Heated Chemotherapy & Mesothelioma

    Most chemotherapy agents for the treatment of mesothelioma are administered intravenously, typically once a week or once every three or four weeks (length of time is determined by the patient's physician). There are several common chemotherapeutic medications that may be used to treat mesothelioma, including Alimta, Cisplatin, and Carboplatin.

    However, a new form of chemotherapy is being tested in clinical trials involving mesothelioma patients. This treatment, known as heated chemotherapy, is showing some promise for the treatment of peritoneal mesothelioma, a form of mesothelioma that attacks the protective lining around the abdomen. (Due to the nature of the treatment, it has been deemed inappropriate for pleural and pericardial mesothelioma.)

    This treatment was developed by Paul Sugarbaker at the Washington Cancer Institute, and is commonly referred to as the Sugarbaker technique.

Peritoneal Mesothelioma & Heated Chemotherapy

    Heated chemotherapy for peritoneal mesothelioma, which is also known as heated intraoperative intraperitoneal chemotherapy, is administered in a very different fashion than most other types of chemotherapy.

    During the heated chemotherapy procedure, a patient is treated with chemotherapeutic medications in liquid form that are administered directly into the peritoneum (the lining of the abdominal cavity). Before this can take place, patients undergo surgery that removes as much of the tumors growing in the peritoneum as possible.

    Once the surgical procedure has been completed, chemotherapy can begin. During this part of the treatment, the patient's peritoneum is permeated with heated chemotherapeutic medications to expose all organs and tissues within the peritoneum in a uniform fashion (this ensures all affected organs receive treatment).

    The chemotherapeutic medications used in the procedure are heated to a temperature between 44 - 46 °C (111-114 F°), and the intraperitoneal environment is maintained at a temperature of approximately 42 - 43 °C (107-109 F°). The chemotherapeutic fluid is perfused in the peritoneum for one to two hours and then drained from the operation site.

Advantages of Heated Chemotherapy

    There are two particularly important features of heated chemotherapy that make this a superior alternative to standard chemotherapy.

    First, the chemotherapeutic medications are applied directly to the affected site. This means the medications are in direct contact with tissues that are affected by mesothelioma. In traditional chemotherapy, the patient is treated with chemotherapeutic medications intravenously and the patient's entire body is affected by the medications. Injecting chemotherapeutic agents directly into the peritoneum increases their concentration at the cancer site and causes less serious side effects than traditional chemotherapy treatments.

    The second important feature is the heating of the medications to the approximate temperature of the human body. Heating the chemotherapeutic agents increases their ability to penetrate tissues. This is vital because traditional chemotherapy treatments do not always effectively penetrate dense tumors.

Who is Eligible for Heated Chemotherapy?

    Heated chemotherapy is only a treatment option for patients with peritoneal mesothelioma. Those coping with mesothelioma of the pleura or pericardium will need to explore other treatment options with their cancer doctor. Patients eligible for heated chemotherapy will be informed by their doctor and will need to discuss treatment options extensively before determining whether this is a good option.

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