The most effective treatment for peritoneal surface malignancies is a combination of surgery and chemotherapy, an approach we pioneered and continue to improve. While a peritoneal surface malignancy diagnosis used to mean a bleak prognosis, many of our patients now live full, active lives after treatment.
We offer a full range of surgery for peritoneal surface malignancies:
- Cytoreductive Surgery (i.e., CRS, or Debulking): As much of the tumor is removed as possible. It may require removing parts of other affected organs as well, like the bowels, liver, gall bladder, spleen, pancreas and stomach. For women, it may also mean removing the uterus and ovaries. This is our main approach and is often paired with hyperthermic intraperitoneal chemotherapy — i.e., HIPEC.
- Hemicolectomy: Removes part of the colon, and may also remove affected blood vessels and lymph nodes
- Peritonectomy: Strips away the peritoneum to remove tumors from the lining of the peritoneal cavity
- Appendectomy: Removes the appendix
Depending on the type of peritoneal surface malignancy you have, and how far it has grown, we may recommend chemotherapy before or after surgery. We often use chemotherapy during surgery, too—an approach we helped develop and improve, and one that requires special expertise. Regardless of the timing, we use the latest, most effective regimens available.
Systemic chemotherapy goes into your bloodstream and destroys cancerous cells throughout your body. There are two general types we may recommend:
- Before Surgery (Neoadjuvant): If tumor(s) is growing quickly (high-grade), we may recommend chemotherapy before surgery. It’s typically taken at home for two months beforehand, with a month to recover before the procedure.
- After Surgery: Some patients may also need chemotherapy following surgery, but only if the cancer is considered high-grade. Chemotherapy after surgery generally lasts about four months, or eight cycles.
HIPEC, or hyperthermic intraperitoneal chemotherapy, is given immediately after a peritonectomy or cytoreductive surgery, while you are still in the operating room. The chemotherapy drugs are heated to make them more potent, then used to directly bathe the surgical site in your abdomen. This method kills any remaining cancer cells and allows you to receive higher, more effective doses of medication, without significantly affecting the rest of your body.