Intraperitoneal Hyperthermic Chemotherapy (IPHC) with Mitomycin C after Cytoreductive Surgery for Patients with Peritoneal Carcinomatosis – a long, technical term for modern medicine in the fight against cancer.

I had the rare opportunity to speak with Dr. Perry Shen of Wake Forest University. As I listened, he explained how this groundbreaking treatment is extending the lives of patients suffering from Peritoneal Carcinomatosis. *(Peritoneal membrane surrounds and lubricates the surface of organs within the abdomen; eg., colon, gallbladder, spleen, ovaries, intestines, liver, etc..) Because Advanced-stage Peritoneal carcinomatosis (cancer) and disseminated peritoneal lymphomas are often resistant to current chemotherapy treatment, medical researchers out of Wake Forest University have engaged in the study and treatment of peritoneal carcinomatosis since 1991.

Dr. John Spratt first began describing using interdominal heated therapy in 1980, and found that this particular method worked well in conjunction with chemotherapy. By giving chemotherapy interdominally with much higher concentrated heat, (41 degrees Celcius – or around 105 degrees Fahrenheit) through tumor-removal surgery, the heated medicine showed an increase in its effectiveness; thus, decreasing tumors. (1. Cytoreductive surgery consists of the removal of all gross tumors and involved organs, peritoneum, or tissue deemed technically feasible and safe for the patient. Any tumors adherent or invasive to vital structures that could not be removes were cytoreduces using the cavitational ultrasonic surgical aspirator.)

Overall survival rates were improved of 109 Patients (with peritoneal carcinomatosis) treated between December 1991 and November 1997. (2. Clinicopathologic factors that independently predicted improved overall survival rates.)

A one-time treatment, IHPC lasts approximately 1-2 hours, but standardly, a 2-hour treatment is utilized by Wake Forest University. Initially, patients are cooled to a core temperature of approximately 34 Degrees C to 35 Degrees C. Once cooled, peritoneal perfusion inflow and outflow catheters are placed peroutaneously into the abdominal cavity. With temperature probes acting as moderators, the abdomen is gently massaged throughout perfusion to enhance drug distribution to all peritoneal areas. Because tumor tissue is more responsive to heat than normal tissue (due to intrinsic thermosensitivity) IHPC improves the chemosensitivity of tumor cells to Mytomycin C(MMC).

With an average life expectancy of 3-6 months after diagnosis of Peritoneal Carcinomatosis, patients are gaining new hope as IHPC treatment is extending life by as much as 15 months; and a few selected patients’ lives have even been extended to 28-30 months.

IHPC is currently utilized by oncologists throughout 8 centers Nationwide, with treatment of an average of 40-50 cases annually. According to Dr. Shen, one study was performed in Europe of a randomized differential of Systemic (traditional) Chemotherapy as opposed to IHPC, and found favor towards Intraperitoneal Heated Chemotherapy. Dr. Shen optimistically explained that more cases could be substantially helped if caught in early stages. (3) Dr. Perry Shen is the Assistant Professor in the Department of General Surgery at Wake Forest University School of Medicine in Winston-Salem, NC.

As with all medical breakthroughs, the health hope of mankind rests in the hands of researchers and medical communities across the globe. While modern technology is steadily improving overall life expectancies, it is also important to remember that if we choose to live healthier, happier lives – prevention is key. In closing, I commend Dr. Shen and his medical research staff for the advancement and hopeful promise of enhancing patient’s lives through committed research and human compassion.

References:

1) Ann Surg Oncol – 2004; 11(2):178-186 – Factors Predicting Survival After Intraperitoneal Hyperthermic Chemotherapy with Mitomycin C after Cytoreductive Surgery for Patients with Peritoneal Carcinomatosis – Perry Shen, MD, Edward A. Levine, MD, Jason Hall, MD, Doug Case, PhD, Greg Russel, MS; Cytoreductive Surgery – © 2003 American Medical Association

2) Ann Surg Oncol – 2004; 11(2):178-186 – Factors Predicting Survival After Intraperitoneal Hyperthermic Chemotherapy with Mitomycin C after Cytoreductive Surgery for Patients with Peritoneal Carcinomatosis – Perry Shen, MD, Edward A. Levine, MD, Jason Hall, MD, Doug Case, PhD, Greg Russel, MS; Cytoreductive Surgery – © 2003 American Medical Association

3) Shen, Perry MD., Biography: Clinical Interests: Surgical Oncology, Hepatic Tumors, Radiofrequency ablation, Sarcoma and Melanoma Surgery – Research Interests: Metastic Liver lesions, radiofrequency ablation, intraoperative ultrasound.

