Chemo
Dr J. S. Rajkumar (third from right) with Dr Sadir Alrawi (right) and other members of the medical team at Burjeel Specialty Hospital Sharjah. Image Credit: Supplied

Sharjah: As a doctor, Mohammad Abdel Rahman, 45, knew the odds were stacked against him when he was diagnosed with advanced middle rectal cancer in February 2020.

“Initially, the doctors used chemotherapy, but as the cancer spread they realised they were fighting a losing battle,” recalls the Sudanese expat.

Early this year, Rahman’s condition worsened. His hopes were then hinged on Burjeel Specialty Hospital Sharjah, where a multidisciplinary team of doctors examined his medical reports and recommended the CRS-HIPEC procedure — an aggressive combination of surgery and chemotherapy in which a surgeon removes cancerous cells manually and floods the abdominal cavity with a hot solution containing chemotherapy drugs to kill any cancer cell that are not visible to the naked eye.

HIPEC is short-form for hyperthermia (heated) intra-peritoneal chemotherapy, and CRS for cytoreductive surgery. In recent years, CRS-HIPEC has gained immense popularity. However, it remains controversial till date with uncertainty about appropriate patient selection and a raging debate in the oncology community about its efficacy.

Last month, a team of doctors led by top oncologist Dr Sadir Alrawi put such concerns behind them as they successfully used the technique on Rahman, giving him a new lease of life. “Many of my friends were sceptical about the procedure, given the controversies surrounding it. They said it was fraught with risks, but I am glad I went ahead with it,” said Rahman who is recovering fast.

“The surgery itself was very complex. We had to remove parts of the pancreas, small intestine, stomach and the gall bladder, and put all of them back again,” said Dr. Mohamed Eraki, consultant of general and laparoscopic and surgery at Burjeel Specialty Hospital, Sharjah.

“The indications for cytoreductive surgery with HIPEC are difficult and always a matter of discussion and controversy at tumor board meetings. In this case, we knew exactly what we were doing,” added Dr Mehdi Afrit, specialist medical oncologist at the hospital.

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Dr Humaid Al Shamsi, director of VPS oncology services in the UAE, attributed the success of the surgery to the hospital’s team-based multidisciplinary approach. “HIPEC is one of the most advanced surgical procedures. It requires a special team with experience and expertise in both medical and surgical oncology,” he said.

Laparoscopic surgeon Dr J.S. Rajkumar said treating cancer with CRS-HIPEC is not a singular effort. “The surgery lasted ten hours, but it involved the combined efforts and expertise of several oncologists, radiologists, pathologists nurses and dietitians who put in hundreds of hours to deliver exemplary care and treatment.”