Bengaluru: Certain chemotherapy drugs when heated up can become more effective, say cancer specialists.
The novel method — Hyperthermic Intra-Vesical Chemotherapy (HIVEC) — is currently being used in city hospitals to treat bladder cancer patients.
The process involves warming the chemotherapy drug before releasing it into the cancer-affected bladder through a special catheter. The drug is heated up to 43-45 degree Centigrade. It’s circulated four times in a minute within the bladder and found to have encouraging results in preventing further development of cancer, say doctors.
Recently, the technique was used on a 58-year-old male bladder cancer patient at Fortis Hospital. “We use the heated chemo drug in the confined space of the bladder. This has greater bio-absorption and improves the entire process of chemotherapy. It further stimulates the body’s immunity to enhance the drug’s benefit,” said Dr Mohan Keshavamurthy, director urology, uro-oncology Fortis Hospital, who headed the treatment team.
“In high-grade bladder cancer, removal of the bladder is an option, but it has social and psychological consequences for a patient. In such cases we suggest HIVEC. Also, there is a significant probability of recurrence of cancer among many patients, which can be prevented using HIVEC,” said Dr Mohan.
At HCG hospital, HIVEC has been used to treat seven first-stage high-risk bladder cancer cases in the last two years.
“Bacillus Calmette-Guerin (BCG), an intravesical immunotherapy used for treating early-stage bladder cancer, may turn out to be unresponsive for some patients. In such cases, we heat a chemotherapy drug, intravesical mitomycin, up to 43-45 degree Centigrade,” said Dr Raghunath S Krishnappa, uro-oncologist, HCG.
Heated chemotherapy drugs are also used in treating select cases of third-stage cancer in gastrointestinal tract and ovaries at some city hospitals. In HIPEC (hyperthermic intraperitoneal chemotherapy), the heated drug is passed via peritoneum, a membrane forming the lining of the abdominal cavity.
According to Dr Manjunath N, medical oncologist, Vydehi Hospital, HIPEC is being used at their hospital for close to seven years. “Increased temperature enhances the efficacy of the drug. It increases cell penetration,” he explained. Dr Rani Bhat, head and senior consultant, gynaecological oncology, HCG said: “Currently, we use HIPEC treatment only for select patients. The outcomes have been satisfying. However, research on this issue is on and we need to understand the future better.”
Not at govt-run Kidwai yet
The heated chemotherapy treatment mode is yet to be tried out at government-run Kidwai Memorial Institute of Oncology (KMIO). The required equipment costs no less than Rs 25 lakh, while one opting for HIPEC pays Rs 60,000.
“HIPEC is more essential at a public hospital like Kidwai, where we get patients in third and fourth stages of cancer. It can be very helpful in treating ovarian colorectal and stomach cancers. After removing the tumour, one sitting of HIPEC can check the recurrence,” said Dr C Ramachandra, director, KMIO.
“We can buy the equipment only when Ayushman Bharat-Arogya Karnataka scheme allows cashless treatment for the same. Else, it becomes very expensive for patients,” Dr Ramachandra.-Times Of India