Heated Chemotherapy and Mesothelioma

Heated chemotherapy is a relatively new type of treatment ofperitoneal mesothelioma, which affects the lining of the abdominal cavity. Known as HIPEC – hyperthermic intraperitoneal chemotherapy – the procedure has helped patients with peritoneal mesothelioma live longer with less pain, clinical trials have shown. That is the goal of this treatment.

Heated chemotherapy is typically available only to patients with early-stage peritoneal mesothelioma, and the treatment is given during a surgery to remove peritoneal mesothelioma tumors. The delivery of chemotherapy drugs directly into the abdominal cavity may be used to target tumor cells.

How Heated Chemotherapy Works

As its name suggests, heated chemotherapy is a process of warming up chemo drugs and then giving them to the patient.  This exposes tumors to high doses of a chemotherapy drug. Chemotherapy drugs are heated to between 42 and 46 degrees Celsius (107.6 degrees to 114.8 degrees Fahrenheit) and then with a catheter are circulated through the abdominal cavity for up to two hours.

The process is similar to a hot water bath – of a heated drug – for cancer-laden tissues. The high temperature of the solution – to just higher than the normal temperature of the body – increases the effectiveness of the drug, enabling it to kill tumor cells while minimizing harm to healthy cells. Because the drugs are heated, the tumor nodules are softened and the chemotherapy drugs can penetrate the tumors better. Traditional chemo treatments don’t always penetrate thick tumors.

After the procedure, drains and a catheter are placed into the abdomen for other applications of drugs after surgery. In some cases, doctors may continue to apply chemotherapy drugs shortly after the completion of the surgery in a procedure known as early postoperative intraperitoneal chemotherapy (EPIC).

Drugs Used in Heated Chemotherapy

There are a number of different heated chemotherapy drugs. One of the more popular chemotherapy agents, mitomycin C, may be mixed with fluorouracil to gain a higher concentration drug for tumor removal. A few of the other regularly used chemotherapy drugs include doxorubicin,cisplatin, melphalan and 5-fluorouracil. When chemotherapy is delivered directly to a tumor site, many common side effects associated with intravenous chemotherapy drugs can be avoided.

Who Can Have Heated Chemotherapy?

The majority of patients who are eligible for heated chemotherapy include those with early stage peritoneal mesothelioma. Because heated chemotherapy is characterized as an adjuvant (additional) treatment during surgery, the treatment is not available to all patients. If the tumors have metastasized, or spread to other organs and areas of the body, surgery to remove the tumors may not be feasible.

Other Uses for Heated Chemotherapy

In a 2006 study led by Dr. David Sugarbaker, heated chemotherapy was used in conjunction with pleurectomy decortication, a treatment for pleural mesothelioma which involves removal of all or part of the lining of the lung along with tumors. Dr. Sugarbaker discovered an improved survival rate for patients with malignant pleural mesothelioma using this method. However, further testing will be needed to determine if heated chemotherapy is a viable option for patients with pleural mesothelioma.

Heated Chemotherapy and Life Expectancy

If you have been diagnosed with mesothelioma and wish to know more about heated chemotherapy and how it could improve your life expectancy, fill out the form on this page. For information about clinical trials for patients with pleural or peritoneal mesothelioma, please visit our clinical trials page or contact one of our Patient Advocates at (800) 615-2270.