Ovarian cancer is one of the most common malignancies affecting Indian women, with around 35,000 new cases diagnosed each year. Globally, India records the second-highest number of ovarian cancer cases. Approximately 1 in 78 women will develop ovarian cancer in their lifetime, highlighting the importance of early detection and advanced treatment options. One such cutting-edge treatment is Hyperthermic Intraperitoneal Chemotherapy (HIPEC), which offers promising results for patients with advanced ovarian cancer.

Understanding Ovarian Cancer

Ovarian cancer originates in the ovaries, the reproductive glands responsible for producing eggs and hormones. It often goes undetected until it has spread within the pelvis and abdomen, making it more challenging to treat. Early-stage ovarian cancer, where the disease is confined to the ovary, is more likely to be treated successfully.

Symptoms of Ovarian Cancer

• Abdominal bloating or swelling
• Quickly feeling full when eating
• Weight loss
• Discomfort in the pelvic area
• Changes in bowel habits, such as constipation
• Frequent need to urinate

Causes and Risk Factors

Several factors can increase the risk of developing ovarian cancer. While a family history of breast or ovarian cancer among first-degree relatives accounts for 5% to 10% of cases, other significant risk factors include:

• Genetic mutations: Inherited mutations in genes such as BRCA1 and BRCA2 increase the risk.
• Age: The risk increases with age, particularly after menopause.
• Reproductive history: Women who have not had children or had their first child after age 35 may have a higher risk.
• Lifestyle factors: Increased sedentary habits, obesity, and dietary factors can contribute.
• Hormone replacement therapy: Long-term use of hormone replacement therapy (HRT) can elevate the risk.
• Endometriosis: This condition is linked to an increased risk of ovarian cancer.

HIPEC: A Breakthrough in Ovarian Cancer Treatment

Hyperthermic Intraperitoneal Chemotherapy (HIPEC) is an advanced treatment option for ovarian cancer that involves the direct application of heated chemotherapy drugs to the abdominal cavity. This technique is typically used after cytoreductive surgery, where as much of the visible tumor as possible is removed.

How HIPEC Works

1. Cytoreductive Surgery: The procedure begins with the surgical removal of visible tumors from the abdomen.
2. Heated Chemotherapy: A heated chemotherapy solution is then circulated within the abdominal cavity. The heat enhances the effectiveness of the chemotherapy drugs, allowing them to penetrate and destroy remaining cancer cells more effectively.
3. Direct Application: By directly applying chemotherapy to the affected area, higher concentrations of the drug can be used without causing severe systemic side effects.

Advantages of HIPEC

• Targeted Treatment: HIPEC allows for higher concentrations of chemotherapy to be applied directly to the cancerous area, increasing its efficacy.
• Heat Enhancement: The heat used in HIPEC increases the absorption of chemotherapy drugs by cancer cells, improving their destruction.
• Reduced Systemic Toxicity: Because the chemotherapy is concentrated in the abdominal cavity, there is less systemic exposure, reducing overall toxicity and side effects.
• Improved Survival Rates: Studies have shown that HIPEC can improve survival rates in patients with advanced ovarian cancer compared to traditional treatments alone.

Eligibility for HIPEC

Not all patients are candidates for HIPEC. Eligibility depends on several factors, including the stage of cancer, overall health, and the ability to undergo extensive surgery. A thorough evaluation by a multidisciplinary team of specialists is necessary to determine the suitability of HIPEC for each patient.

The Treatment Process

1. Preoperative Assessment: A comprehensive assessment, including imaging and diagnostic tests, is conducted to evaluate the extent of the disease and plan the surgery.
2. Cytoreductive Surgery: The surgical team removes visible tumors from the abdomen, aiming for maximal tumor reduction.
3. HIPEC Procedure: The heated chemotherapy solution is circulated in the abdominal cavity for about 60 to 90 minutes.
4. Recovery: Postoperative care is crucial for recovery. Patients may require a hospital stay of several days to monitor for complications and ensure adequate recovery.

Post-Treatment Care

Post-treatment care is essential for the best outcomes. Patients will have regular follow-ups to monitor for recurrence and manage any side effects. A healthy lifestyle, including a balanced diet and regular exercise, is also recommended to support overall health and well-being.