Just when his cancer was getting worse, Sudanese doctor Mohammad Abdel Rahman took the risk and agreed to an emerging procedure called “hot chemotherapy”. Thanks to the complex operation, he is now feeling much better – with up to “99 percent of his tumor” gone.
“I am happy that the United Arab Emirates have surgeons trained to perform these complex procedures and where one can expect to have the level of care to support such complexity. This country is truly passionate about health innovation, ”said Mohammad, 36, a resident of Ras Al Khaimah who fights medium rectal cancer.
“My condition started to get worse and that’s when I started having extensive discussions with my doctors about this high-risk procedure. I always had confidence in their skill level and decided to go ahead. I’m glad I did that, because I’m feeling so much better now. I will be indebted not only to the team of doctors who operated on me, but also to all the nurses who took great care of me. “
His surgery, also known as intraperitoneal chemotherapy (Hipec) hyperthermia (heated), was performed a few weeks ago. It was the first time that the critical operation was carried out in the Northern Emirates.
Dr. Sadir Alrawi – the surgical oncologist who led the procedure conducted at Burjeel Specialty Hospital Sharjah – said the operation combined abdominal surgery and peritoneal chemotherapy to attack cancer in several ways at the same time.
Although advanced, morbidity, mortality and complications remained high in this procedure. “There have been several attempts and only a very experienced hand can succeed with that. Although morbidity or mortality is less than any cardiac surgery and even pancreatic surgery, fear of the extra cost and extra time and other complications makes it a high-risk procedure, ”said Dr. Alrawi.
“In the United Arab Emirates, more than 40 cases of Hipec have been made and these cases have been successful. There is an approach of multidisciplinary acceptance that is followed here in the country before carrying out a surgery of this nature. It has been approved for mesothelioma for appendix cancer, but it is still considered controversial for colorectal cancer, as some say it may or may not be beneficial for the patient. Therefore, patient selection is important and is done on a case-by-case basis. “
Dr. Alrawi said that Hipec therapy was developed in government hospitals in the United Arab Emirates and later taken to private health facilities like Al Zahra and VPS.
“We did three cases at the VPS last month, two in Burjeel Medical City in Abu Dhabi and the first in Sharjah that was done two weeks ago on this patient – who was a young doctor with extensive peritoneal tumor carcinomas. Despite the difficulties and with many approvals from our multidisciplinary tumor council and after the patient’s consent, we proceeded with this procedure ”, he explained.
After eight hours of surgery, doctors claim to have removed at least 99 percent of Mohammad’s tumor.
Dr Mehdi Afrit, a specialist in medical oncology at the Burjeel Specialty Hospital, Sharjah, said that “the most important risk involved in the procedure was the allergic reaction to the chemotherapy drug used, infection and neutropenia and postoperative complications.”
Therefore, the decision to proceed must be made at the multidisciplinary board meeting. “If successful, this procedure can change and improve quality of life, decrease symptoms and reduce the rate of recurrence in a patient,” said Dr. Afrit.
Difference between chemo and Hipec
Explaining the difference between usual chemotherapy and Hipec, Dr. Prasanta Kumar Dash, an oncologist at Canadian Specialist Hospital, said: “It is a cancer treatment that injects hot chemotherapy drugs into the abdomen. The patient receives a very large dose of chemotherapy, but it is not as toxic. This is because the drugs are not injected into a person’s bloodstream, so they do not move through a person’s body as much as chemotherapy administered intravenously.
“Chemotherapy drugs are heated to about 106-109 degrees Fahrenheit. Cancer cells cannot cope with heat. Heat also helps drugs enter cells more easily and work better. “
First, the surgeon eliminates any visible tumors in a step called cytoreductive surgery or CRS. Then, to target any remaining cancer, the abdomen is filled with a heated liquid that contains chemotherapy drugs.
Hipec is used so far for abdominal cancers that are difficult to treat. It has also shown promise against ovarian and gastric cancer.
Dr. Arun Karanwal, an oncologist at Prime Hospital, noted: “This combination of surgery and heated chemotherapy is now becoming an important treatment option for some recurrent cancers.
“It can provide significant improvements in cancer control when administered to properly selected patients. It is not an individual therapy and, in most cases, it requires good surgery to remove small cancerous spots on the abdomen. It is often followed by additional cycles of chemotherapy administered via the vein or orally. Its treatment requires good support and care from the multidisciplinary team, as it can cause serious reactions or side effects in a small percentage of patients. “