Peritoneal Mesothelioma HIPEC Program Comes to Alabama

Treatment & Doctors

Patients in Alabama diagnosed with peritoneal mesothelioma cancer no longer need to leave the state in pursuit of optimal care and long-term survival. The best possible mesothelioma treatment is now closer to home.

The O’Neal Comprehensive Cancer Center at the University of Alabama at Birmingham recently launched a complex treatment program for several abdominal malignancies that combines extensive cytoreductive surgery with hyperthermic intraperitoneal chemotherapy, also known as HIPEC.

This combination, used only at select specialty centers throughout the U.S., has been especially effective for peritoneal mesothelioma, a rare cancer caused primarily by asbestos exposure.

“We’re excited to bring it here and get this program rolling,” surgical oncologist Dr. Salila Hashmi told The Mesothelioma Center at “Peritoneal mesothelioma is such a unique disease. We want the best for our patients.”

Specialty Treatment Benefits Alabama Mesothelioma Patients

Hashmi joined the specialists at the cancer center in 2021 and played a major role in the launch of the only mesothelioma program of its kind in the state. She was specially trained in the treatment.

In the past, patients with peritoneal mesothelioma who lived in Alabama needed to travel to New Orleans, Atlanta or North Carolina to find this survival-extending combination. Unfortunately, many stayed closer to home and received less-effective treatment.

The difference in survival can be significant. Studies have shown that patients receiving only standard systemic chemotherapy have a median survival of just 12-14 months. Those receiving the cytoreductive surgery and HIPEC have a better than 50% chance of living five years or longer.

There are peritoneal patients throughout the country today who received the combination and have lived more than 10 years afterward, some of whom underwent a treatment repeat after tumor recurrence.

A recent retrospective study at Wake Forest Baptist Medical Center, one of the first in America to use the combination, demonstrated an almost seven-year median survival for peritoneal mesothelioma patients who repeated the treatment more than once.

Aggressive Cytoreductive Surgery Includes HIPEC

The cytoreductive surgery is a lengthy and aggressive procedure designed to remove all visible tumor cells from the abdominal cavity. It can include removing parts or all of the spleen, pancreas, liver, gallbladder and intestinal tract.

HIPEC, which is used immediately following surgery, involves circulating heated chemotherapy throughout the abdominal cavity to kill any tumor cells that may have evaded the surgeon. After up to 90 minutes of circulation, the heated chemotherapy is removed.

The HIPEC procedure is considered a more targeted way of delivering high-dose chemotherapy. Because the chemotherapy solution is removed, HIPEC typically has fewer side effects than systemic chemotherapy.

This combination also is being used with appendix, colorectal and gastric cancers.

Mesothelioma Specialty Centers Are Critical

Although the cytoreductive surgery and HIPEC combination has been recognized as a more effective treatment, less than half of those diagnosed with peritoneal mesothelioma nationally receive it. Some patients don’t qualify for various reasons, and others are discouraged by their oncologists who rarely encounter mesothelioma. They often treat the disease only with systemic chemotherapy.

“You need someone with the knowledge and insight to even realize this is an option for you,” Hashmi said. “Not everyone will qualify, but everyone at least deserves the chance to be evaluated.”

Hashmi also said sometimes a patient who doesn’t qualify initially can qualify after undergoing other treatments such as immunotherapy or systemic chemotherapy.

O’Neal Comprehensive Cancer Center, which carries the respected NCI designation for maintaining the highest standards of care, has been treating the more common pleural mesothelioma cancer for more than a decade and often is hailed for its wide array of medical programs.

The addition of this latest program for peritoneal diseases is particularly significant.

“Patients no longer have to travel further away from home,” Hashmi said. “We can serve them here now. We can give them the best possible care.”

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