Metastatic cancer presents unique challenges in treatment, but advancements in medical technologies and therapies, such as HIPEC (Hyperthermic Intraperitoneal Chemotherapy) and PIPAC (Pressurized Intraperitoneal Aerosol Chemotherapy), are transforming outcomes for patients worldwide. These cutting-edge techniques offer hope where traditional treatments may fall short. In this article, we explore the benefits of HIPEC and PIPAC, highlight top doctors and clinics globally, and guide you on finding the best care for metastatic cancer.
Understanding HIPEC and PIPAC: Game-Changing Cancer Therapies
What is HIPEC?
HIPEC involves the direct administration of heated chemotherapy drugs into the abdominal cavity after the surgical removal of visible tumors. The procedure ensures higher drug concentration in the targeted area while minimizing systemic side effects. HIPEC is particularly effective in treating cancers such as peritoneal mesothelioma, ovarian cancer, and colorectal cancer with peritoneal metastases.
What is PIPAC?
PIPAC delivers chemotherapy as a pressurized aerosol spray into the peritoneal cavity through minimally invasive laparoscopic surgery. The pressurization enhances drug penetration into the tumor, requiring lower doses and reducing toxicity. PIPAC is often used in palliative settings to improve the quality of life and extend survival in patients with advanced-stage peritoneal cancer.
Latest medical advances introduce practitioners offering alternatives for HIPEC or PIPAC surgery for those patients who can’t have the procedure done.
What is Regional Chemoperfusion?
Regional chemoperfusion techniques such as isolated thoracic perfusion with chemofiltration and isolated abdominal/pelvic perfusion with chemofiltration offer alternative treatment options. These methods involve the localized delivery of high-dose chemotherapy to specific body regions, combined with filtration systems to remove excess drugs from circulation. This targeted approach is particularly beneficial for treating metastatic cancers confined to the thoracic or abdominal cavities, as it limits systemic toxicity while maximizing the therapeutic effect on cancerous tissues.
Benefits of HIPEC and PIPAC
- Targeted Drug Delivery: Both techniques concentrate chemotherapy in the abdominal cavity, sparing healthy tissues and organs.
- Enhanced Effectiveness: Heat and pressure improve drug absorption and tumor sensitivity to chemotherapy.
- Reduced Side Effects: Lower systemic exposure means fewer adverse effects compared to traditional intravenous chemotherapy.
- Improved Survival Rates: For select patients, HIPEC and PIPAC have shown significant improvements in overall survival and disease-free intervals.
Types of Cancers Treated with HIPEC, PIPAC, and Regional Chemoperfusion
In addition to the previously mentioned types of cancer, there are several other cancers that may benefit from HIPEC, PIPAC, and regional chemoperfusion treatments. These therapies are generally used when cancer has spread to the peritoneal cavity, offering localized and direct treatment to the affected areas.
1. Ovarian Cancer
Ovarian cancer frequently spreads to the peritoneum, making HIPEC and PIPAC valuable options for managing the disease when traditional chemotherapy alone isn’t sufficient. A study indicated that combining HIPEC with cytoreductive surgery resulted in improved survival rates compared to traditional chemotherapy alone. However, specific survival percentages vary across studies.
2. Colorectal Cancer
Colorectal cancer, especially in cases of peritoneal metastasis, is one of the most common cancers treated with HIPEC. It helps target cancerous cells in the peritoneum, offering an improved prognosis for patients. For colorectal cancer patients with peritoneal metastasis, HIPEC has demonstrated improved survival outcomes. A systematic review and meta-analysis reported a 3-year survival rate of approximately 24% for patients undergoing HIPEC, with higher rates observed in those receiving prophylactic treatment.
3. Gastric Cancer
HIPEC has been shown to improve survival in patients with gastric cancer who have peritoneal spread. The chemotherapy treatment directly targets the cancerous cells in the peritoneal cavity. HIPEC has been utilized in gastric cancer cases with peritoneal dissemination. While specific survival rates vary, studies suggest that HIPEC can offer survival benefits, especially when combined with cytoreductive surgery.
4. Appendix Cancer
Appendix cancer, particularly pseudomyxoma peritonei, often spreads within the abdominal cavity. HIPEC is frequently used to treat this rare form of cancer, providing a better quality of life and extending survival. Appendix cancer, particularly pseudomyxoma peritonei, often benefits from HIPEC. Research indicates that HIPEC can lead to improved survival rates and quality of life for patients with this condition.
5. Peritoneal Mesothelioma
A rare cancer originating from the lining of the abdomen, peritoneal mesothelioma can benefit from HIPEC as part of a multimodal treatment approach, offering a chance for extended survival.
