PIPAC: Promising new treatment for abdominal cancers

Abdominal cancers are among the most common cancers across the world. These include ovarian cancer, stomach cancer, colon cancer, appendicular cancer and other tumours. Thanks to the advancements in medical science, with the rise of incidence, various treatment options are also becoming available.

For most abdominal cancers, one of the most conventional and effective treatments involved is chemotherapy. It is advised when the cancer cells have substantially spread within the abdominal cavity and may also be given if the tumour recurs after surgery or other initial treatment.

Chemotherapy has been deemed effective when used in conjunction with other treatment methods. This form of treatment is injected or infused in liquid form through a needle in your vein. However, sometimes these options are not feasible for certain cancers due to a variety of medical reasons.

So what happens when multiple lines of systematic chemotherapy are exhausted? As technology has evolved, one such new and novel technique for abdominal cancers is PIPAC (Pressurized Intraperitoneal Aerosol Chemotherapy).

In this article, with insights from Dr Vinay Gaikwad, a leading surgical oncologist in Gurgaonwe will explore the benefits of PIPAC treatment for abdominal cancers.

What is PIPAC? 

PIPAC is a minimally invasive method of administering chemotherapy in the form of an aerosol. In this advanced procedure, tumours are not surgically removed and chemotherapy is instilled directly into the abdominal cavity in the form of a spray via a laparoscope.

This procedure is performed under the effect of general anaesthesia at modular operating theatres with specifically trained clinicians. Usually, the PIPAC procedure takes nearly an hour.

PIPAC vs traditional chemotherapy

PIPAC is an efficient treatment method when traditional chemotherapy deems ineffective. As well, it has a wide range of benefits compared to the conventional drug delivery system. Several studies have shown that this treatment alternative largely improves the overall patient experience.

A large number of patients have responded positively to the treatment as it has better tolerability. Through PIPAC, chemotherapy is administered in smaller dosages which in turn offers lesser toxicity and side effects for the patients. Another great advantage of PIPAC includes its ability of homogeneous drug distribution.

The distribution of drugs across all tissues is affected by a variety of factors such as plasma protein binding, overall body weight and body fluid spaces. However, in PIPAC, drug distribution takes place through a faster-repeated application resulting in better treatment outcomes. 

PIPAC is most often used as a treatment option for final-stage peritoneal carcinomatosis. This is a rare form of cancer that develops in the thin layer of tissues that line the abdomen. It is usually offered to patients with cancers in the digestive system or female reproductive organs.

It should be noted that PIPAC is a palliative treatment option. It means that the approach of this technique is aimed at prolonging the patient’s life and preserving its quality as well as alleviating symptoms. It is not a curative treatment.

This state-of-the-art technique is offered in select centres such as The Oncology Centre at the CK Birla Hospital®. It is also offered to select patients who have not benefitted from other traditional chemo-delivery systems and is most often used for end-stage peritoneal carcinomatosis. Usually, a patient requires multiple sessions of chemo administration via this procedure.

Is PIPAC safe?

PIPAC is a safe and efficient procedure. It has a lesser risk of complications and side effects as compared to systematic chemotherapy. However, there are a few side effects associated with this procedure. Common complications include slight pain and discomfort in your stomach and mild nausea.

There is substantial evidence on the effectiveness of this treatment and more data is emerging which reports superior survival rate and quality of life.

The concluding note

While PIPAC is still a new treatment, its results are looking highly promising with emerging data. Overall, it is an encouraging new treatment offering better outcomes for eligible patients with abdominal cancer and is worth considering when other options have been exhausted.

For more information on the treatment of abdominal cancers, book an appointment with Dr Vinay Gaikwad at the CK Birla Hospital.