A "hot" option for treating a rare cancer is being ignored in Taiwan, Wanfang Hospital's chief of surgery said yesterday.
Hsieh Mao-chih (謝茂志) said that intra-abdominal heated chemotherapy is the only treatment with which he has successfully combatted pseudomyxoma peritonei, a rare, slow-growing, delocalized cancer of the abdominal cavity.
The cancer secretes a mucus that resembles a wobbly yellow jelly, Hsieh said.
"The tumor doesn't kill the patient -- the mucus does, eventually," he said.
The "jelly" builds up in the abdominal cavity until it impacts upon the gastrointestinal and respiratory systems and other vital organs.
Conventional therapy involves cutting away as much of the tumor as possible, but cells left behind can lead to a new tumor.
The cancerous cells are also hard to reach by conventional chemotherapy since it spreads deep in the viscera. Instead, Hsieh applies a technique he learned in Japan more than a decade ago.
"We flood the patient's abdominal cavity with a chemotherapy agent heated to 42oC to 43oC for one to two hours," Hsieh said.
In order to reach all surfaces, an open-ended tank is inserted into a large, lengthwise incision in the patient's abdomen, allowing the viscera to bathe freely in a large volume of the liquid agent.
"This way, all organ and visceral surfaces are coated directly with the agent," he said.
Although the sight of intestines floating freely inside a tank inserted into the abdominal cavity is alarming, Hsieh said it is less risky than merely filling the cavity with the hot liquid, another technique used.
"With a tank allowing additional volume, there is better coverage and better temperature control," Hsieh said.
"We are very careful to put everything back where it belongs afterwards," he said.
Five patients with pseudomyxoma peritonei have undergone the treatment at Wanfang since it was introduced more than five years ago. Four are still doing well, he said.
The operation is not covered by the National Health Insurance, nor is it among the procedures hospitals are allowed to charge patients for.
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