State-of-the-Art Options
In addition to HIPEC, regional therapies are designed for cancers that have begun to metastasize (spread to other parts of the body). These patients often have advanced cancers, and novel treatments represent the most meaningful approach. For example, melanoma that has spread throughout a limb can now be treated with a regional therapy called isolated limb infusion. During this minimally invasive procedure, physicians infuse a heated chemotherapy solution into the limb for 30 minutes. “The response is phenomenal,” Dr. Turaga said. “You can see the tumor shrivel and die.”
Kiran Turaga, MD, MPH
Regional therapies are also available to treat challenging liver cancers. According to William Rilling, MD, Medical College of Wisconsin interventional radiologist, liver tumors that cannot be surgically removed can often be treated with chemoembolization. Using minimally invasive catheter tools, microscopic beads loaded with chemotherapy are deposited at the site of the cancer. “The beads release the drug in a controlled manner over a long period,” Dr. Rilling said.
A similar approach called radioembolization uses radioactive beads. Both procedures expose liver tumors to high-dose therapy while sparing surrounding healthy tissues.
According to Dr. Turaga, HIPEC can be an effective treatment for patients with a variety of cancers that have spread to the abdomen, including colorectal cancer, appendix cancer, mesotheliomas and several other tumors. When Liz Herzog received her diagnosis of metastatic appendiceal cancer, she learned that HIPEC was the most effective therapy available.
The Big Day
Before her HIPEC procedure, Liz received several weeks of standard intravenous chemotherapy. The surgery took place Nov. 9, with Drs. Turaga and Pappas leading the operating room team.
Therasphere® uses microscopic
When they opened her abdomen, the surgeons discovered much less cancer than they expected. “She had a very dramatic response to the chemotherapy,” Dr. Pappas said. “We saw very little disease.” Liz found out more later on: “A nurse told me the doctors were smiling from ear to ear about how well it had worked. She said they were just about dancing in the operating room.”
radioactive glass beads to treat liver cancer. (Photo credit: MS Nordion)
The HIPEC procedure is technically complex and can involve extensive tissue removal. For Liz, the surgery took about six hours, including 90 minutes of heated chemotherapy. “I had very little pain afterward,” Liz said. “I went home in six days.” Subsequent scans of her abdomen, pelvis and chest have shown no evidence of disease.
Taking the Time to Understand
Although Dr. Turaga has extensive experience performing HIPEC and other regional therapies, he continues to be amazed at the results. “Oncologists typically send patients to us because they have few options left,” he said. “It is so gratifying to see people respond to these therapies. We are able to offer hope where most people say there is no hope.”
Liz, who just turned 53, said her experience has taught her the importance of getting a second opinion. “When you find out you have cancer, you want to do something about it right away,” she said. “But the more people who look at your case before you get started, the better your chance of getting the most effective treatment.”
Beth Erickson, MD 10
froedtert.com/cancer
She appreciates her care team’s dedication. “From my first appointment, I felt I was in the right place. They were so thorough, and I knew they would take the time to come up with the best possible plan for me. I’m so thankful they took the time to understand.”
Clinical Cancer Center
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