By Dr Upasana Palo, Consultant Gynecologic Oncologist and Robotic surgeon, Narayana RN Tagore Hospital, Mukundapur
Ovarian cancer continues to rank among the most lethal gynecologic malignancies worldwide, primarily because it is often diagnosed at an advanced stage and has a high tendency to recur despite aggressive treatment. For decades, outcomes for advanced ovarian cancer were discouraging, with limited options to effectively control disease spread within the abdominal cavity. Today, however, a specialised and scientifically advanced therapy—Hyperthermic Intraperitoneal Chemotherapy (HIPEC)—is redefining treatment possibilities and offering renewed hope to patients.
One of the defining challenges of ovarian cancer is its propensity to spread across the peritoneum, the thin lining of the abdominal cavity. While conventional management has relied on extensive surgery followed by systemic chemotherapy, microscopic cancer deposits frequently remain hidden, making complete disease eradication difficult. HIPEC directly addresses this challenge through an innovative and targeted approach.
Following cytoreductive surgery, in which all visible tumours are meticulously removed, heated chemotherapy is circulated throughout the abdominal cavity for approximately 90 minutes. The elevated temperature enhances the penetration of chemotherapy drugs into residual cancer cells while simultaneously impairing their ability to repair DNA damage, thereby significantly increasing the treatment’s effectiveness.
Why HIPEC Is a Game Changer
Unlike traditional intravenous chemotherapy, which circulates throughout the body and can cause widespread side effects, HIPEC delivers high concentrations of cancer-fighting drugs directly to the site most vulnerable to disease spread. This localised delivery limits systemic toxicity while maximising impact on microscopic residual disease.
Clinical studies have demonstrated that incorporating HIPEC into treatment—particularly after initial chemotherapy and during interval debulking surgery—can lead to improved survival outcomes and longer disease-free intervals. Long-term follow-up data from select studies suggest that patients undergoing HIPEC show better outcomes even five to ten years after treatment compared to surgery alone.
Patient Selection and Recovery
HIPEC is not suitable for every patient. Careful selection is essential and depends on multiple factors, including cancer stage, tumour distribution, overall health status, and the feasibility of achieving complete or near-complete tumour removal. For eligible patients, the procedure involves major surgery, with hospital stays typically ranging from one to two weeks and recovery extending over several weeks to months.
As with any advanced surgical intervention, HIPEC carries potential risks, including fatigue, nausea, infections, and, in rare cases, organ dysfunction. These risks underscore the importance of experienced surgical teams and comprehensive postoperative care.
A Significant Step Forward
While HIPEC is not a universal solution, it represents a major advancement in the management of advanced ovarian cancer for carefully selected patients. By combining surgical precision, targeted chemotherapy delivery, and the biological advantages of heat-enhanced drug action, HIPEC is helping transform ovarian cancer from a relentless adversary into a more manageable disease.
In an era where innovation is rapidly reshaping cancer care, HIPEC stands out as a powerful example of how science and clinical expertise can converge—bringing renewed optimism and literally turning up the heat in the fight against one of the most challenging cancers in women’s health.
