What's On News June 2020 Fellowship builds on Mater's growing expertise in novel chemotherapy treatment

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Fellowship builds on Mater's growing expertise in novel chemotherapy treatment

Friday 26 June 2020

Mater gynaecological oncologist Dr Nisha Jagasia recently spent six months in Ireland working alongside experts in hyperthermic intraperitoneal chemotherapy, a novel therapy Mater is currently offering to women with advanced ovarian cancer.

Hyperthermic intraperitoneal chemotherapy (HIPEC) is highly concentrated, heated chemotherapy delivered directly into the abdomen immediately following surgery. The raised temperature and delivery into the abdominal cavity is designed to improve the absorption of chemotherapy and destroy any microscopic cancer cells that remain after surgery. 

Dr Jagasia had the opportunity to undertake a prestigious fellowship in the Peritoneal Malignancy Institute at Mater Misericordiae University Hospital in Dublin–a recognised hub for HIPEC treatment. Her time in the peritoneal malignancy unit, from July to December last year, allowed Dr Jagasia to broaden her surgical skills and gain valuable insights into the multidisciplinary approach to this complex surgery and HIPEC delivery.

“There are very few fellowships like it available and I feel privileged to have been given this experience at this stage in my specialist career,” Dr Jagasia said.

“It happened because Mater has maintained strong connections with Mater Misericordiae University Hospital in Dublin (Dr Donal Brennan, Head of Gynaecological Oncology was previously based at Mater here in Brisbane) and because our lead clinician, Prof Lew Perrin and his peers here at Mater work hard to facilitate opportunities for fellows and specialists where there can be this cross-pollination of skills,” she said.

Mater’s trial of ovarian cancer surgery with HIPEC began in December 2018, motivated by the results of a seminal study in the Netherlands which showed ovarian cancer patients who received HIPEC following surgery had an improved survival of up to 12 months, compared with patients who did not receive the therapy.

To date the team has successfully performed surgery with HIPEC on 10 patients with advanced ovarian cancer.

Multidisciplinary approach

Dr Jagasia said her fellowship had highlighted how critical the multidisciplinary approach to surgery and after care is to HIPEC treatment and its outcomes for patients.

“What I learned during my time in Ireland was much broader than how to carry out the HIPEC element of a patient’s operation–it was gaining an intricate understanding of all the components that need to be pre-planned and then perfectly executed for an optimum outcome,” she said.

Dr Jagasia explained this includes the surgical team’s planning and decision-making before surgery, coordination of everything that happens in the operating theatre including multiple surgeons working on the patient over several hours and the detailed after-care involving specialised nurses and allied health practitioners, such as dieticians and physiotherapists.

“It was a lesson in how all the cogs in the wheel must work together to achieve good patient outcomes,” she said.

Collaboration

Dr Jagasia said both the Mater HIPEC program and her peritoneal malignancy fellowship had been the result of collaboration.

“Dr Sanjeev Naidu and his team at the Princess Alexandra Hospital have extensive experience in peritoneal malignancy surgery with HIPEC and their mentorship was extremely important in helping Mater set up our HIPEC program for ovarian cancer,” she explained.

“Meanwhile, our collaboration with the gynaecological oncology unit at Mater in Dublin is instrumental to our ongoing research,” she said.

Under Dr Perrin’s leadership, Mater is the first centre in Queensland to treat ovarian cancer using HIPEC and hopes to be part of a large randomised study being launched by the Dutch research team who published the first breakthrough results in early 2018.

“Mater is positioning itself at the forefront of gynaecological cancer management and it is exciting for me as a young gynaecological oncologist to be a part of that,” Dr Jagasia said.