Intraperitoneal Hyperthermic Chemotherapy (IPHC) with Mitomycin C after Cytoreductive Surgery for Patients with Peritoneal Carcinomatosis - a long, technical term for modern medicine in fight against cancer.
I had rare opportunity to speak with Dr. Perry Shen of Wake Forest University. As I listened, he explained how this groundbreaking treatment is extending lives of patients suffering from Peritoneal Carcinomatosis. *(Peritoneal membrane surrounds and lubricates surface of organs within abdomen; eg., colon, gallbladder, spleen, ovaries, intestines, liver, etc..) Because Advanced-stage Peritoneal carcinomatosis (cancer) and disseminated peritoneal lymphomas are often resistant to current chemotherapy treatment, medical researchers out of Wake Forest University have engaged in study and treatment of peritoneal carcinomatosis since 1991.
Dr. John Spratt first began describing using interdominal heated therapy in 1980, and found that this particular method worked well in conjunction with chemotherapy. By giving chemotherapy interdominally with much higher concentrated heat, (41 degrees Celcius - or around 105 degrees Fahrenheit) through tumor-removal surgery, heated medicine showed an increase in its effectiveness; thus, decreasing tumors. (1. Cytoreductive surgery consists of removal of all gross tumors and involved organs, peritoneum, or tissue deemed technically feasible and safe for patient. Any tumors adherent or invasive to vital structures that could not be removes were cytoreduces using cavitational ultrasonic surgical aspirator.)
Overall survival rates were improved of 109 Patients (with peritoneal carcinomatosis) treated between December 1991 and November 1997. (2. Clinicopathologic factors that independently predicted improved overall survival rates.)
A one-time treatment, IHPC lasts approximately 1-2 hours, but standardly, a 2-hour treatment is utilized by Wake Forest University. Initially, patients are cooled to a core temperature of approximately 34 Degrees C to 35 Degrees C. Once cooled, peritoneal perfusion inflow and outflow catheters are placed peroutaneously into abdominal cavity. With temperature probes acting as moderators, abdomen is gently massaged throughout perfusion to enhance drug distribution to all peritoneal areas. Because tumor tissue is more responsive to heat than normal tissue (due to intrinsic thermosensitivity) IHPC improves chemosensitivity of tumor cells to Mytomycin C(MMC).
With an average life expectancy of 3-6 months after diagnosis of Peritoneal Carcinomatosis, patients are gaining new hope as IHPC treatment is extending life by as much as 15 months; and a few selected patients' lives have even been extended to 28-30 months.