December 1, 2005 In efforts to boost the effectiveness of anti-cancer drugs, a new method called intra-peritoneal hyperthermic chemotherapy works by flushing a heated chemotherapy drug through tissue surrounding a tumor. Immediately after the tumor is removed, heat boosts the drug's potency and weakens the tumor's ability to repair itself. The targeted delivery means a higher concentration of the anti-cancer drug reaches the tumor.
WINSTON-SALEM, N.C.--There are some cancers against which chemotherapy is virtually useless, but a new technique is making a major difference for some patients.
Day-by-day cancer patient Fred Blum is regaining his strength. Just five months ago, he was battling intestinal cancer -- and the prognosis was bleak. "You just think of this tumor growing and enlarging and getting worse and spreading. And psychologically, it's very hard."
Standard chemo does little to fight advanced abdominal cancers like Blum's. But now, surgical oncologists are using a new twist to make chemo effective and extend survival for patients who often have no other options.
It's called intraperitoneal hyperthermic chemotherapy. It works by flushing a heated chemotherapy drug through tissue surrounding a tumor immediately after the tumor's removed. Perry Shen, an assistant professor of surgery at Wake Forest University Baptist Medical Center in Winston-Salem, N.C., says "That hopefully provides kind of a mop-up or cleanup of any residual cancer cells left behind."
Heat boosts the drug's potency and weakens the tumor's ability to repair itself. The targeted delivery means a higher concentration of the chemo reaches the cancer. "This procedure can provide them a longer-term survival than regular chemotherapy alone," Dr. Shen says.
Before the treatment, Blum's prognosis was about six months. Now, he's planning on staying healthy and strong for a long time.
Some patients are undergoing treatment in an effort to prevent cancer from spreading to the abdomen from nearby organs like the appendix. There's potential the heated chemo could be applied to some non-intestinal, hard-to-treat cancers, like pancreatic cancer.
BACKGROUND: Researchers at Wake Forest University Baptist Medical Center have shown that surgery plus inserting heated chemotherapy drugs directly into the abdomen can improve survival rates, as well as the quality of life, in patients who suffer from several types of cancer. These cancers include tumors of the abdominal cavity (peritoneal cancer, which affects the lining of the abdominal wall) that have spread to multiple organs, and advanced ovarian cancer. Patients with these types of cancer usually fare poorly with conventional cancer treatments.
HOW IT WORKS: There are two stages to the new procedure. First, as much as possible of the cancer is removed with surgery. This often involves multiple organs. Next, while the patient is still on the operating table, the surgeon injects a heated saline solution combined with the chemotherapy drug directly into the abdominal cavity. Scientists have found that tumor tissue is more sensitive to heat than normal tissue. So raising the temperature of the drug makes the tumor less resistant to chemotherapy.
THE RESULTS: The results from four separate studies conducted on animals indicate that the new procedure could kill cancer cells that have spread to other parts of the body. And delivering the drug immediately after the surgery means that more of the drug remains near the tumor instead of spreading throughout the entire body. This means less of the usual unpleasant side effects of chemotherapy.
Editor's Note: This article is not intended to provide medical advice, diagnosis or treatment.