From Hopeless to Hopeful with HIPEC & CRS

What Are Peritoneal Surface Cancers?

HIPEC & CRS

Peritoneal Surface Cancers (PSC) affect the lining of the abdominal cavity (the peritoneum). Just a decade ago, these cancers were considered incurable. Today, with advancements like Cytoreductive Surgery (CRS) and HIPEC (Hyperthermic Intraperitoneal Chemotherapy), long-term survival—even cure—is possible in carefully selected patients.

This transformation is backed by high-quality scientific evidence and expert surgical techniques.

Cancers That Can Spread to the Peritoneum

Some common cancers can seed the peritoneal lining, including:

  • Ovarian Cancer (Stage IIIC)
  • Stomach/Gastric Cancer (Stage IV)
  • Colorectal Cancer (Stage IV)
  • Appendix-origin tumors like Pseudomyxoma Peritonei

Cancers That Start in the Peritoneum

  • Primary Peritoneal Mesothelioma – a rare but aggressive tumor that originates in the peritoneal lining itself

Regardless of the origin, the treatment strategy remains the same:

Cytoreductive Surgery (CRS) + HIPEC

Symptoms to Watch For

Peritoneal cancers often present subtly at first. Common signs include:

  • Persistent abdominal bloating or distension
  • Ascites (fluid in the abdomen)
  • Loss of appetite or feeling full quickly (early satiety)
  • Swelling in the legs
  • Breathing difficulty
  • Reduced mobility or fatigue

If you or a loved one experience these symptoms, early evaluation is crucial.

Diagnosis & Evaluation

A thorough workup includes:

  • CT Scan (Chest, Abdomen & Pelvis) – to assess spread
  • Peritoneal MRI – in selected cases
  • Tumor Markers like CEA and CA-125
  • Biopsy – of any suspicious peritoneal nodules or fluid

Treatment Approach: A Team-Based Strategy

Each patient is discussed in a multidisciplinary tumor board to ensure personalized care.

chemotherapy

Step 1: Neoadjuvant Chemotherapy

Typically 3–4 cycles of intravenous chemotherapy are given first to shrink tumor burden and optimize the patient’s fitness for surgery.

cytoreductive surgery

Step 2: Cytoreductive Surgery (CRS) + HIPEC

A complex, high-precision surgery performed by experts

The goal: complete removal of all visible cancer across the abdominal cavity, including affected organs or bowel segments

This is followed by HIPEC – heated, high-dose chemotherapy circulated within the abdomen during surgery to destroy microscopic cancer cells

hospital

Step 3: Postoperative Recovery

Patients are closely monitored in the ICU for 48 hours post-surgery for a safe and smooth recovery

Novel Therapies for Intractable Peritoneal Disease: PIPAC

What is PIPAC?

Pressurized Intraperitoneal Aerosol Chemotherapy (PIPAC) is a minimally invasive technique that delivers aerosolized chemotherapy into the abdomen using laparoscopy.

When is PIPAC Used?
  • For patients not fit for CRS + HIPEC
  • In recurrent or refractory peritoneal cancers
  • As a bridge to surgery or palliative control in select patients
Benefits of PIPAC
  • Minimally invasive, repeatable procedure
  • Lower systemic toxicity
  • Better penetration of drugs at tumor sites
  • Can improve symptoms and quality of life even in advanced disease

💬 Facing a Diagnosis of Peritoneal Surface Cancer?

You don’t have to go through it alone. The journey is complex, but with expert care and advanced treatment, hope is very much alive.

Meet Dr. Pradeep

Consultant Surgical Oncologist & Peritoneal Surface Oncologist

HIPEC & PIPAC Specialist

Book a consultation to explore treatment options that go beyond conventional cancer care.
Dr. Pradeep