Although treating pseudomyxoma peritonei (PMP) can be difficult, most people living with PMP are typically treated with the goal of curing it. As the experience of specialists develops, there are a growing number of people with PMP who are experiencing many years with no evidence of disease¹ (NED) following cytoreductive surgery² and HIPEC³. The fact that the cancer is usually confined to a specific area (the abdomen) makes it more feasible to remove all of the cancer than certain other cancers. PMP typically does not spread throughout the entire body.
Written by the Pseudomyxoma Survivor editorial team
Updated March 30th, 2023
References
No evidence of disease
No evidence of disease means that tests are not detecting any cancer in the body.
HIPEC
Hyperthermic Intraperitoneal Chemotherapy
Heated chemotherapy, delivered directly into the abdomen, after complete cytoreduction. If the surgeons are able to remove the all the tumours, you may be given HIPEC.
Hyperthermic means that the chemotherapy solution used during the procedure is heated to a higher-than-normal temperature, typically around 41-43°C (105.8-109.4°F). This is usually Mitomycin C. This is put directly in your abdomen while you are in theatre. This elevated temperature is maintained throughout the duration of the procedure, usually around 90 minutes, to enhance the effectiveness of the chemotherapy drugs and to target cancer cells in the abdominal cavity. HIPEC will penetrate tumour nodules up to 2.5mm in size. The combination of chemotherapy drugs and hyperthermia can help to destroy cancer cells (increased cytotoxicity) while minimizing damage to healthy tissue.
Chemotherapy given into the abdomen during surgery is called intraoperative chemotherapy.
Complete cytoreduction
Complete cytoreduction is the complete surgical tumour removal. This is a long operation which takes about 10 hours to complete and includes:
- removal of the right hemicolon
- spleen
- gall bladder
- greater omentum and lesser omentum
- stripping of the peritoneum from the pelvis and diaphragms
- tripping of tumour from the surface of the liver
- removal of the uterus and ovaries in women
- removal of the rectum in some cases
This is also referred to as a full peritonectomy. The goal is to remove tumour nodules down to 2.5mm.
You might also want to read…
What is the most important prognostic factor for pseudomyxoma peritonei?
The key prognostic factor for pseudomyxoma peritonei is how completely the cytoreduction surgery removes all visible tumours.What is the most important prognostic factor for pseudomyxoma peritonei?
Why is HIPEC controversial?
Some doctors still view HIPEC (hyperthermic intraperitoneal chemotherapy) as a controversial procedure for multiple reasons.
Is pseudomyxoma peritonei a cancer?
Yes, pseudomyxoma peritonei (PMP) is a rare cancer that usually starts in the appendix and can spread to the peritoneum, which is the lining of the abdominal cavity.