6. Peritoneal Carcinomatosis
A condition where cancer from other organs, such as the stomach, ovaries, or intestines, spreads to the peritoneum, HIPEC can offer significant benefits in controlling the disease and improving patient outcomes.
7. Endometrial Cancer
Endometrial cancer (cancer of the uterine lining) may spread to the peritoneum in advanced stages. HIPEC and regional chemoperfusion can provide additional control over peritoneal dissemination of the disease.
8. Pancreatic Cancer
Pancreatic cancer can sometimes metastasize to the peritoneum, making it a candidate for HIPEC treatment. When surgery is feasible, HIPEC can be an effective option to treat residual cancer in the abdominal cavity.
9. Liver Cancer (Hepatocellular Carcinoma)
In cases where liver cancer has spread to the peritoneum, HIPEC or PIPAC can be utilized as part of a multidisciplinary treatment approach to target peritoneal metastasis and improve survival rates. Check out TACE for HCC as a reasonable alternative.
10. Small Bowel Cancer
Small bowel cancers that spread to the peritoneum may be treated with HIPEC to address localized peritoneal metastasis. This is often used in conjunction with surgery for maximum benefit.
11. Neuroendocrine Tumors
Neuroendocrine tumors, especially those originating in the gastrointestinal tract or pancreas, can metastasize to the peritoneum. HIPEC can be used to treat peritoneal metastasis, improving patient outcomes.
12. Biliary Cancer (Cholangiocarcinoma)
In advanced stages of biliary cancer, where there is peritoneal spread, HIPEC can offer localized treatment to target the peritoneal deposits and potentially increase survival.
13. Bladder Cancer
While less common, bladder cancer that spreads to the peritoneum may be treated using HIPEC as part of a more aggressive surgical approach aimed at removing cancerous tissue and treating metastases.
14. Melanoma
Advanced melanoma that has metastasized to the peritoneum can be treated with HIPEC, especially when traditional treatments like immunotherapy or targeted therapies are not effective in managing peritoneal spread.
15. Sarcomas
Certain types of sarcomas, particularly those that involve abdominal organs or soft tissue sarcomas with peritoneal spread, may be treated with HIPEC. The localized nature of the treatment helps target sarcoma cells within the abdominal cavity.
16. Mesenteric Tumors
Tumors that develop in the mesentery, the tissue that connects the intestines to the abdominal wall, may benefit from HIPEC treatment, especially when they cause peritoneal spread or carcinomatosis.
17. Cervical Cancer
In advanced stages of cervical cancer, when the disease spreads to the peritoneal cavity, HIPEC and regional chemoperfusion may be used to treat peritoneal implants and enhance survival outcomes.
18. Thyroid Cancer (Follicular and Medullary Subtypes)
Though less common, advanced thyroid cancers, particularly follicular and medullary types, can spread to the peritoneum. HIPEC may be used to address peritoneal metastasis when other treatments are not sufficient.
19. Esophageal Cancer
Esophageal cancer that has spread to the peritoneum can be treated with HIPEC to manage peritoneal metastasis, improving survival in advanced-stage cases where systemic therapies have limited effectiveness.
These cancers, which often present with peritoneal dissemination or metastasis, are the primary targets for HIPEC, PIPAC, and regional chemoperfusion. These therapies are typically used in conjunction with surgery, and their goal is to provide localized chemotherapy directly to the peritoneal cavity, offering an alternative or supplement to traditional chemotherapy treatments for peritoneal cancer spread.
Top Doctors and Clinics Specializing in HIPEC / PIPAC and regional chemotherapy Worldwide
Finding the right specialist and clinic is critical for optimal outcomes. Below is a curated list of leading experts and centers offering HIPEC and PIPAC treatments. The rating and data for analysis are provided by a famous medical travel platform – Airomedical.
1. Spain
- Dr. Domenico Sabia and Dr. Lana Bijelic – a renowned team from Teknon Medical Center in Barcelona Spain, offering the surgery, reporting the highest success rate performing the operations. Doctors with extensive experience in surgical oncology and advanced therapeutic approaches. Together, they have contributed significantly to the field through groundbreaking research and patient-centered care, earning them widespread recognition in the medical community.
2. Germany
- Prof. Dr. Karl Reinhard Aigner – is a renowned expert in oncology and regional chemotherapy, with decades of experience and groundbreaking contributions to surgical oncology. As the Medical Director of Medias Cancer Clinic Burghausen, he has pioneered advanced techniques like isolated liver perfusion and authored 282 scientific publications, earning him widespread respect in the medical community.
