HIPEC (hyperthermic intraperitoneal chemotherapy) is a special kind of chemotherapy that is used to treat cancer in the abdomen. Unlike traditional chemotherapy, HIPEC is given during surgery. First, the surgeon removes any visible cancer in the abdomen, then a warm solution of chemotherapy drugs is put into the abdomen.
HIPEC and traditional chemotherapy work differently in several key ways:
- Delivery method:
HIPEC is delivered directly into the abdominal cavity, bathing cancer cells with high concentrations of the drugs. Traditional chemotherapy uses intravenous (IV) infusion or oral medication to deliver drugs throughout the body, so cancer cells are exposed to lower, systemic drug levels. HIPEC achieves much higher local drug concentrations.
- Treatment duration:
HIPEC typically lasts 30-90 minutes. Chemotherapy infusions are done over several hours or days. So HIPEC leads to a shorter exposure to the drugs.
HIPEC doses tend to be lower since the drugs are confined to the abdomen. This can reduce side effects and toxicity compared to higher IV doses used for traditional chemotherapy.
HIPEC specifically targets cancer cells in the abdominal cavity, including metastases on abdominal organs and surfaces. Traditional chemotherapy circulates through the whole body, so it targets cancer cells throughout the body in a less targeted fashion.
HIPEC is usually used after cytoreductive surgery to remove as much cancer as possible. It helps destroy any remaining microscopic cancer cells. Chemotherapy is also often used before or after surgery but has a more systemic function.
Some cancers may develop resistance to chemotherapy over time. Doing chemotherapy intraperitoneally with HIPEC can potentially overcome drug resistance that develops from traditional IV chemotherapy delivery.
So in summary, HIPEC allows for higher drug doses, shorter exposure, less toxicity, more targeted treatment, and can possibly overcome treatment resistance compared to traditional chemotherapy.
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Some doctors still view HIPEC (hyperthermic intraperitoneal chemotherapy) as a controversial procedure for multiple reasons.
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Hyperthermic intraperitoneal chemotherapy: Rationale and technique
González-Moreno S. Hyperthermic intraperitoneal chemotherapy: Rationale and technique. World Journal of Gastrointestinal Oncology. 2010;2(2):68. doi:10.4251/wjgo.v2.i2.68
Then and now: cytoreductive surgery with hyperthermic intraperitoneal chemotherapy (HIPEC)...
Neuwirth MG, Alexander HR, Karakousis GC. Then and now: cytoreductive surgery with hyperthermic intraperitoneal chemotherapy (HIPEC), a historical perspective. J Gastrointest Oncol. 2016;7(1):18-28. doi:10.3978/j.issn.2078-6891.2015.106
Hyperthermic intraperitoneal chemotherapy (HIPEC) in the management of peritoneal...
Ray MD, Dhall K. Hyperthermic intraperitoneal chemotherapy (HIPEC) in the management of peritoneal surface malignancies – an evidence-based review. Current Problems in Cancer. 2021;45(6):100737. doi:10.1016/j.currproblcancer.2021.100737