When a 35 year-old-woman with stage 4 stomach cancer showed up at a Dubai hospital, doctors realised that cancer had spread aggressively inside her abdomen, making it inoperable.
This is when they decided to treat her with a novel and advanced application of chemotherapy called pressurised intraperitoneal aerosolised chemotherapy (PIPAC) that has given her what doctors call “the best chance” for beating the deadly disease.
PIPAC is a minimally invasive novel way of introducing chemotherapy into the abdomen under pressure through 1 cm size ports to treat advanced cancers of the stomach, colon and ovaries.
It is a method of administering chemotherapy in the form of an aerosol. It consists of performing a laparoscopy, and with the pressure obtained inside the abdomen, a high concentration of chemotherapy is achieved without the side effects of systemic chemotherapy, doctors explained.
This was the first time such treatment was performed in the UAE, and it was done at Mediclinic Parkview Hospital in Dubai.
The treatment was jointly performed by consultant surgeons Dr Zakir K Mohamed and Prof Amir Nisar and Consultant Oncologist Dr Shaheena Dawood. It involves laparoscopy to assess cancer and infusion of two different chemotherapy agents under pressure onto cancer.
Dr Olivia Sgarbura, Oncological Surgeon from Montpellier Regional Cancer Institute, France, flew to Dubai to help the team perform the first procedure.
Talking about the advantages of such a treatment, Dr Zakir Mohamed, Consultant General and Colorectal Surgeon, Mediclinic Parkview Hospital, said: “Young patients with advanced cancer have been disadvantaged and often had to travel abroad to seek advanced therapies. Mediclinic aims to provide the most advanced cancer treatments locally. With the introduction of PIPAC, in addition to the recent introduction of robotic surgery, HIPEC therapy and transplant surgery at Mediclinic, the UAE reaffirms its position as a regional leader in medical care and medical tourism.”
Patients with advanced cancers restricted to the abdomen are often disadvantaged with systemic chemotherapy alone to attain a good response, said Dr Shaheena Dawood, consultant oncologist at Mediclinic City Hospital Comprehensive Cancer Centre and Mediclinic Parkview Hospital.
“Combining both strategies of systemic chemotherapy with novel approaches like PIPAC (which allows chemotherapy to be directly inserted into the abdomen) allows enhancing responses to therapy. Our ultimate goal is to be able to improve the prognostic outcome of our patients, and to be able to do that; we need to adopt and adapt novel strategies.”
Explaining how the novel treatment works, Professor Amir Nisar, consultant general surgeon at the hospital, said: “Chemotherapy (anti-cancer drugs) is generally given by injection, however, PIPAC is an innovative way of exposing cancer inside the abdomen directly to chemotherapy by a minimally invasive approach.”
He added: “Recovery is quick, and studies have shown benefit in survival with this approach in advanced cancers like stomach (gastric), bowel (colonic), ovarian and some other cancers involving the abdominal organs.