Cancer Care Northwest Surgical Oncologist, Dr. Ryan Holbrook, MD, FACS, discusses Hyperthermic (Heated) Intraoperative Peritoneal Chemotherapy (HIPEC), an innovative chemotherapy procedure performed during surgery to treat certain advanced abdominal cancers. Dr. Holbrook has been performing this advanced procedure for over 24 years, and is recognized throughout the nation for his expertise in HIPEC.

HIPEC is a procedure performed immediately following a cytoreductive surgery, which uses standard surgical methods to remove all visible tumors in the abdominal cavity. During this procedure, Dr. Holbrook delivers heated chemotherapy into the abdominal cavity to penetrate diseased tissue directly. Heated chemotherapy drugs are circulated for around 90 minutes, sometimes more, throughout the abdominal cavity to kill any remaining cancerous cells that can’t be seen. Heating chemotherapy agents makes killing the cancerous cells more effective. Your abdomen is then flushed out with a sterile solution. This therapy is effective at preventing or slowing down the recurrence of your disease.

HIPEC is used to treat cancer that has spread to the lining surfaces of the peritoneal (abdominal) cavity from primary colorectal cancer, ovarian cancer, gastric cancer, appendiceal cancer or from mesothelioma and pseudomyxoma peritonei (known as peritoneal carcinomatosis).

Learn more at CancerCareNorthwest.com.

Doctors say a rare cancer called peritoneal cancer is hard to spot, but patients can get better if they're diagnosed correctly and get some aggressive treatment.

Peritoneal Malignancy refers to cancers/tumours that have originated in or spread within the abdominal cavity, such as appendix cancer, colon or rectal cancer, gastric and ovarian cancer, and very rare conditions such as Pseudomyxoma peritonei (PMP), peritoneal mesothelioma, and primary peritoneal cancer

What is the peritoneum?

The peritoneum is a clear lining which covers both organs within the abdomen and the wall of the abdomen.

It has 2 layers.
- One layer lines the abdominal wall and is called the parietal layer.
- The other layer covers the organs and is called the visceral layer.

There is a small amount of fluid between the two layers, which separates them and allows them to slide over each other.

This fluid allows us to move around without causing any friction on the layers.

Simply if one imagines a room like the inside of an abdominal cavity. The organs are the furniture, and the peritoneum covers both the organs and also the abdominal wall, like lining or wall paper

Umar Shariff
Consultant Surgeon
General, Colorectal & Peritoneal Surgery
Good Hope Hospital
University Hospitals Birmingham NHS Foundation Trust, and BMI The Priory and Edgbaston Hospitals.

In this lecture given at Surgical Grand Rounds in January 2016, Mr Faraz Khan of the Colorectal Surgery Service at the Mater Misericordiae University Hospital (MMUH) details the surgical laparoscopic calculation of a patient's peritoneal carcinomatosis index.

MMUH is a major surgical teaching and training hospital in Dublin as well as being one of Ireland's leading surgical centres in the fields of complex elective surgery, trauma and emergency surgery and adult cancer surgery.

Dr Pramod Kumar Julka
Senior Director, Max Oncology Daycare Centre, talks about the diagnosis and treatment of peritoneal cancer and states how peritoneal cancer is a rather rare form of cancer, therefore not commonly heard of. While it has ovarian remnants, it is still less common than ovarian cancer. and is more prevalent in women but can also be found in men in some

Experts provide insight on the role of heated intraperitoneal chemotherapy (HIPEC) for advanced primary peritoneal cancer.

Peritoneal tumours refer to a variety of cancers that affect the peritoneum - a thin membrane that lines the abdominal and pelvic cavities - and may also affect some of the abdominal organs.

In this video, NCCS (National Cancer Centre Singapore) A/Prof Melissa Teo shares the causes, symptoms and treatment of peritoneal tumours. The video also talks about the criteria for peritoneal tumour surgery.

Professor Iain McNeish at the Ovarian Cancer Action Research Centre explains what is meant by immunotherapy, how it differs from existing therapies and the promise it holds for treating women with ovarian cancer.

Nicoletta Colombo, MD, PhD, European Institute of Oncology, Milan, Italy & University of Milan-Bicocca, Milan, Italy, discusses how to make treatment decisions with patients who have terminal ovarian cancer. The decision over whether to undergo a chemotherapy regimen, which typically has low success rates in these patients, or to offer palliative care instead relies on a lot of factors and can be a difficult decision for both clinicians and patients. Clinical trials can offer improved progression free survival or quality of life for these patients, so should also be considered when deciding on treatment. A key challenge for clinicians is how to communicate about end-of-life issues with patients and their families.