Cytoreductive surgery & HIPEC

What Is Cytoreductive Surgery?

Cytoreductive surgery focuses on removing large volumes of cancer spread throughout the abdomen. By reducing the tumor burden, therapies like chemotherapy or targeted drugs can work more effectively. This approach is sometimes called “debulking,” targeting the biggest and most accessible tumors. As these significant tumor masses are removed, your body and follow-up treatments gain a stronger foothold in managing any residual disease.

What is HIPEC and how does it work?

HIPEC (Hyperthermic Intraperitoneal Chemotherapy) is a cancer treatment that combines surgery with heated chemotherapy. After removing visible tumors from the abdomen, doctors circulate a warm chemotherapy solution inside the abdominal cavity to kill remaining cancer cells.

Why is chemotherapy heated in HIPEC treatment?

Heating the chemotherapy enhances its effectiveness by improving drug absorption, increasing cancer cell death, and reducing systemic side effects compared to traditional chemotherapy.

Which types of cancer can be treated with HIPEC?

HIPEC is mainly used for abdominal cancers like peritoneal carcinomatosis, ovarian cancer, colorectal cancer, and appendiceal cancer.

How Does the Procedure Differ from Routine Surgeries?

Unlike a standard operation that focuses on a single organ, cytoreductive surgery tackles multiple sites of spread. Surgeons may remove parts of the bowel, spleen, or other tissues covered in tumors. It’s more extensive, meaning longer operating times and a higher level of complexity. Recovery can also be more challenging, but many patients find the benefits worth the extra effort.

What Is the Purpose of Cytoreductive Surgery in Ovarian Cancer Treatment?

The main objective of cytoreductive surgery is to excise as much of the tumor burden as feasible. By reducing the volume of cancerous tissue, this surgery enhances the efficacy of chemotherapy, leading to improved survival rates for patients with advanced-stage ovarian cancer.

How Is the Decision made to perform cytoreductive surgery?

A multidisciplinary team evaluates various factors, including the patient’s overall health, the extent of cancer spread, and the feasibility of achieving optimal tumor reduction. Advanced imaging techniques and diagnostic tests are utilized to determine the potential benefits and risks associated with the surgery.

What Does the Cytoreductive Surgery Procedure Involve?

During the surgery, the surgeon aims to remove all visible tumors. This may involve resecting parts of affected organs such as the uterus, ovaries, fallopian tubes, and portions of the intestine or bladder if they are involved. The extent of the surgery is tailored to each patient’s specific situation to achieve maximal tumor reduction while preserving essential functions.

Who Is an Ideal Candidate?

• Abdominal cancers, such as advanced ovarian or gastrointestinal tumors, where the disease is potentially resectable.
• Adequate overall fitness to endure a lengthy, intricate procedure.
• Imaging evidence that tumors can be safely removed without excessive risk.
• Age isn’t a strict barrier; rather, good health and a willingness to undergo rigorous treatment are key considerations.

Will This Surgery Affect My Fertility?

For women of childbearing age, removing the uterus or ovaries can end fertility. If you wish to preserve fertility, discuss it early. Some consider egg freezing or other fertility-sparing procedures, although advanced cancer usually mandates more radical surgery. Balancing life-saving measures with future family planning is a personal decision that needs in-depth medical advice.

How Does It Improve Survival?

By reducing the “tumor load,” subsequent treatments like chemotherapy can target fewer cells. Studies show that patients with minimal residual disease tend to live longer and experience fewer cancer-related complications. The cost of additional therapies may also be more justified if the tumor burden is smaller, as the treatments are more likely to succeed.

Is Minimally Invasive Surgery an Option?

In some cases, laparoscopic or robotic-assisted methods help diagnose or remove smaller lesions. However, full cytoreductive surgery typically involves an open approach for extensive disease. While minimally invasive techniques may reduce hospital stay and costs, they aren’t always feasible if the cancer is widespread. Your surgeon will recommend the safest route.

What are the Potential Outcomes and Follow-up Treatments After Cytoreductive Surgery?

Achieving optimal cytoreduction, where minimal or no visible tumor remains, is associated with improved survival outcomes. Post-surgery, patients typically undergo chemotherapy to target any residual cancer cells. Regular follow-up appointments are crucial to monitor recovery, assess treatment effectiveness, and detect any signs of recurrence promptly.

How Does It Combine with Chemotherapy or Other Treatments?

Often, cytoreductive surgery is followed by chemotherapy to eradicate microscopic cancer cells. This dual approach can prolong survival more effectively than chemo alone. Some patients get “neoadjuvant” chemo before surgery to shrink tumors. Coordinating these treatments may raise the overall cost, but increases the odds of success.

Can You Get Recurrence or Need Repeat Surgery?

Cancer can recur, especially in advanced stages. If you remain healthy and the new tumors are isolated, a second cytoreductive surgery might be considered. This means additional expenses, but also a renewed opportunity to extend life. Regular follow-ups and scans help detect recurrence early, when re-surgery might still be an option.

Cytoreductive surgery in Mumbai offers renewed possibilities for those confronting advanced cancers, particularly under the guidance of a Top gynecologist in Mumbai skilled in complex oncology. Though it may involve more demanding recovery, the potential for extended survival and better symptom control makes it a crucial option. Dr. Maitreyee Parulekar combines expertise and compassion, creating tailored treatment plans. Schedule your appointment today.