Treating patients whose cancers have metastasized — spread beyond their original location — remains one of the greatest challenges in medicine today. But a new therapy, only available in Arizona at the University of Arizona Department of Surgery and University Medical Center, is offering hope to patients with metastasized abdominal cancers.
“Regional and metastatic disease is the new frontier in cancer treatment,” said Evan S. Ong, MD, an Arizona Cancer Center member and UA assistant professor of surgery who has created the Regional and Metastatic Center to address this challenge. “We deal with patients with stage IV cancers.”
These include cancers of the stomach, colon, ovaries, liver, appendix and other organs of the abdomen that have spread but are still limited to the abdominal region.
“In the past, no effective treatment options were available for these patients,” Dr. Ong said. “Surgery would be followed by chemotherapy treatments, but eventually the cancer became resistant to the chemotherapy. But now we’re seeing survival rates of 30 to 40 percent over five years for patients with stage IV colorectal cancer versus 0 percent just 10 or 20 years ago.”
Hyperthermic intraperitoneal chemoperfusion is a relatively new treatment for several types of metastasized abdominal cancers.
Immediately following surgery to remove cancerous lesions, UA surgeons administer a heated chemotherapy solution that is circulated throughout the abdomen for nearly two hours. Because the chemo drug is retained in the abdominal cavity and not spread throughout the body, the surgeons are able to give 80 to 400 times the usual dose, depending on the drug. Heating the chemotherapy to high temperatures (102 degrees) helps it to work more effectively.
Throughout the treatment, patients are surprised by how little pain they have experienced, said Dr. Ong. “In the past, you often saw cancer patients who died in agony. But with newer, minimally invasive surgical techniques, plus new chemotherapies and better ways to relieve pain, that is no longer the picture.”
The Regional and Metastatic Center provides patients with a multidisciplinary team approach to cancer management, consisting of specialists in surgery, radiation therapy, chemotherapy and pathology (the study of a tumor’s biology to determine diagnosis and treatment options).
“That’s the benefit of being treated here at the center. We have specialists in all the disciplines,” said Dr. Ong. “We meet regularly to confer about each case. The group comes to a consensus about what needs to be done, and we can immediately begin to treat patients without the delay of having to refer them to other locations.”
Dr. Ong cautions that this procedure is for selected patients who otherwise are healthy and robust enough to tolerate the treatments.
“This is really an evolution in the treatment of these diseases,” he said. “With stage IV cancer, it is possible we can provide a cure, but more importantly, it is our goal to extend the length and the quality of life for the patient.”