Dr Arash Rafii Tabrizi in the operation theater.
DOHA: A doctor at Weill Cornell Medicine – Qatar (WCM-Q) wants to bring an innovative form of surgery for ovarian cancer to Qatar in the hope of improving survival rates among women.
Dr Arash Rafii Tabrizi, professor of genetic medicine in obstetrics and gynecology at WCM-Q, recently took part in a new surgical protocol in France that has only been in use for a few months. Doctors believe that it may improve the survival rate of patients with ovarian cancer and Dr Tabrizi would like to work with local stakeholders to set up an innovative program for advanced ovarian cancer management and introduce the new personalized medicine approach in Qatar.
Dr Tabrizi explained that ovarian cancer is the deadliest form of gynecological cancer, with patients who are diagnosed when the disease at an advanced stage only likely to live for three or four years. This is compared to breast cancer which has a survival rate of 80-90 percent. The reason that the prognosis for ovarian cancer is so poor is that it develops in the abdomen. As this is such a large cavity, the symptoms often go unrecognized until the cancer is at an advanced stage and it has spread throughout the body.
Currently, the standard treatment is surgery to remove all tumors, followed by intravenous chemotherapy, but recurrence of the disease is common and Dr Tabrizi believes this is because microscopic cancer cells are able to hide in the peritoneum.
“For the last 10 years, my laboratory, supported by Qatar Foundation through both the biomedical research program and the Qatar National Research Fund, has examined the relationship between the peritoneum and cancer cells. We have identified that the peritoneum cells become activated during surgery and this reaction is hijacked by the cancer cells to evade the chemotherapy drugs. So, we have to disrupt this relationship to improve the chances of destroying the disease,” he said.
Dr Tabrizi explained that in 2004 he became involved with the concept of HIPEC - hyperthermic intraperitoneal chemotherapy – in advanced ovarian cancer. This involves heating the chemotherapy drugs and then applying them directly to the abdominal cavity rather than giving them intravenously. The heat provides a shock to the cancer cells which leads to cell death, and applying the chemotherapy directly to the abdomen allows it to be delivered in a higher concentration than delivering it intravenously. Unfortunately, though, the technique was not effective.
However, doctors still believed the peritoneum to be the key so the process has been changed; in order to reduce the shock to the patient’s body, the temperature of the chemotherapy drugs has been reduced by two degrees to 40 degrees.
