow-up and treatment program. In patients receiving standard chemotherapy for cancer treatment, treatment can be started after surgery and healing of the wounds. 


However, in the application of hot chemotherapy, hot chemotherapy is applied during the operation in tumors that are not visible during surgery and cannot be surgically removed.


At which patients can Hot Chemotherapy (HIPEC) not be used?

Since it is accepted that hot chemotherapy is not effective in cancer patients with non-abdominal and distant metastases, it cannot be used in these patients. 


In intraperitoneal membrane cancers such as Hot Chemotherapy (HIPEC), large intestine-rectum cancers, ovarian cancer, appendix cancer, some stomach cancers and malignant mesothelioma, all tumors are removed by surgery. 


Small tumor cells that cannot be seen with hot chemotherapy are destroyed by poisoning with chemotherapy.

HIPEC has no toxic effects on the body

Although very high doses of chemotherapy are given to the body in the treatment of HIPEC, there is no toxic effect because the drugs are not given to the bloodstream. 


Chemotherapy drugs are heated to about 42 degrees. Since cancerous cells are more sensitive to heat than healthy cells, drugs can enter cells more easily due to high temperature. This helps the treatment to be applied better. 


The HIPEC procedure is a procedure that should be performed by specialist physicians in the hospital setting. HIPEC is performed under general anesthesia. 


First, the general surgeon cuts out the tumorous organ and organs where it has spread into the abdomen and the peritoneum. This step is called cytoreductive surgery or CRS. It is then filled with heated fluid containing chemotherapy drugs into the abdomen to target any remaining cancerous cells. 


Oncology specialists in the operating room during the surgery decide on the exact combination of drugs and the duration of stay in the body. This time is usually between 30-90 minutes. The surgical team places a drain in the appropriate position so that the drugs are distributed in the abdomen. 


Warm chemotherapy is applied to the abdomen with the help of the HIPEC device through these drains. After sufficient time has passed, the drugs are discharged from the abdomen. 


The patient's body temperature is monitored by anesthesiologists by administering appropriate fluid therapy during the operation. The effectiveness of HIPEC treatment varies depending on the type of cancer and the extent of its spread to the peritoneum. 


This treatment can be very effective in ovarian, appendix and peritoneal tumors.