Sunnybrook has launched the first Hepatic Artery Infusion Pump (HAIP) Chemotherapy Program in Canada for patients with limited treatment options where colon or bowel cancer (colorectal cancer) has spread to many areas of the liver.
The Hepatic Artery Infusion Pump (HAIP) is a small, disc-shaped device that is surgically implanted just below the skin of the patient, and is connected via a catheter to the hepatic (main) artery of the liver. About 95 percent of the chemotherapy that is directed through this pump stays in the liver, sparing the rest of the body from side effects.
Patients receive HAIP-directed chemotherapy in addition to regular intravenous (IV) chemotherapy (systemic chemotherapy), to reduce the number and size of tumours. Remaining tumours may then be able to be removed with surgery.
"Our goal is to provide patients with a coordinated approach across many cancer specialties. Currently, Sunnybrook's Odette Cancer Centre is the only Canadian cancer centre offering HAIP therapy. The program requires close collaboration with surgical oncology, medical oncology (chemotherapy), interventional radiology, nuclear medicine and oncology nursing," says Dr. Paul Karanicolas, surgical oncologist, Sunnybrook's Odette Cancer Centre Gastrointestinal Cancer Care team who collaborates with colleague and medical oncologist, Dr. Yooj Ko.
Traditionally, for patients with multiple liver cancer tumours where first-line chemotherapy is not working, treatment options are limited to second-line IV chemotherapy. Second-line regular IV chemotherapy treatment provides a 25 percent chance of response for patients. When second-line treatment stops working, there are even fewer and less effective chemotherapy options.
With combined HAIP-directed chemotherapy and IV chemotherapy, response in patients occurs up to 75 percent of the time.
"There have been several patients where standard chemotherapy was not working. A pump was put in and the patients had a dramatic response — from having many tumours to having only two or three that could then be removed surgically," says Dr. Karanicolas, who did his surgical training at Memorial Sloan-Kettering Cancer Center where he gained experience in the technique.
"We believe that HAIP chemotherapy may help 100 or more Canadians a year, and we hope this treatment option will continue to expand across the country to help more patients."
Colorectal cancer (also known as colon cancer or bowel cancer) is the third most common cause of cancer death in Canada. For about half of colorectal cancer patients, the cancer metastasizes to the liver.