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HIPEC Surgery - George's Story

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Posted 10/13/2014

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Things moved pretty quickly for George Rasmussen. A stomach ache sent him to the doctor's office. A scan showed he needed to have his appendix removed. After that surgery, he found out a cancerous tumor on his appendix had burst. A relative referred him to Dr. Jason Foster who specializes in hyperthermic intraperitoneal chemotherapy (HIPEC). During the operation, Dr. Foster removed all the visible cancer from George''s organs. Then, using the HIPEC or "hot chemo" he and the surgical team bathed his organs in a heated solution of chemotherapy to kill the microscopic cancer cells which almost certainly still remained. "With this approach, we do the surgery and the chemo all at once," Dr. Foster explained. "It complements the IV chemotherapy and allows us to treat the organ surfaces and inner abdominal walls which could have been exposed to the cancer." The typical course would be multiple surgeries to remove some of the tumors, followed by multiple rounds of chemotherapy each time the disease recurred. Unfortunately, 65-80 percent of abdominal cancers likeGeorge's will recur, Dr. Foster said. The hot chemo (HIPEC) approach is well-suited for treating cancer in the abdominal cavity since the organs and inner abdominal wall are at risk, and the cancer cells can spread from one area to another. After removing the visible tumors, surgeons close the abdomen, and fill the abdominal cavity with the heated chemo and bathe all the organs with the solution. The cancer-fighting benefit does not just come from the high dose chemo solution itself. "Cancer cells do not dissipate heat well and can be killed by heat; we know that from research," Dr. Foster said. "So for this to work, we had to find a temperature warm enough to kill the cancer cells, but not too hot to damage the healthy tissue inside the body." That temperature is 42 degrees Celsius, or 108 degrees Fahrenheit. Hot chemo treatments can be used for some patients with ovarian and colorectal cancer, and is the primary treatment for cancer of the appendix and peritoneal mesothelioma. "The exact treatment is different for each patient and depends on the type of cancer they have," Dr. Foster said. "But the concept is generally the same." Patients who are candidates for hot chemo treatment are facing very steep odds. They are typically stage four cancer patients and in many cases have already experienced surgery and chemotherapy. "Ideally we would like to see all patients at the time of diagnosis to avoid multiple surgeries but often patients are not aware of this option until they relapse", said Dr Foster. For some people, the treatment has the potential to save a life. In others, it is used to make the remaining months or years more tolerable. "In some cases, it's a quality of life issue," said Dr. Foster. "A patient may be looking at spending what time they have left undergoing traditional chemo and the side effects that sometimes come with it. For the right person, this can be a viable alternative; improving their quality of life Jason Foster, MD and potentially extending their survival. For more information about HIPEC, or to make an appointment with Dr. Foster, visit http://www.nebraskamed.com/cancer or call 1-800-922-0000. Background music: "impromptu in blue" and "Eternal Hope" by Kevin MacLeod www.incomptech.com.