Renowned Harvard-trained American cancer surgeon explains peritoneal metastases cancer treatment options. Cytoreductive surgery and Hyperthermic Intraperitoneal Chemotherapy (HIPEC). It is also known as hot chemo bath or heated chemotherapy. Sugarbaker Procedure is used today to treat stage 4 metastatic cancers. Colorectal cancer, ovarian cancer, gastric cancer or peritoneal mesothelioma. Peritoneal metastases cancer treatment options. Dr. Anton Titov, MD. Preoperative evaluation of patients with peritoneal metastatic cancer spread from ovarian cancer, colon cancer or gastric caner, or peritoneal mesothelioma. Dr. Paul Sugarbaker, MD. Cytoreductive surgery is done first. Colon cancer, gastric cancer, ovarian cancer spread in the abdomen and peritoneal cavity. Peritoneal metastases in advanced stage 4 colon cancer treatment by cytoreductive surgery and Hyperthermic Intraperitoneal Chemotherapy (HIPEC), hot chemo bath, heated chemotherapy. Dr. Paul Sugarbaker, MD. 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. Anton Titov, 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. 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. Peritoneal metastases cancer treatment options. Dr. Anton Titov, MD. Before we get into more details of the Sugarbaker Procedure to treat peritoneal cancer metastases. What is in the overall treatment strategy when patient is diagnosed with cancer metastases into peritoneal space? Dr. Anton Titov, MD. What is a high-level picture of cytoreductive surgery and Hyperthermic Intraperitoneal Chemotherapy (HIPEC)? What happens when someone is diagnosed with abdominal cancer metastases to the peritoneal space? Metastases from colon cancer, gastric cancer, ovarian cancer or appendiceal cancer. Dr. Paul Sugarbaker, MD. Renowned Gastrointestinal Cancer Surgeon. It is very important before peritoneal cancer metastases treatment to assess the prognostic indicators. Metastases from primary cancer: colon cancer, gastric cancer or ovarian cancer. Prognostic indicators in peritoneal cancer tell if this patient is going to profit from cytoreductive surgery and Hyperthermic Intraperitoneal Chemotherapy (HIPEC). This preoperative assessment after peritoneal cancer diagnosis is very important. it is not so easy to do. Preoperative assessment of peritoneal metastatic cancer patient involves the CT scan. It involves an assessment of the patient's performance status. Dr. Paul Sugarbaker, MD. Preoperative review of the pathology of underlying tumor seeks to determine the type of malignancy. For example, colon cancer, gastric cancer, ovarian cancer, appendiceal cancer. Dr. Anton Titov, MD. What kind of cancer has spread into peritoneal space? preoperative assessment is extremely important. Sometimes the peritoneal metastatic cancer patient is considered by a multidisciplinary team to be a candidate for cytoreductive surgery then they go to the operating room. Usually we first do cytoreductive surgery. Sometimes we want to give peritoneal metastatic cancer patients a limited course of cancer chemotherapy first. Dr. Anton Titov, MD. We call that neoadjuvant chemotherapy. Dr. Paul Sugarbaker, MD. But for the most part patients go straight to the operating room. In cytoreductive surgery and Hyperthermic Intraperitoneal Chemotherapy (HIPEC) we make a big abdominal incision. Patients can have six hours or eight hours or ten hours of surgery in order to remove every last piece of peritoneal cancer. All the visible component of the peritoneal cancer metastases should be removed. In doing the cytoreductive surgery we want to remove the cancer metastases in the peritoneum down to the cellular level. Dr. Paul Sugarbaker, MD. That's why it is called cytoreductive surgery. After cytoreductive surgery we flood the abdomen with a large volume of warm chemotherapy solution. That is an attempt to eradicate what we call minimal residual disease. It is peritoneal metastatic cancer cells that the surgeon does not see. It is what the surgeon does not see what kills the patient. Dr. Anton Titov, MD. It is metastatic disease that usually kills the patient. The micro-metastases. Dr. Paul Sugarbaker, MD. Renowned Gastrointestinal Cancer Surgeon. Yes, micrometastatic disease. We are trying to get rid of those free cancer cells and micrometastatic disease by Hyperthermic Intraperitoneal Chemotherapy (HIPEC) Dr. Anton Titov, MD. Then after the cytoreductive surgery and Hyperthermic Intraperitoneal Chemotherapy (HIPEC) procedure the patient is followed by a multidisciplinary team. The histology nature of the cancer that metastasized into the peritoneum is known. Dr. Paul Sugarbaker, MD. Renowned Gastrointestinal Cancer Surgeon. That is correct. for the most part the cytoreductive surgery and Hyperthermic Intraperitoneal Chemotherapy (HIPEC) is added on to the appropriate systemic chemotherapy. We add cytoreductive surgery and Hyperthermic Intraperitoneal Chemotherapy (HIPEC) to the primary chemotherapy of patient's cancer [colon cancer, gastric cancer, abdominal cancer or appendiceal cancer]. Dr. Paul Sugarbaker, MD. Because this is a treatment in addition to systemic chemotherapy and not exclusive of systemic chemotherapy. Dr. Anton Titov, MD. Peritoneal metastases cancer treatment options: heated chemotherapy and cytoreductive surgery. Cancer surgeon explains stage 4 cancer treatment by HIPEC.