A 47 year old lady presented with complaints of early satiety and weight loss. Most common causes of early satiety include gastroesophageal reflux disease, commonly known as GERD, and peptic ulcers. In some cases, a more serious problem such as stomach cancer could also be a factor. On evaluation by Dr Krunal Khobragade, Onco Surgeon at Alexis Hospital, it was found that she had a lump in lower abdomen and her CT scan revealed bilateral ovarian masses with deposits in peritoneum and omentum (Peritoneum is the serous membrane lining the cavity of the abdomen and covering the abdominal organs. Omentum plays a key role in in immune-regulation and tissue regeneration).
Her tumour markers were also elevated and her staging laparoscopy indicated it to be ovarian cancer spread to peritoneum and omentum, along with some free fluid in pelvis. Her biopsy also confirmed – ovarian cancer.
All the investigations suggested of stage III ovarian cancer. The treating doctors met over an internal tumor board meeting to discuss and plan the best course of action and decided to proceed with neoadjuvant chemotherapy. She then received four cycles of neoadjuvant chemotherapy under the supervision of Dr Mukesh Bang, Medical Oncologist.
Dr Krunal shares, “She was treated with the most technically demanding and most advanced treatment: cyto-reductive surgery with heated intra-peritoneal chemotherapy. This surgery has the best outcomes for patients with ovarian cancer.”
Multiple procedures were done in the initial stage to remove the tumors spread in her abdominal area, followed by a HIPeC procedure where few tubes were inserted in the peritoneal cavity and heated chemotherapy was given in the abdomen for one and half hours. During this procedure we have to carefully monitor patient’s kidney and liver function. The lady endured the procedure very well and post-operation, she did not require any further support. Even after such complex surgeries she recovered gradually in the ward itself with due support from the well-trained nursing staff..”
She started a planned diet three days after her procedure and was discharged on the tenth day in a stable condition and will be following up as planned.
Patient, during her discharge shared, “Dr. Krunal & Dr. Mukesh, treated me very well with utmost compassion & care which we never found in any other hospital. The care along with the new treatment modality worked wonders for me to get back to good health.”
How does HIPeC Surgery help?
HIPeC essentially targets the cancers cells in peritoneum where the systemic chemotherapy drugs do not reach effectively. It has proven results on diseases with peritoneal spread. The peritoneal surfaces of the abdomen and pelvis are important sites for the dissemination of gastrointestinal and gynecologic malignancy. Transcoelomic dissemination of cancer cells gives rise to carcinomatosis, which, without special treatment, is a fatal manifestation of these diseases. To treat peritoneal carcinomatosis, cytoreductive surgery removes gross disease plus perioperative intraperitoneal and perioperative intravenous chemotherapy eradicates microscopic residual disease and chemical compatibilities.
Dr Tushar Gawad, Director Administration shares that, “We always believe in evidence based, outcome driven clinical practices and offer the best available clinical solutions to the community. This is possible only with the availability of comprehensive services under one roof which allows us to perform beyond conventional modes of treatment!”
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