Hipec

There are a number of people on the colorectal board who have had HIPEC.  I had debulking surgery followed by Intraperitoneal Chemo, which is what Memorial Sloan Kettering does instead of HIPEC - it is a bit more tolerable and less risky; with most if not all of the same rewards (depending on the cancer.  Mine was appendix.)

Make sure whoever does the HIPEC has lots of experience with it - you don't want someone learning on your dad.

westie66 said:

HIPEC Surgery

Hi:  HIPEC surgery is usually (always?) preceded as far as I know by either debulking surgery (often done on women that have ovarian cancer that then spread to the peritoneum - removes entities like the ovaries, omentum, etc.) or peritoneum removal surgery (can be done on women who have ovarian cancer as well but also other patients who have say colon cancer that has spread to the peritoneum).  The latter surgery has been called "the mother of all surgeries" - usually 10-17 hrs long, removes the complete peritoneum which is a huge "bag" that lines the abdominal cavity and is I think 1 cell thick).  These surgeries are then followed by HIPEC which, as far as I can tell, is injection of heated (or sometimes non-heated) chemicals into the abdominal cavity. 

I was in line for the 2nd kind of surgery, the nasty one, which removes the peritoneum before the HIPEC procedure, but I was deemed unacceptable re my age(69)  as well as the fact that I also had mets to the liver.  Only if the liver mets were removed, would the surgeons even consider the peritoneal surgery. 

From what I understand, the HIPEC procedure on its own does not seem to be done without either of these other surgeries but I don't understand why not if the procedure would slow down the growth of the peritoneum tumours.  I've never had an answer to why not, however!

Perhaps your father would be better off having chemotherapy to manage the peritoneum cancer - in other words, view the cancer as chronic and control the growth of the tumours with ongoing chemo? I would think that someone 84 would not be a good candidate for the HIPEC procedure if it had to be preceded with one of the two surgeries described above.  They are nasty and require long convalescent times.  Any other ideas on this?

Cheryl

 

 

 

 

The surgery need not be as extreme as you note, Cheryl.  Removal of the peritoneum is not required.  What is required is removal of virtually all visible tumor, as the chemo cannot penetrate more than a millimeter or so.  Thus, if any larger tumors remain, the HIPEC will not be effective.  That is why it is only done on a "clean" belly.  My surgeon does not like to removed the peritoneum, as that can help keep the cancer cells confined.  I know I had some small bits of my peritoneum removed where cancer had attached, but most of it was left intact.

Regardless, it is still a very hard process to tolerate.