The program and live surgery highlighted treatment of stage 4 cancers that have spread to the
Bengaluru, 18th April, 2015: Innovation in the effective treatment and management of abdominal cancers has ensured improved outcomes and a better quality of life for patients. A live surgery organised at Fortis Hospitals, Bannerghatta Road by the Peritoneal Surface Oncology Group International (PSOGI) headed by noted oncologist Dr Paul Sugarbaker, demonstrated this to Indian oncologists on 17th April.
The live surgery demonstration by Dr Sugarbaker was part of a workshop on Peritoneal Surface Malignancies held from April 16-18 with an aim to provide a comprehensive idea about the current standards in the management of such cancers. The workshop disseminated valuable information on the use of advanced techniques such as cytoreductive surgery and Hyperthermic Intraoperative Chemotherapy (HIPEC ) to treat abdominal cancers and prolong the patient’s life.
The surgery was performed on a 46-year-old man from Nagpur who was diagnosed with a tumour arising from the appendix four years ago, which subsequently spread all over his abdominal cavity leading to a condition known as pseudomyxoma peritonei. Cytoreductive surgery has been developed for the treatment of peritoneal tumors( The peritoneum is the inner lining of the abdominal cavity and the surfaces of the intestines). Cancer from other sites like the colon, ovary etc can spread to the peritoneal lining (known as peritoneal metastases) or can arise from the peritoneum itself.
Peritoneal cancer spread restricts the peritoneum from expanding due to a buildup of fluid in the peritoneal cavity. This causes the pain and swelling associated with the disease.
“This is an extensive and complex procedure as this cancer is spread all over the abdomen. During the procedure, surgeons explore all the regions of the abdomen and remove the areas/organs bearing tumor. Once the surgery to remove the tumour is done, chemotherapy (HIPEC) is given directly to the peritoneal cavity, wherein a hot solution is circulated inside the cavity to totally destroy the residual tumour. Earlier such tumours could only be treated symptomatically or with limited chemotherapy. The advantage of this surgery is that even in some stage 4 cancers, this kind of procedure can promote long term control and prolong the life of the patient from anything between 3-15 years,” explains Dr Aditi Bhatt, Consultant Oncologist at Fortis Hospitals and a specialist in the treatment of Peritoneal cancers.
For the patient from Nagpur, the specialised surgery comes as a boon as till now he had not received any specific advanced treatment for his rare cancer. Four years ago, his appendiceal tumour ruptured and spread all over the abdominal cavity. At that time only his appendix was removed but no other treatment was given.
“Since it was a slow growing tumour, he did not have any symptoms for four years. Suddenly in the last few months he was suffering from abdominal pain and tests detected a tumor growth in the peritoneal cavity and around the liver, spleen and intestinal surfaces. He has come to us at the right time as it is still possible to completely remove the tumor,” Dr Aditi added.
This workshop is unique as there are very few surgeons across India who are trained and have the expertise to perform this complex surgery, therefore the treatment itself is rare and offered only in a few centres in the country.
The programme also included lectures on the basics of cytoreductive surgery and HIPEC as well as on specific diseases like colorectal, ovarian, gastric and appendiceal cancer and rare conditions like pseudomyxoma, peritonei and peritoneal mesothelioma.
PSOGI is a non-profit organization to promote research, education and innovations in patient care regarding peritoneal cancers. It provides support at various levels to enable progress in the prevention and treatment of such cancers. Dr. Sugarbaker is supported ably in this endeavor by other pioneers in the field of peritoneal surface oncology like Dr. David Morris (St. George’s Hospital, Sydney), Dr Olivier Glehen (Hospital Lyon Sud, France), Dr Diane Goere (Institute Gustave Roussy, Paris).