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 However, Smith, a 74-year-old retired ironworker from rural Cantrall,
was the first person in central Illinois to receive a surgical
treatment that rinsed his abdominal cavity with heated chemotherapy.
“I didn’t think I’d be here,” Smith said. “I already prepared myself
in case I didn’t get off the table.”
The life-saving procedure is known as hyperthermic intraperitoneal
chemotherapy, or HIPEC. Because of it, Smith has more time with his
wife of 54 years, Linda, as they raise the four girls – sisters from
4 to 8 years old – they adopted last year after their mother was
diagnosed with cancer, which later claimed her life. The alternative
would have been to watch the girls split up into different homes,
said Smith, who has five great-grandchildren, four grandchildren and
three children.
And Smith can continue to travel to Jacksonville on weekends to work
on a 1935 Chevy Master town car that he and his son, Jason, are
rebuilding, along with some help from his other son, Jeff.
“I didn’t think I’d be able to finish it,” Smith said.
Southern Illinois University School of Medicine and Memorial Medical
Center worked together to bring the procedure to the region. Dr.
Sabha Ganai, an assistant professor in the department of surgery at
SIU School of Medicine, performed Smith’s eight-hour procedure on
Oct. 8 at the hospital.
Smith was diagnosed in January 2014 with peritoneal mesothelioma, a
cancer that attacks the lining of the abdomen. The peritoneum is a
membrane that lines the abdominal cavity and the organs within it
and produces a fluid that lubricates those organs.
Only a few hundred people are diagnosed with peritoneal mesothelioma
each year. They have few treatment options and typically survive
less than a year, Ganai said.
The HIPEC procedure, which has increasingly become the standard of
care for these patients, has changed that, Ganai said.
Patients first undergo traditional surgery during which the surgeon
removes all the visible tumor deposits in the abdominal cavity. For
Smith, that included the removal of his spleen, appendix and lining
of his diaphragm.
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Once all visible tumors have been removed, a chemotherapy
drug heated to nearly 108 degrees Fahrenheit is pumped into the
abdominal cavity, and a special pump circulates and heats the
fluid. The heat increases the effectiveness of the chemotherapy
drug, mitomycin, which destroys the microscopic cancer cells
that remain.
“A lot of pre-planning took place prior to the day of surgery,”
Ganai said, and involved a multidisciplinary team of more than 20
people from Memorial working with her, including the operating room
staff, cardiac perfusionists and pharmacy personnel.
The hospital leased a new FDA-approved pump, which heated and
filtered the mitomycin that circulated through Smith’s abdominal
cavity for about 90 minutes, said Drew Snyder, director of oncology
services at the nonprofit hospital.
After the procedure, Smith was in the hospital for about a week.
Ganai, who is also director of gastrointestinal oncology at Simmons
Cancer Institute, trained on the HIPEC procedure at the University
of Chicago during her fellowship in complex general surgery
oncology. She also trained in a rotation with Dr. Paul Sugarbaker, a
leading proponent of the procedure, with Washington Hospital Center.
Smith is back at home with his four adopted daughters. He and his
wife get up every weekday morning to make breakfast for them and
send them off to school. He enjoys working outside and hopes to
resume that when he’s back up to full strength, which doctors told
him could be about a year. He says he’s feeling good but is usually
fatigued by the day’s end. He’s grateful for the doctor who gave him
more time to be with his family.
“Dr. Ganai is just great. If she hadn’t of been here, I wouldn’t be
here either,” Smith said. “She is our family hero.”
[Michael Leathers, memorial Medical
Center]
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