The HIPEC Procedure: Learn More About This Advanced Cancer Treatment

Malignancies such as gastrointestinal tumors, ovarian cancer, mesothelioma, and appendiceal cancer often metastasize, or spread to the abdominal cavity – the largest hollow space of the body that stretches from the diaphragm to the upper plane of the pelvic cavity. The abdominal cavity is lined by the peritoneum, a membrane that covers not only the inside wall of the cavity (parietal peritoneum) but also every organ in it (visceral peritoneum). The space between the visceral and parietal peritoneum is called the peritoneal cavity. Chemotherapy is usually the treatment of choice in these cases. Unfortunately, the prognosis is often bad.

The problem with conventional chemotherapy in these cases is that it is almost always administered intravenously, while many of these cancers have poor blood circulation, meaning it is difficult for the chemotherapy drugs to reach their targets via the circulatory system.

What is HIPEC Surgery?

Hyperthermic intraperitoneal chemotherapy (HIPEC) is a chemotherapy ‘wash’ applied after surgical removal of visible abdominal tumors through cytoreductive surgery. During the HIPEC procedure, the peritoneal cavity is bathed in highly concentrated doses of chemotherapy at an elevated temperature of 42 degrees Celsius. After about 90 minutes of the infusion, the chemotherapy drugs are washed out.

Benefits of the HIPEC Procedure

HIPEC allows administering approximately 20 times the IV dose of chemotherapy, drastically increasing efficacy. Since the chemotherapy is delivered locally rather than systemically, the resulting toxic effects are also minimized. This high, heated dose of chemotherapy, combined with surgical removal of tumors, is currently the most effective method of addressing metastatic cancer in the abdominal cavity.

As reflected by published studies, the results of HIPEC far exceed those of conventional chemotherapy or surgery alone.

Who is a Candidate for HIPEC?

The HIPEC procedure is used to treat metastatic abdominal cancer, which often originates from gastrointestinal tumors, ovarian cancer, or mesothelioma. To qualify for a HIPEC procedure, a patient must fulfill several criteria. These include:

• Metastatic cancer limited to the peritoneal cavity, without spread to distant organs, as confirmed by a chest/abdomen CT or PET-CT.
• The patient should have a good functional status and be free of other significant diseases, such as kidney or cardiovascular disease.

HIPEC Procedure at Sheba Medical Center

With a very high success rate, more than 500 patients have already undergone the HIPEC procedure at Sheba Medical Center in Israel, recognized as a global leader in its application. Prof. Aviram Nissan, Head of the Surgical Oncology Department at Sheba, was one of the first doctors worldwide to train in this innovative procedure, and surgeons from around the world travel to Israel to learn how to perform HIPEC from Prof. Nissan.
At Sheba, the HIPEC procedure can also be performed laparoscopically by creating tiny port incisions through which a camera and instruments are inserted into the abdominal cavity instead of using a long incision as in open surgery. Laparoscopic HIPEC patients require no surgical drains and are typically able to leave the hospital after just a few days.
Other advantages of receiving treatment at Sheba include:

• As a government institution, we have no hidden costs, and our fees are transparent. Although we offer advanced treatments that are available only in select medical institutions around the world, our prices are affordable.
• Sheba treats each patient as a unique individual, personalizing every therapy program.
• Sheba’s 360-degree care approach to every patient, which means that Sheba’s professionals will assist you with arranging medical record reviews, travel, visas, accommodations, and language interpretation as needed.
• Sheba has full accreditation from the Joint Commission International (JCI), the premier international healthcare accrediting group. 
• Sheba has both advanced treatment and laboratory facilities. At Sheba, patients receive every aspect of their treatment in a single facility.
• Our physicians are actively involved in the latest research and application of progressive treatments.
• Multidisciplinary medicine: at Sheba, specialists from various departments collaborate to create a holistic treatment plan.