Alcohol dependency is really a serious issue, and according to the American Medical Association, it is an illness. This isn’t a thing that is likely to simply go away for good by itself. It has to be handled quickly but it will require a good deal of work and continual vigilance even subsequent to completing an alcohol rehab program to avoid any relapses.

Alcohol addiction is a chronic ailment that just cannot be cured with a simple trip to a therapist. The procedure will be extensive and involved, and it might also be painful, but the harm a one does to his own body as well as to friends and family members is often much worse.

Substance abuse and dependency actually leads to physical changes in the human brain and body. Gradually a user starts to depend on these substances to be able to sustain regular systemic operation, and the brain won’t understand how to proceed without it. That is why the most effective alcohol rehab program should include a period of detoxification as well as a continuous support system once the substances are gone and the body starts to heal itself.

How do you know when a person ought to enter an alcohol rehab program? Alcohol usage is so prevalent and common that it could be hard for some people to realize that there’s a problem. Is a friend that tends to drink too much on evenings out in trouble? Are a few glasses of wine prior to going to bed excessive? What about that shot of whiskey in the morning coffee? The best way to find out may be to take away the alcohol from those situations and see just what will happen.

Sadly, an individual might fully understand they have a drinking problem but never look for an alcohol rehab program. There was a famous writer that spoke about his drinking problem and of the day he came to the realization he was an alcoholic. It had been a nasty realization, but he didn’t think: “I best get help,” he just thought: “I had better be careful.” He understood he had a condition, but he didn’t believe he could live or write without the crutch of substance abuse.

Alcohol rehab, however, does not have to be voluntary to work. Whether a person is coerced or directed into a rehabilitation program, there’s a comparatively high rate of success and many people will remain sober after finishing the process. This is the reason interventions by friends and family are often step one for effectively conquering the compulsion.

An alcohol rehab plan will always start with the detoxification period. A body needs to clear away the chemicals that have been causing problems. Giving up this physical dependency can be hard, and it will have some withdrawal symptoms that could be quite intense depending on the length of time and how much a person has been drinking.

After this physical issue is overcome, though, it’s time to overcome the psychological effects. In order to prevent any relapses and ensure an individual stays clean, a lot of alcohol rehab programs offer continuous help and guidance to help these people maintain their sobriety and start a healthier and happier life.

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Alcoholism is a really serious issue, and according to the American Medical Association, it is also a disease. It isn’t a thing that can just disappear for good . without treatment. It must be treated as fast as possible and it’ll need a good deal of work and continual vigilance even subsequent to finishing an alcohol rehab program to prevent any relapses.

Alcohol addiction is a chronic ailment that simply cannot be cured with a single visit to a counselor. The process will be very long and involved, and it could also be painful, but the damage that a one does to his own body as well as to friends and family members is often much worse.

Drug abuse and addiction literally triggers physical alterations in the brain and body. Ultimately a person starts to depend on these types of drugs to support normal systemic operation, and the brain won’t know how to proceed without it. This is why the best alcohol rehab program should include a time of detoxification as well as a continuous support system once the toxins are eliminated and the body begins to restore itself.

How do you know when someone will need to get into an alcohol rehab program? Alcohol usage is so prevalent and common that it can be hard for some people to realize that there is a problem. Is the friend that has a tendency to consume too much on evenings out in trouble? Are a few glasses of wine prior to going to bed excessive? What about a shot of whiskey in the morning coffee? The simplest way to find out may be to take away the alcohol from those situations and find out what happens.

Unfortunately, a person might know and understand they have a drinking problem but will never seek an alcohol rehab program. There was a well-known author who talked about his drinking problem and of the day he came to the realization that he was an alcoholic. It was a harsh realization, yet he did not think: “I better get help,” he only thought: “I better be careful.” He understood he had a problem, but he didn’t believe he could live or write without the crutch of substance abuse.

Alcohol rehab, however, does not have to be voluntary to work. Regardless of whether a person is coerced or directed into a rehab program, there’s a fairly high rate of success and many people will stay sober after completing the process. This is why interventions by friends and family can be step one for effectively conquering the addiction.

An alcohol rehab program will always begin with a detox period. A body needs to eliminate the chemicals that have been doing damage. Ending this physical addiction can be tough, and you’ll encounter a number of withdrawal symptoms that may be quite severe based on how long and how much an individual was drinking.

When this physical problem is overcome, though, it is time to address the psychological effects. In order to avoid any relapses and be sure a person remains clean, many alcohol rehab programs offer continuous help and guidance to help them maintain their sobriety and begin a healthier and happier life.

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