Targeting hidden ovarian cancer cells

Bathing the abdomen with heated chemotherapy drugs can prevent cancer cells from spreading

Ovarian is the deadliest of the gynecological cancers, primarily because it usually is not discovered until it has metastasized, or spread. Treatment is most effective when cancer is detected early.

At UC Irvine's Ovarian Cancer Center, doctors are using a novel treatment that targets and kills hidden ovarian cancer cells before they can spread the cancer elsewhere.

"We take an aggressive approach to treating ovarian cancer," says Dr. Robert Bristow, director of the Ovarian Cancer Center and an internationally recognized ovarian cancer expert. "For women with advanced-stage or recurrent ovarian cancer that is confined to the abdomen, we can offer a new treatment that combines cytoreduction surgery (an operation to remove all visible tumors), with chemotherapy called HIPEC."

HIPEC, or hyperthermic intraperitoneal chemotherapy, is used to treat malignancies that have originated in or spread to the peritoneum—the membrane that covers the abdominal walls and organs.

With ovarian cancer, it works like this: As surgery is ending, four catheters are placed in the abdomen. The incision is temporarily closed around the tubes, and a machine pumps a large quantity of heated, high-dose chemotherapy solution into the abdominal cavity, filling the belly. The surgeon gently massages the belly, circulating the warm fluid so that it reaches every nook and cranny. The solution is drained, the abdomen rinsed and then the incision is closed.

"The heated drugs are more effective in killing hidden microscopic cancer cells," says Bristow. "With HIPEC, every surface in the abdomen is bathed in the powerful anti-cancer drugs. And the concentrated form of chemotherapy has none of the long-term side effects, such as nausea and hair loss, associated with conventional chemo."

HIPEC may be an option for selected ovarian cancer patients with disease confined to the abdomen, and patients must be able to sustain a surgery that can last as long as six to 10 hours. UC Irvine Medical Center is the only university medical center in Orange County — and one of a handful of hospitals in Southern California — to offer HIPEC to treat ovarian and other gynecologic cancers.

"If we can eradicate the microscopic cancer cells and prevent development of new tumors, we can stop the disease from recurring," says Bristow. "For those who qualify, HIPEC could increase survival up to five years, or possibly mean a complete recovery."

To make an appointment with a UC Irvine gynecologic oncologist, call 714-456-8000 or visit ucirvinehealth.org.