Complex state-of-the-art method reduces cancer extent and delivers heated chemotherapy drugs directly to cancer cells in the abdomen
Itzhak Avital, M.D., M.B.A., chairman, department of surgery at Saint Peter’s University Hospital, New Brunswick, and his team have completed two of the region’s first medical tourism-based cytoreductive (CRS) and hyperthermic intraperitoneal chemotherapies (HIPEC), or CRS- HIPEC surgeries, for the treatment of peritoneal surface malignancies of colorectal and gynecological origins.
CRS plus HIPEC is a cancer treatment that involves filling the abdominal cavity with chemotherapy drugs that have been heated. Also known as “heated chemotherapy,” HIPEC is performed after the surgeon removes tumors or lesions from the abdominal area. Avital was assisted in both procedures by Saint Peter’s surgeons James E. Gervasoni Jr., M.D., and Derek Christian, M.D.
In both cases, in which other physicians saw cancer patients with perhaps only months or weeks to live, Saint Peter’s team of experts saw patients whose quality of life was abysmal and could be improved – quite possibly extending life by several years – with the surgery. For Virginia Motzinges, 34, of Richmond, Va., who traveled to Saint Peter’s for this complex procedure, the hope of extra time was everything, notably the chance to see her 3-year-old adopted daughter grow to school age and enter first grade.
Motzinges’ surgery stretched for 14 hours. One day later she was walking hospital halls with some help. The young mother was stricken with masses in all four quadrants of her abdomen – a “full-fledged carcinomatosis,” as Dr. Avital described it. She had undergone surgery before. This was her last hope.
“I believe now that Mrs. Motzinges will indeed see her daughter off to school,” Dr. Avital said afterward.
Unlike systemic chemotherapy delivery, which circulates through the body, HIPEC delivers chemotherapy directly to cancer cells in the abdomen. This allows for higher doses of chemotherapy treatment. Heating the solution may improve the effectiveness of chemotherapeutic drugs by destroying tumors and microscopic cancer cells that remain in the abdomen after surgery. This highly concentrated heated chemotherapy treatment is delivered directly to the abdomen during surgery.
“Very few surgeons tackle this kind of patient,” said Avital. “For many patients with peritoneal surface malignancies and various types of cancers such as colon, gastric, ovarian, mesothelioma and others, HIPEC is the only way to potentially extend their lives.”
Dr. Avital is a nationally and internationally known surgical oncologist who came to Saint Peter’s from Bon Secours Cancer Institute, Richmond, Va., where he served as executive medical director of Bon Secours Cancer Institute. He is professor of surgery, Medical School, University of Novi Sad, Serbia; professor of surgery, Chinese National Colorectal Cancer Institute, Nanjing, China, and visiting professor of surgery, department of surgery, Hadassah Hospital, Israel. He previously served as head of the gastrointestinal (GI) and hepato-pancreato-biliary GI and HPB malignancies section in the National Cancer Institute (NCI-NIH). Avital is an expert in solid organ cancer stem cells and headed a laboratory for cancer stem cells research at the National Cancer Institute/National Institute of Health in Bethesda, Md., and as assistant professor of surgery uniformed services, University of the Health Sciences (USUHS).
Approximately 30 percent of Dr. Avital’s patients come from beyond New Jersey to seek his care. Avital has constructed at Saint Peter’s a world-class team of experts in surgical oncology, complex GI cancer and benign surgery, hepatobiliary surgery, gastric surgery and CRS+HIPEC. Additionally, the team at Saint Peter’s invests heavily in research and finding innovative clinical and administrative solutions to complex patient problems.
“Dr. Avital is an experienced and innovative healthcare administrator,” said Ronald C. Rak, CEO of Saint Peter’s Healthcare System. “Among his achievements he has constructed multidisciplinary disease management teams, built a clinical trial unit, established a research division, led cancer operations encompassing multiple hospitals, created tumor and gene banks, and led philanthropic efforts to support a cancer institute. We are thrilled he is here.”
Saint Peter’s University Hospital provides comprehensive, interdisciplinary and evidence-based cancer treatment, as well as support and survivorship programs for oncology patients in New Jersey and beyond. Recognized for excellence in cancer care by the Commission on Cancer of the American College of Surgeons, the program is comprised of highly skilled and specialized cancer specialists, including surgical oncologists, medical oncologists and radiation oncologists.
Visit www.saintpetershcs.com for more information.
