Advanced Peritoneal Cancer Treatment: Cytoreductive Surgery and HIPEC

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• Demanding the Best Cancer Treatment
• HIPEC Procedure Explained
• Role of a Medical Second Opinion
• Preventing Peritoneal Metastases
• International Collaboration Effort
• Full Transcript

Demanding the Best Cancer Treatment

Dr. Paul Sugarbaker, MD, states that patients must take an active stance in seeking the best cancer treatment. He advises patients to learn what the best treatment protocols in the world are for their specific cancer. This proactive approach saves money, saves lives, and ultimately allows people to live longer and happier. Patients should push their surgeons and oncologists for the highest quality of care, even seeking treatment internationally if necessary.

HIPEC Procedure Explained

The best treatment for peritoneal metastatic cancer often involves a two-part procedure. Cytoreductive surgery is performed to remove all visible tumor deposits within the abdomen. This is followed immediately by Hyperthermic Intraperitoneal Chemotherapy, or HIPEC. HIPEC is a heated chemotherapy bath that circulates throughout the abdominal cavity to destroy any remaining microscopic cancer cells. Dr. Paul Sugarbaker, MD, is a renowned expert in this advanced surgical technique for cancers like colon, ovarian, gastric, and appendiceal cancer.

Role of a Medical Second Opinion

Dr. Anton Titov, MD, and Dr. Paul Sugarbaker, MD, highlight the critical importance of a medical second opinion. For advanced stage 4 cancer with peritoneal metastases, a second opinion can clarify the diagnosis. It confirms whether a curative approach with cytoreductive surgery and HIPEC is a possibility. This process helps patients select a precision medicine treatment plan, ensuring they are on the best possible path forward.

Preventing Peritoneal Metastases

Dr. Paul Sugarbaker, MD, discusses the future goal of tertiary prevention. This means preventing peritoneal metastases from occurring in the first place in cancers like colon, gastric, and ovarian cancer. Even if the primary cancer is not completely cured, preventing its spread to the peritoneal cavity can dramatically change the disease's natural history. This prevention would represent a huge accomplishment in oncology, sparing patients from what Dr. Sugarbaker describes as one of the worst methods to die from cancer.

International Collaboration Effort

The fight against peritoneal metastatic cancer is a global effort. Dr. Paul Sugarbaker, MD, notes the strong camaraderie between leading groups in the United States, UK, France, Germany, Holland, Japan, and Korea. These teams work together to advance the techniques of cytoreductive surgery and HIPEC. As Dr. Anton Titov, MD, observes, this international, borderless collaboration is essential because cancer itself knows no borders. This united front is spearheading progress against this terrible manifestation of cancer.

Full Transcript

Dr. Anton Titov, MD: Renowned Harvard-trained American cancer surgeon talks about the importance of an active stance of patients in seeking the best cancer treatment. Patients must demand the best cancer treatment from oncologists and surgeons. International collaboration between cancer specialists is important to spread the best cancer treatment methods around the world.

Find the best treatment for peritoneal metastatic cancer.

Dr. Paul Sugarbaker, MD: Metastatic cancer patients must seek the best and most aggressive surgeon to treat metastatic colon cancer, gastric cancer, ovarian cancer, and appendiceal cancer. Patients have to learn what is the best treatment in the world for their cancer.

The future for peritoneal surface oncology is tertiary prevention of peritoneal metastatic cancer from colon cancer or ovarian cancer. Colon cancer, gastric cancer, and ovarian cancer spread in the abdomen and peritoneal cavity.

Peritoneal metastases in advanced stage 4 colon cancer are treated by cytoreductive surgery and Hyperthermic Intraperitoneal Chemotherapy (HIPEC), or hot chemo bath with heated chemotherapy.

Dr. Anton Titov, MD: A medical second opinion clarifies colon cancer or ovarian cancer diagnosis. A medical second opinion confirms that a cure is possible in metastatic colon cancer.

Intraperitoneal chemotherapy treatment is for advanced stage 4 cancer with metastatic lesions in the abdomen.

Dr. Paul Sugarbaker, MD: A medical second opinion helps to select a precision medicine treatment for stage 4 ovarian cancer, stage 4 colon cancer, or metastatic stage 4 gastric cancer. Get a medical second opinion on advanced cancer with peritoneal metastases.

