Renowned Harvard-trained American cancer surgeon talks about challenges to select correct chemotherapy medication. How to use Hyperthermic Intraperitoneal Chemotherapy (HIPEC). “Only half of cancer patients are going to respond to Mitomycin C chemotherapy medication.” Molecular characterization of metastatic peritoneal cancer tumor and the patient hold key roles in better chemotherapy selection. We have to move from anatomical organ-based cancer classification to molecular and genetic classification of tumors. Personalized chemotherapy selection for metastatic peritoneal cancer. Dr. Anton Titov, MD. Precision medicine and precision surgery. Dr. Paul Sugarbaker, MD. Peritoneal metastatic cancer treatment: precision medicine and precision surgery. Leading cancer surgeon Dr. Paul Sugarbaker on personalized medicine to treat peritoneal metastatic cancer. Each patient should have personalized chemotherapy chosen for his or her cancer treatment. 90% efficacy is in cytoreductive surgery part of cytoreductive surgery and Hyperthermic Intraperitoneal Chemotherapy (HIPEC). Colon cancer, gastric cancer, ovarian cancer spread in the abdomen and peritoneal cavity. Dr. Anton Titov, MD. Peritoneal metastases in advanced stage 4 colon cancer treatment by cytoreductive surgery and Hyperthermic Intraperitoneal Chemotherapy (HIPEC) [hot chemo bath, heated chemotherapy]. Medical second opinion clarifies colon cancer or ovarian cancer diagnosis. Medical second opinion confirms that cure is possible in metastatic colon cancer. Intraperitoneal chemotherapy treatment for advanced stage 4 cancer with metastatic lesions in the abdomen. Dr. Paul Sugarbaker, MD. Medical second opinion helps to select a precision medicine treatment for stage 4 ovarian cancer or stage 4 colon cancer or metastatic stage 4 gastric cancer. Dr. Anton Titov, MD. Get medical second opinion on advanced cancer with peritoneal metastases. Best peritoneal metastatic advanced cancer treatment by surgical operation and regional chemotherapy. Video interview with Dr. Paul Sugarbaker. Leading expert in peritoneal metastatic cancer treatment (cytoreductive surgery and Hyperthermic Intraperitoneal Chemotherapy (HIPEC), hot chemo bath, heated chemotherapy. Personalized chemotherapy selection for metastatic peritoneal cancer - precision medicine and precision surgery. Chemotherapy to treat peritoneal metastatic cancer: precision medicine and precision surgery. Dr. Paul Sugarbaker, MD. Renowned Gastrointestinal Cancer Surgeon. I would say that choosing the correct chemotherapy medication requires the most work at this point in time. We need to work more on the selection of the optimal chemotherapy agent for a particular patient. Dr. Anton Titov, MD. At this point in time we tend to choose cancer treatment medications based on the anatomic location of the cancer. For colorectal cancer we usually mitomycin C or mitomycin C and doxorubicin. But is that the best chemotherapy medication for a particular patient? It probably is not. Dr. Anton Titov, MD. This is a continuous topic of discussion that I had with a lot of oncologists. The goal is to move from anatomical classification of tumors and into the molecular markers in the tumor and in the patient. Dr. Anton Titov, MD. We have to use for personalized medicine for the patient to select chemotherapy. Not just the anatomical classification of cancers. That seems to be what you are talking about. Dr. Paul Sugarbaker, MD. Renowned Gastrointestinal Cancer Surgeon. Absolutely. It is distressing that we know that using mitomycin C maybe helps 50% of the patients. Dr. Paul Sugarbaker, MD. Only half of cancer patients are going to respond to that chemotherapy medication. Even though it is heated during Hyperthermic Intraperitoneal Chemotherapy (HIPEC) treatment. A lot of peritoneal metastatic cancer patients will not benefit from this chemotherapy medication. all patients are getting is 90 minute washing of their abdomen. Dr. Anton Titov, MD. Only 50% of patients benefit from this chemotherapy medication during Hyperthermic Intraperitoneal Chemotherapy (HIPEC)? That is a toss of a coin? Dr. Paul Sugarbaker, MD. Renowned Gastrointestinal Cancer Surgeon. That's correct! That's correct! We now need to begin using multiple chemotherapy agents for Hyperthermic Intraperitoneal Chemotherapy (HIPEC) to treat abdominal cancer metastases. Medications given into the peritoneal space that are augmented by heat. we have to use chemotherapy medications that are given in the bloodstream, this are augmented by heat. Dr. Paul Sugarbaker, MD. Because these chemotherapy medications will circulate to the abdominal organs. chemotherapy to treat peritoneal metastatic cancer will be augmented by the heat within the peritoneal space during Hyperthermic Intraperitoneal Chemotherapy (HIPEC). Dr. Anton Titov, MD. We need now to be thinking about a combination of intravenous and intraperitoneal chemotherapy agents to get a maximal response from peritoneal cancer tumor. Because we have 90 minutes to treat peritoneal metastatic cancer during Hyperthermic Intraperitoneal Chemotherapy (HIPEC). we have to be very accurate in what we're doing. Sometimes we do not select chemotherapy medications correctly, a lot of patients are going to be treated with chemotherapy and not benefit from cancer treatment. Luckily probably the most meaningful treatment method of all aspects of Hyperthermic Intraperitoneal Chemotherapy (HIPEC) is surgery. It is the peritonectomy and the visceral resection that is the most important part of Hyperthermic Intraperitoneal Chemotherapy (HIPEC). I would say 90% of it is in the surgical part of peritoneal cancer treatment. 10% of benefit for patients is in the Hyperthermic Intraperitoneal Chemotherapy (HIPEC) [hot chemo bath, heated chemotherapy] Dr. Anton Titov, MD. It is a combination of precision medicine and precision surgery to treat peritoneal metastases from colorectal cancer, ovarian cancer or gastric cancer? Dr. Paul Sugarbaker, MD. Renowned Gastrointestinal Cancer Surgeon. Absolutely, Yes. Hot chemo bath, heated chemotherapy. Dr. Anton Titov, MD. Personalized chemotherapy selection for metastatic peritoneal cancer. Precision medicine and precision surgery must be used for each cancer patient today.