Hi friends, I’m Dr Praveen Kammar, Cancer Surgeon. In this video, I’ll explain a treatment option called PIPAC, which we consider in stage 4 colorectal cancer when the disease has spread to the peritoneum and causes fluid accumulation in the abdomen.
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Video Flow:
0:00 Introduction to PIPAC for Stage 4 colorectal cancer
0:31 Why aggressive treatments like HIPEC are not possible
1:18 When standard chemotherapy stops working
2:04 What is PIPAC and how it helps
2:52 Step-by-step explanation of the procedure
3:30 Role of CapnoPen and aerosol chemo delivery
4:10 Importance of pressure for drug absorption
5:00 How PIPAC controls tumor growth and fluid
5:22 Patient response and real-world results
5:52 Hospital stay, safety, and repeatability
6:21 Conclusion
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PIPAC Treatment: Stage 4 Colorectal Cancer और पेट में पानी का Best Treatment! | Dr Praveen Kammar
When Aggressive Surgery Isn’t an Option
At this advanced stage, where the cancer has spread extensively in the peritoneum and fluid has built up, aggressive treatments like cytoreductive surgery or HIPEC are usually not feasible. These patients often cannot be cured. So, the focus shifts to controlling the disease and improving the patient’s quality of life.
Why PIPAC Becomes Relevant
Many patients in this condition have already undergone several rounds of chemotherapy. Yet, the disease progresses, fluid keeps accumulating, and the patient’s nutritional status worsens. They become weaker with time, and additional systemic chemotherapy becomes difficult to administer. In such scenarios, PIPAC becomes a highly valuable treatment option.
What Is PIPAC?
PIPAC stands for Pressurized Intraperitoneal Aerosol Chemotherapy. In simple terms, it’s a method of delivering chemotherapy directly into the abdominal cavity in a microscopic aerosol form, allowing for better contact with the cancer nodules. It's a chemo delivery technique done inside the operation theatre under general anesthesia.
How the Procedure Is Done?
Under anesthesia, we create small laparoscopic ports, similar to keyhole surgery. Through these, we insert a camera to assess the disease spread and drain out the accumulated fluid. If required, we take a biopsy. Then, we introduce a device called a CapnoPen through a port to deliver the chemotherapy drug at high pressure and speed.
Why Pressure Matters in PIPAC
During laparoscopy, we maintain intra-abdominal pressure at around 10 to 12 mmHg. This pressurized environment forces the aerosolized drug particles into the tumor tissue. This enhances drug penetration, improves cell kill, and helps control both tumor proliferation and fluid accumulation.
Effectiveness and Outcomes
We’ve seen that when PIPAC is repeated two to three times at monthly intervals, about 60 to 70% of patients show a positive response. It helps control the disease in the peritoneum, reduces fluid buildup, relieves symptoms like pain, and improves nutritional status. In some cases, it also enables patients to restart chemotherapy.
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Related Videos:
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2. Colon Cancer में की जाने वाली Surgery: Right Hemicolectomy | Procedure & Recovery | Dr Praveen
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About Dr. Praveen Kammar
Dr Praveen Kammar is a surgical oncologist practising in the city of Mumbai.
He completed his MCh course in surgical oncology from the reputed Tata Memorial Centre, Mumbai, one of the premier cancer care centres in the country. He also holds a fellowship in Colorectal surgery from Yopnsei cancer centre, Seoul, South Korea. Dr Praveen’s main area of focus is colorectal and GI oncology, Gynecological cancers, minimal access surgeries for abdominal and thoracic malignancies, transanal surgeries, and sphincter-saving surgeries for rectal cancer, cytoreductive surgeries, and HIPEC for advanced abdominal cancers.
#ColorectalCancer #Stage4Cancer #PeritonealCancer #MetastaticCancer #CancerTreatment #PIPAC #PIPACTreatment #DrPraveenKammar
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