Pseudomyxoma peritonei is a rare form of cancer which usually relates to intra-abdominal tumours that, when burst, release jelly-like mucus into the abdominal cavity. These cancers have previously been treated by serial operations to remove the jelly, often resulting in scarring or adhesions in the abdomen. The patient loses pieces of bowel tissue with each operation, and eventually dies from either tumour regrowth or bowel obstruction.
A patient at Knox Private Hospital was diagnosed with this disease and surgeon Mr Adam Skidmore implemented the world’s current best practice, using a multidisciplinary approach to treat this patient. As well as the surgeon, the team of cancer specialists included nurses, medical consultants, and pharmacists.
First the patient’s tumour, jelly, spleen, part of his small bowel, and the surface of the liver were removed at Knox Private Hospital, then followed by intraperitoneal chemotherapy, which was formulated and prepared by HPS’ oncology pharmacists. The chemotherapy solution was heated to 41.5ºC prior to being circulated through the patient’s peritoneal cavity over 90 minutes.
Post-operatively the patient was transferred to Ringwood Private Hospital for further intraperitoneal chemotherapy. The solution was warmed to 37ºC to prevent pain during administration as well as to improve efficacy.
This patient was the first in Victoria to undergo the Sugarbaker technique, named after its developer, Dr Paul Sugarbaker of the Washington Cancer Institute, and while it is not a definitive cure, Mr Skidmore reported that the procedure was a success in offering the patient a return to a normal quality of life.
- Sugarbaker PH. New standard of care for appendiceal epithelial neoplasms and pseudomyxoma peritonei syndrome? Lancet Oncol 2006; 7(1): 69-76.