A new promising treatment option (PIPAC) if routine chemotherapy is no longer practical for certain abdominal cancers

HIPEC (Hyperthermic Intraperitoneal Chemotherapy) is relatively well-known now. This surgery entails the removal of all abdominal tumours (Complete cytoreductive surgery) followed by the circulation of heated chemotherapy within the abdominal cavity to directly kill microscopic tumor cells. This treatment option is usually curative, which means complete tumor eradication may be possible. But this is often not feasible.

For tumors like ovarian cancer, stomach cancer, colon cancer, appendicular cancer, as well as some other abdominal tumors, which have spread substantially within the abdominal cavity, generally, chemotherapy is advised. Chemotherapy may also be given if the cancer recurs after surgery or other initial treatment.

Is there an option if multiple lines of systemic chemotherapy are exhausted? Yes, there is. One such option is a novel treatment called PIPAC (Pressurized Intraperitoneal Aerosol Chemotherapy). Firstly, this is a comforting treatment option, and a cure is unlikely. Secondly, no tumor is surgically removed. It is a new chemo-delivery system in which chemotherapy is instilled directly into the abdominal cavity in a spray form via a laparoscope. This procedure requires general anesthesia and a particular operation theatre set-up with trained clinicians. Also, the patient’s general condition should be fit enough to undergo this procedure. 

Finally, PIPAC is offered only in centers like ours, which select appropriate patients for the best outcomes. Evidence already exists, and more data is emerging, reporting superior survival and quality of life when PIPAC is used. 

Multiple sessions are usually required, but it is a safe and effective procedure when performed selectively and effectively. Cost prohibitions exist because of the extensive number of disposable products used during this procedure. 

Overall, PIPAC is an encouraging new treatment option offering better outcomes for selected patients with abdominal cancer and is worth considering, especially when other options have been exhausted.