Hot chemo offers targeted treatment and less toxicity for cancer patients

Medical Watch

Hot chemo. It’s extending lives for those diagnosed with lung cancer, breast cancer and mesothelioma. Doctors heat up chemotherapy and then swirl it inside the body directly where the tumor grew.

That targeted treatment means less toxicity throughout the body.

It is new tool in the arsenal for the thoracic surgery/oncology team from Northwestern Medicine and Central DuPage Hospital.

Dr. John Abad is the director of surgical oncology.

“It’s a very novel therapy and we are going to see more and more places really look to use this treatment approach,” he said.

It’s an option Abad was thrilled to offer his patient diagnosed with cancer that had spread in the lung and chest.  Traditionally, chemotherapy would be given intravenously, the medication, which is toxic to cancer cells and healthy ones, courses through the body. In this approach, it’s administered at the site of the tumor.

“The idea being you debulk and remove all visible disease and the microscopic disease that we can’t see and we can’t appreciate, is taken care of by the infusion,” Abad said.

So first surgeons remove what they can see of the cancerous tumor. But they know tiny, microscopic cancer cells are still there just waiting to grow.

Dr. Ankit Bharat is chief of thoracic surgery at Northwestern Medicine.

“When the cancer cells are left behind, they will multiply over time and then they will start to spread, erode into the local organs, and ultimately lead to the demise of the patient,” Bharat said. “We often tell patients, when we look at a scan and we look in the abdomen, it’s not the disease we can see that we are concerned with. It’s always the disease we can’t see. And that’s really the Achilles heel of some of these cancers and why they come back and recur.”

So for a recent patient, after surgical tumor resection, doctors gave what’s called hyperthermic intrathoracic chemotherapy from machine into the chest cavity. They have to take extra precautions in the operating room to protect themselves from the chemotherapy. But they know it’s worth it since they can deliver higher concentrations of therapy.

“What we know for sure is with this approach it definitely makes the patient survive much longer,” Bharat said. “It’s much more effective.”

To make it even more effective, doctors heat the chemo cocktail to 107-degrees helping it penetrate and kill cancer cells.

“By this approach we can directly apply the chemotherapy to the cells and kill them,” Bharat said.

And that means other healthy cells are spared the common ravages of treatment.

“By this approach, we are only increasing the concentration at the very specific site where the cancer cells are present,” Bharat said. “Allowing us to give that targeted concentration to that site and preventing toxicity to the other sites in the body.”

And the treatment approach is likely to spread to other types of cancer therapy.

“it’s a very novel therapy and we are going to see more and more places really look to is as a treatment approach,” Abad said.

“Cancers of the appendix, of the small bowel, intestines going to the lungs … to be able to innovate the treatment field and to be able to help these patients is very, very satisfying,” Bharat said.

Not all cancer patients are eligible for the hot chemo treatment. Doctors will evaluate to see who will benefit most. More information on Northwestern Medicine’s website.

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