A major difficulty of treating patients with peritoneal carcinomatosis (advanced cancer of the abdomen) is that it is often not possible to remove all the cancer cells. As a result, the cancer often persists despite surgery, chemotherapy and other treatments.

Conventional surgery is ineffective because for every visible growth that surgeons remove, they leave behind dozens of microscopic cells. Chemotherapy drugs delivered through the bloodstream are frequently too diluted by the time they reach the tumor to be effective. Radiation doses needed to kill the cancerous cells would be too strong for healthy organs to withstand.

Since 1991, patients have been treated at Wake Forest Baptist with a promising and innovative therapy. Performed by only a handful of surgeons across the country, intraperitoneal hyperthermic chemotherapy - also known as hyperthermic intraperitoneal chemotherapy (HIPEC) - is performed in concert with traditional surgery.

The logic behind the procedure is that, if cancer-fighting drugs could be put directly on the malignant cells, they are more effective.

During the procedure, the surgeon removes all visible growth from the patient’s abdomen, inserts plastic tubes in the abdominal wall and closes the incision. The tubes are attached to a pump which moves a heated anti-cancer drug fluid into the abdominal cavity and then back out for a constant flow. The heat improves the drug’s effectiveness and can add years and quality of life to patients for whom there was previously no hope. The Comprehensive Cancer Center has performed over 1,100 of these procedures, representing one of the most experienced teams worldwide.

Wake Forest Baptist’s expertise in HIPEC draws patients from all over the United States for both established treatments and clinical trials. Our team has been honored with numerous prestigious medical publications and has trained surgeons performing the procedure at other leading institutions. This approach has led to hope and even cures of patients thought to be untreatable elsewhere.

Hyperthermic Intraperitoneal Chemotherapy

Edward A. Levine, MD, professor, surgery, and chief, surgical oncology service, Wake Forest Baptist Medical Center, discusses clinical and research expertise in Hyperthermic Intraperitoneal Chemotherapy (HIPEC).