Breakthrough in cancer treatment at Mount Sinai

Aug 2 2007

A 32-year-old mother of two small children, who was recently diagnosed with metastatic stomach cancer, underwent surgery using Hyperthermic Intraperitoneal Chemotherapy (HIPEC) at The Mount Sinai Medical Center.

The surgery, which took place on Thursday, July 26th is a breakthrough in cancer treatment at Mount Sinai, giving a heated form of chemotherapy to the patients during surgery directly into the abdomen while in the operating room.

Dr. Daniel Labow, Assistant Professor of Surgery and Surgical Oncology at The Mount Sinai Medical Center was the lead surgeon. Mount Sinai is one of a few places around the country that can perform this groundbreaking treatment. “Gastric cancer is very aggressive and with heated chemotherapy you get a better penetration of the chemotherapy locally in the peritoneal cavity, where systemic or traditional chemotherapy is ineffective,” says Dr. Labow.

According to Dr. Labow, the patient had debulking surgery to remove all visible malignant tissue around her belly. Once all visible cancer was removed, the heated chemotherapy was instilled. Four tubes were then placed in the abdomen—two to instill the heated chemotherapy and two to drain it. The new HIPEC technology by Thermasolutions allowed the heated chemotherapy to bathe all of her internal organs to kill any microscopic cancer cell that remained in the abdomen. The heated chemotherapy saturated the once cancer stricken area for 60-90 minutes before being drained. The entire surgery lasted 10 hours.

This new technology produced by Thermasolutions heats chemotherapy to 105 degrees Fahrenheit/ 41 degrees Celsius. Surgery with HIPEC helps doctors to remove the cancer and treat it aggressively while minimizing the negative effects of high doses of intravenous chemotherapy, while extending the patient's life. “We know in peritoneal cancer intravenous chemotherapy is ineffective. This is a new aggressive way to treat cancer, with a multi-prong approach,” said Dr. Labow.

The term “Intraperitoneal” means that the treatment is delivered to the abdominal cavity. The term “Hyperthermic Chemotherapy” means that the solution containing chemotherapy is heated to a temperature greater than normal body temperature. Before HIPEC is administered, the surgeon--using standard surgical methods--will remove all visible tumors that can be removed throughout the peritoneal cavity. This is known as cytoreductive surgery.

Following cytoreductive surgery, in the operative setting the surgeon will administer HIPEC treatment. During the HIPEC procedure, the surgeon will continuously circulate a heated sterile solution--containing a chemotherapeutic agent--throughout the peritoneal cavity, for a maximum of two hours. The HIPEC procedure is designed to attempt to kill any remaining cancer cells. The procedure also improves drug absorption and effect with minimal exposure to the rest of the body. In this way, the normal side effects of chemotherapy can be avoided.

Dr. Daniel Labow's clinical and research interests include the diagnosis and treatment of a broad range of both primary and metastatic malignancies including gastric and esophageal cancer, pancreatic neoplasms, primary and metastatic liver malignancies, biliary tract disease, colon and rectal cancer, sarcoma, melanoma and breast cancer. Additionally, he is interested in the application of minimally invasive techniques and their role in cancer care.

His research and training allow him to understand the entire spectrum of treatments for these cancers, including investigational approaches to help guide each individual patient along the appropriate treatment pathway. Dr. Labow's research interests include diagnosis and treatment of a both primary and metastatic malignancies including: gastric and esophageal cancer, pancreatic neoplasms, primary and metastatic liver malignancies, biliary tract disease, colon and rectal cancer, sarcoma, melanoma and breast cancer. He is also passionate about minimally invasive techniques to cancer treatment.

The Mount Sinai Medical Center encompasses The Mount Sinai Hospital and Mount Sinai School of Medicine. The Mount Sinai Hospital is one of the nation's oldest, largest and most-respected voluntary hospitals. Founded in 1852, Mount Sinai today is a 1,171-bed tertiary-care teaching facility that is internationally acclaimed for excellence in clinical care. Last year, nearly 50,000 people were treated at Mount Sinai as inpatients, and there were nearly 450,000 outpatient visits to the Medical Center.

Mount Sinai School of Medicine is internationally recognized as a leader in groundbreaking clinical and basic-science research, as well as having an innovative approach to medical education. With a faculty of more than 3,400 in 38 clinical and basic science departments and centers, Mount Sinai ranks among the top 20 medical schools in receipt of National Institute of Health (NIH) grants.