When I had appendix cancer, I did not receive HIPEC treatment, I received EPIC, early post-operative intraperitoneal chemotherapy. When I was searching for treatment, I’d read about HIPEC and wanted HIPEC, but it was hard to find, and I didn’t want my surgeon to be the one I knew of that offered HIPEC. Both EPIC and HIPEC are chemotherapy that is put directly into the abdomen after cytoreduction surgery. You receive several EPIC treatments after surgery vs. the one HIPEC treatment that is done while you are in surgery for the cytoreduction surgery. I’d hoped for HIPEC as I’d read that the heat itself can kill cancer cells, that the heated chemotherapy is more able to penetrate cancer cells, and that the heat also potentiated the chemotherapy, i.e. made it work better. The surgeon I chose, though, use EPIC.
EPIC is sometimes done 4-5 days after the surgery, but I insisted my first treatment be done within 24 hours of my surgery. Scar tissue and adhesions that can interfere with the circulation of abdominal chemotherapy can occur within 4 days after cytoreduction surgery. I had a portacath in my abdomen to infuse the chemotherapy. I’ve read that often the EPIC chemotherapy is drained from the abdomen after a certain number of hours, but we did not drain mine at all, we just let my body absorb the chemotherapy and the solution. I had a total of 6 treatments. Was interesting, I’m a nurse so learned how to do my peritoneal treatment at MSKCC. I only had my first two treatments at MSKCC and the last 4 done with my oncologist at home. As I am a nurse, I had to train my home office how to do the peritoneal treatments, they had never done them before!
EPIC worked for me, I have been cancer free for 19 years. Memorial Sloan Kettering, where I was treated, is doing a study comparing EPIC and HIPEC to see how they compare. The study is ICARuS. You can read of it here. It was started in 2013 and is expected to be completed in September of 2021. MSKCC offers EPIC, but not HIPEC that I am aware of. It will be interesting to see the results of the study.
Some specialists use 5 treatments of EPIC after HIPEC, so they use both EPIC and HIPEC. Studies have been done comparing HIPEC also to HIPEC and EPIC both used. One study I read said the complication rate is higher when both are used, but I haven’t yet read any studies that compare the survival rate of using both HIPEC and EPIC together yet. Most specialists now treating appendix cancer are using HIPEC for the benefits of the heat.