Best peritoneal metastatic advanced cancer treatment is by surgical operation and regional chemotherapy.

Dr. Anton Titov, MD: It is important for patients with many serious diseases to find the most precise and complete diagnosis, especially for cancers that will require surgical treatment and for complicated chemotherapy treatments.

Patients have to learn what is the best treatment in the world for their cancer. Patients have to know the best treatment protocols. Then patients must try to find the place for the surgery and medical oncology treatment where cancer treatment is the best in their region and possibly internationally.

This method to diagnosis and treatment saves money. It saves lives and ultimately makes people live longer and happier.

Dr. Paul Sugarbaker, MD: Anton, probably the worst method to die from cancer is with peritoneal metastases. It is the ugliest method to leave this Earth. Peritoneal cancer metastases lead to intestinal obstruction.

Patients with peritoneal metastatic cancer usually have one or two or three operations to palliate the obstruction and the pain from cancer so that they can live for a few more months.

Sometimes we could prevent peritoneal metastases from colon cancer, gastric cancer, pancreas cancer, or ovarian cancer. Sometimes we could completely prevent or treat peritoneal metastases from these cancers, even though we perhaps did not cure the primary cancer completely.

But we would change the natural history of gastric cancer, pancreas cancer, or colon cancer forever.

One of the things that is a future for peritoneal surface oncology is tertiary prevention of peritoneal metastatic cancer. The patient might have abdominal cancer, such as colon cancer, gastric cancer, ovarian cancer, or pancreatic cancer.

But if we can prevent through some nuance in treatment the adverse outcome of that cancer, sometimes we could prevent deaths from peritoneal metastases from cancer. This would be a huge accomplishment for oncology.

Dr. Anton Titov, MD: Twenty-three years after actress Audrey Hepburn died from peritoneal metastases from appendiceal cancer, a huge progress in peritoneal metastatic cancer treatment has been made. You, Dr. Sugarbaker, and your colleagues made enormous progress in treatment of peritoneal metastases from colon cancer, ovarian cancer, and gastric cancer.

Today if Audrey Hepburn was treated in your hands, she could have lived longer and had a higher quality of life. I'm careful not to use the word "cure" to describe Audrey Hepburn's peritoneal metastatic cancer from the appendix, but cure is a possibility today in similar cancer that Audrey Hepburn had. Correct?

Dr. Paul Sugarbaker, MD: OK. One of the things that you were asking before is this: how is it that we have maintained our continued enthusiasm to combat peritoneal cancer metastases? I would have to say the following to answer that question.

Dr. Anton Titov, MD: It is the relationships and the camaraderie that we have built up around the globe to attack peritoneal metastatic cancer together. This camaraderie has been most satisfying.

Peritoneal metastatic cancer treatment is an effort that involves the best groups in the United States, the UK, France, and Germany. Holland has been very active in the effort to develop cytoreductive surgery and Hyperthermic Intraperitoneal Chemotherapy (HIPEC). Japan and Korea have participated in advancing cytoreductive surgery and Hyperthermic Intraperitoneal Chemotherapy (HIPEC).

Dr. Paul Sugarbaker, MD: We are all working together. We all are worrying together about what the next best step is in curing this terrible manifestation of cancer.

Dr. Anton Titov, MD: Cancer has no borders. Cancer knows no borders. Therefore, what you are doing is a true international borderless collaboration to treat peritoneal metastatic cancer. You are spearheading this very important cancer treatment.

Dr. Sugarbaker, thank you very much for this wonderful, detailed, and thorough conversation. I'm sure that this conversation about treatment of peritoneal metastases in cancer will be very helpful for those people around the world who will watch our conversation.

Physicians and patients will hopefully watch and learn about best practices of peritoneal metastatic cancer treatment.

Dr. Paul Sugarbaker, MD: Patients clearly have to be more proactive in seeking the best treatment. Patients even have to be pushing their surgeons for the best treatment. Thank you very much!

Absolutely. It has been a pleasure! Thank you, Anton.

Dr. Anton Titov, MD: Cancer patients must demand the best treatment and quality of care from surgeons and doctors. Find the best treatment for metastatic cancer with a leading cancer surgeon.