Kauvery Hospital Successfully Treats Advanced Appendiceal Cancer

Chennai: Kauvery Hospital, a healthcare chain in Tamil Nadu, successfully treated a 63-year-old woman with an advanced stage of appendiceal cancer (peritoneal cancer) through surgery (Debulking Surgery & Hyperthermic Intraperitoneal Chemotherapy (HIPEC).

The procedure involves pumping heated chemotherapy drug into the abdominal cavity, to act upon the cancer cells which are not visible to the naked eye.

Speaking about the patient, Dr. U. P Srinivasan, Consultant GI Surgeon, Kauvery Hospital Chennai, said, "The woman came to us with an unusual bloating of her stomach. She was diagnosed to have a cancerous tumor in her abdomen which had to be treated immediately. She had been to different healthcare centers previously and none were able to identify that it was a cancerous tumor. She was denied surgery owing to the complexity of the condition, as she had undergone multiple surgeries in the past which included hysterectomy (removal of uterus and ovaries) in the recent past."

"To rule out the possibility of the spread of cancer to other organs such as liver, lungs, spine, etc., we did a PET scan. Fortunately, there was no spread of the tumor. Hence we recommended debulking surgery and HIPEC which was the best possible option available for this patient."

Most cancer treatments have a chemotherapy component and some would involve a combination of surgery and chemotherapy. Generally, chemotherapy is either given as tablets or as an Intravenous medication (IV).

"This type of cancer usually occurs in the appendix, colon, ovaries, etc. At a stage where surgery alone won't be enough, we recommend the HIPEC procedure. In this method, first, the visible tumor cells are removed through surgery which is known as cytoreductive surgery. Thereafter a few tubes are inserted from the device that pumps the chemotherapy drug into the abdominal cavity at a heated temperature of 42 degrees Celsius which is monitored using an intra-abdominal temperature probe. This inflow of liquid goes on for 90 minutes, which impacts the micro cancer cells. We then remove the tubes, check for any bruises or bleeding in the abdomen and complete the procedure," he adds.

Delivering the chemo this way also means that it does not get absorbed systemically. It goes right to where the tumor cells are and doesn't have the kind of systemic side effects that can come with traditional chemotherapy.

The entire procedure took around 9 hours (Surgery & HIPEC) and she was shifted to the ICU. "This procedure is done by highly skilled surgeons, supported by the medical oncologist, intensivist, and anesthesiologist. Post-surgery, they together shall be monitoring the oxygenation and electrolyte status and also the white blood cell and platelet counts," says Dr. U P Srinivasan.

HIPEC treatment improves the longevity of life for a patient who has reached an advanced stage of cancer, with a 5-year survival rate of 20% to 30%. This will eliminate the spreading of tumors to other organs in the body and will aid the patient to live a better quality of life free from cancer.

HIPEC is also an effective palliative therapy for people with malignant ascites or an accumulation of fluid buildup in the abdomen. This is a side effect of having tumors lining the peritoneum. A one-time HIPEC treatment can replace repeated visits for paracentesis for some patients.

Speaking about the successful treatment, Dr. Aravindan Selvaraj, Co-Founder & Executive Director, Kauvery Hospital Chennai says, "Cancer is a dreaded disease across the globe. We have been seeing many innovations in treatment technology and ongoing research has led to successful treatments. This technology of HIPEC is a boon for patients who are finding it hard to survive as they reach an advanced stage. However, all this requires good infrastructure, a well-qualified team, and expertise to execute the whole process. I congratulate Dr. U P Srinivasan and team, for offering to this patient this complex procedure thereby helping the patient to live a disease-free life for a longer period."