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Gastrointestinal Cancers

Hyperthermic Intraperitoneal Chemotherapy (HIPEC) and Cytoreductive Surgery (CRS)

Learn more about advanced treatments for peritoneal and other cancers at the OSUCCC – James.

    As central Ohio’s leading provider of comprehensive cancer care, we use the latest techniques to treat different cancer types. Experts at the OSUCCC – James work every day to research and develop treatments that target advanced disease. This includes techniques to treat advanced cancers in the abdominal cavity, such as hyperthermic intraperitoneal chemotherapy (HIPEC) and cytoreductive surgery (CRS).

    What is CRS/HIPEC?

    The abdominal cavity contains a lining called the peritoneum. The peritoneum houses your digestive and reproductive organs. This lining provides physical support for those organs to keep them in place and allows for the movement of fluid and other important functions (including nerves and blood vessels) to support those systems. Often, cancer that starts in these organs can metastasize (spread) into the peritoneum. When this occurs, treatment can be complex. Cytoreductive surgery (CRS) and hyperthermic intraperitoneal chemotherapy (HIPEC) are specialized procedures that can be used as treatment for those with advanced cancers, and rare primary cancers, of the abdominal cavity.

    CRS and HIPEC treatments are reserved for those with advanced disease; cancer is described as “advanced” when it has spread within the abdominal cavity. CRS with or without HIPEC can be used as part of an overall aggressive cancer treatment plan. Cytoreductive surgery removes all visible tumor while HIPEC destroys cancer cells that may be left over after surgery.

    These treatments occur inside the operating room. The general progression is as follows:

    1. Surgical exploration: The first phase includes exploratory surgery where the inside of the abdomen is evaluated to determine how much cancer has spread within the abdominal cavity, and to identify the location of any tumors / organ involvement by tumors.
    2. CRS: The second phase of treatment is called cytoreductive surgery (CRS). During CRS, surgeons remove all visible diseased tumor tissue. By surgically removing the cancerous tumors along with affected organs as necessary, this reduces the likelihood of cancer coming back or spreading more.
    3. HIPEC: HIPEC is the third phase where heated chemotherapy is perfused directly into the abdomen to eliminate any remaining cancer cells. Chemotherapy then circulates inside the abdomen at 107.6°F (42°C) for 60–90 minutes depending on the agent used. Following the treatment, the chemotherapy solution is completely flushed from the abdomen.

    The OSUCCC – James is one of only a few select centers in the country to offer CRS with HIPEC. This treatment can be offered for treatment of certain cancers that arise from the lining of the abdomen, or for other cancers that have spread through the abdominal cavity from other organs.

    What are the potential benefits of HIPEC?

    While HIPEC is a more aggressive form of treatment for advanced disease, it has several advantages over more traditional chemotherapy administration. Once your doctors have determined this is an ideal treatment for you, some of the benefits may include:

    • Fewer side effects. HIPEC directly attacks the cancer cells in the abdomen instead of filtering through the entire body like traditional chemotherapy. Because the solution is washed away, the ongoing potential toxic impact of the medicine is greatly reduced.
    • Reduced symptoms. CRS/HIPEC can reduce some of the symptoms associated with late-stage diseases.
    • More effectively eliminates cancer cells. HIPEC is a powerful, concentrated cancer fighting treatment that circulates throughout the abdomen. Because the medicine is heated, it works more quickly and effectively to destroy any cancer cells that may linger after surgery.
    • Improved outcomes. Research shows that this type of highly directed treatment can significantly extend survivorship for those who have been determined as appropriate treatment candidates.

    HIPEC procedure risks

    While HIPEC may be helpful for those eligible for treatment, it’s considered major surgery and has associated potential risks and complications that can occur. Your oncologist(s) will discuss any potential risks of the procedure.

    HIPEC procedure program

    The OSUCCC – James HIPEC procedure program experts work to address the unique needs of those diagnosed with advanced, metastatic peritoneal cancer.

    The multidisciplinary team of specialists and subspecialists, including experts in surgical oncology, medical oncology, gynecologic oncology, radiation oncology, radiology, pathology and more, all work together. This team specializes in treating peritoneal cancers and works directly with you to design the very best personalized treatment plan. In fact, the OSUCCC – James is considered one of the best hospitals for cancer treatment in the nation according to U.S. News & World Report.

    If you’ve been diagnosed with peritoneal cancer or would like a second opinion, please call The James Line at 800-293-5066 or 614-293-5066 (Ohio) to make an appointment.

    Learn more about HIPEC and peritoneal cancer

    Are You a Candidate for HIPEC?
    HIPEC and Innovation at The James
    HIPEC Treatment Team
    Peritoneal Cancer
    Peritoneal Cancer Treatment Options