- Prof. Dr. med. Martin Strik – is a highly experienced surgeon specializing in general, vascular, abdominal, oncologic, and transplant surgery, with 36 years of expertise. Currently at Helios Hospital Berlin-Buch, he has held leadership roles, authored 163 scientific publications, and is renowned for his innovative research on brain health and advanced surgical techniques, earning widespread respect in the medical community.
- Prof. Dr. med. Karl J. Oldhafer – a renowned surgeon with 40 years of experience, specializes in liver, bile duct, and pancreas surgery. Currently Chief Physician at Asklepios Hospital Hamburg, he has authored 431 scientific publications and received multiple awards for his contributions to liver transplantation, HIPEC, and abdominal surgery, earning him a place among the top physicians in his field.
- Prof. Dr. med. Helmut Friess – a highly experienced surgeon with 35 years of expertise, specializes in abdominal, thoracic, oncosurgery, endocrine surgery, and transplantology. Currently at University Hospital Rechts der Isar in Munich, he has authored over 1,000 scientific publications and received numerous awards for his groundbreaking research in pancreatic surgery, earning him widespread respect in the medical community.
3. Turkey
- Prof. Dr. Metin Cakmakci – is a highly experienced general surgeon with 42 years of expertise, specializes in oncological and breast surgery. Currently at Anadolu Medical Centre in Turkey, he has worked at renowned institutions worldwide and authored 66 scientific articles on breast cancer, trauma, and emergency care. A member of prestigious medical societies, Dr. Cakmakcı is widely respected for his dedication to patient care and medical innovation.
4. Asia
- Dr. K. S. Hemant Kumar – Apollo Hospitals, India. An expert in minimally invasive cancer surgery, Dr. Kumar specializes in HIPEC for gastrointestinal cancers.
- National Cancer Center Hospital – Tokyo, Japan. A leader in innovative cancer treatments, including PIPAC for advanced peritoneal cancer.
5. Australia
- Dr. David L. Morris – St. George Hospital, Sydney. Renowned for his expertise in HIPEC and cytoreductive surgery, Dr. Morris has helped advance peritoneal cancer care in the region.
6. Middle East
- Cleveland Clinic Abu Dhabi – UAE. This state-of-the-art facility offers HIPEC and PIPAC, combined with personalized cancer care programs.
How to Choose the Best Doctor or Clinic for HIPEC/PIPAC?
Selecting the right healthcare provider involves thorough research and consultation. Consider the following factors:
- Experience: Look for specialists with extensive experience and a proven track record in HIPEC and PIPAC.
- Facilities: Ensure the clinic has advanced surgical suites and comprehensive cancer care programs.
- Multidisciplinary Team: Seek centers that offer a collaborative approach involving oncologists, surgeons, and supportive care specialists.
- Patient Reviews: Read testimonials and reviews from previous patients to gauge satisfaction and outcomes.
- Accessibility: Consider the location, language support, and travel logistics, especially for international patients.
To choose the best doctor or clinic for HIPEC (Hyperthermic Intraperitoneal Chemotherapy) or PIPAC (Pressurized Intraperitoneal Aerosol Chemotherapy) using Airomedical.com, start by reviewing the platform’s detailed doctor profiles and clinic specialties. Look for experienced surgeons or centers with expertise in advanced oncological treatments, patient reviews, and success rates. Airomedical which is a medical travel platform, offers a comprehensive database of accredited medical professionals, allowing you to filter options by location, expertise, and patient feedback for a well-informed decision.
Frequently Asked Questions (FAQs)
Are HIPEC and PIPAC suitable for all metastatic cancer patients?
These treatments are typically recommended for specific cancers with peritoneal involvement. A thorough evaluation by a specialist is necessary to determine eligibility.
What are the risks associated with HIPEC and PIPAC?
Common risks include infection, bleeding, and temporary digestive issues. However, these are minimized under expert care.
How can I access these treatments if I live in a remote area?
Many top clinics offer medical travel support, including teleconsultations and assistance with travel arrangements.
Is HIPEC/PIPAC effective for all types of cancer?
While HIPEC and PIPAC are effective for certain types of abdominal cancers, they are not suitable for all cancers. The suitability of the treatment depends on the cancer’s location, stage, and how much it has spread.
What is the recovery time after HIPEC or PIPAC treatment?
Recovery times vary depending on the individual and the extent of the surgery. For HIPEC, recovery typically takes a few weeks, while PIPAC involves a less invasive procedure with a shorter recovery time.
Final Thoughts
HIPEC and PIPAC surgery represent groundbreaking advances in the fight against metastatic cancer. By targeting the disease more effectively and reducing side effects, these treatments provide new hope for patients worldwide. If you or a loved one is exploring advanced cancer therapies, consider consulting one of the top doctors or clinics mentioned in this article. Take the first step towards life-saving care today.
