Combination therapy can extend life for those with ovarian cancer

A procedure that uses a combination of surgery and chemotherapy is a “significant advancement” for women with ovarian cancer, according to a UCD professor.

Over 200 Cytoreductive Surgery (CRS) combined with Hyper-thermic Intraperitoneal Chemotherapy (HIPEC) procedures have been carried out at the Mater Hospital in Dublin since repatriation from the UK in 2013.

The procedure was originally a treatment option for peritoneal cancer patients but since last year is now an option for women with advanced stage ovarian cancer through the Ireland East Hospital Group cancer directive. Peritoneal cancer affects the abdominal cavity or surface of the abdominal organs.

Prof Donal Brennan, consultant obstetrician and gynaecological oncologist said "this is a significant advancement in gynae oncology and for woman's healthcare as a specialised treatment for those woman who have been given a difficult and devastating diagnosis".

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“It is because of this collaborative and integrated approach to cancer care that the HIPEC programme at the Mater Hospital is now able to perform this procedure for woman who have advanced stage ovarian cancer,” he said.

The procedure involves removing all visible tumours throughout the peritoneal cavity (cytoreductive surgery) followed by a highly concentrated heated chemotherapy to the abdomen to kill any remaining cancer cells (HIPEC).

Since last September, 10 women with ovarian cancer have received the treatment.

“The combination of surgery and the chemotherapy is a relatively new area in ovarian cancer, it’s been well established in other cancers,” Prof Brennan said.

Live longer

“Studies to date have shown that women who get the treatment live nearly a year longer, so that’s a big change in ovarian cancer outcomes because up to that we didn’t have a whole lot of options available.”

Prof Brennan said of the 400 new diagnoses of ovarian cancer in Ireland every year, between 50 and 100 would be suitable for the surgery.

Kathleen Reid (71) from Dublin was diagnosed with ovarian cancer in June 2018 and underwent the procedure after initial rounds of chemotherapy.

“I had my last bout of chemo last Wednesday and had a scan so I’m waiting to hear back from my doctor but I’ve been fine. I’ve been feeling good for weeks,” she said.

Siobhan Patchell (52) from Dublin was diagnosed with peritoneal cancer in September 2014 and underwent the treatment three weeks later at the Mater Hospital.

“It was quite tough but very doable... I knew if I did it that my chances of survival are very high.

“I had my operation, it was a long procedure. I was in hospital for two weeks afterwards,” she said.

“It’s incredible what the body can do and how the body can come back from something like that. I was home in two weeks and then it’s about getting your strength back...I’m perfectly healthy now and would absolutely recommend it.”

The National Centre for Peritoneal Malignancy at the Mater Hospital has received in excess of 400 referrals from across the country since 2013. Approximately 40 per cent of patients referred with this type of cancer are eligible for CRS and HIPEC.

Jürgen Mulsow, consultant general and colorectal surgeon at the Mater Hospital said: “We now know that a subset of patients can benefit with improved survival, and importantly, improved quality of life, from an aggressive surgical approach known as cytoreductive surgery combined with HIPEC.”