Unprecedented collaboration: Mercy oncologists save lives with HIPEC treatment for ovarian cancer

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A groundbreaking partnership at Mercy Medical Center is giving hope to women battling ovarian cancer.

Dr. Armando Sardi, a surgical oncologist at The Institute for Cancer Care, and Dr. Teresa Diaz-Montes, a gynecologic oncologist at The Gynecologic Oncology Center, have teamed up to use an innovative technique called hyperthermic intraperitoneal chemotherapy, or HIPEC, to treat advanced ovarian cancer. Their collaboration combines expertise from different surgical disciplines to address one of the most challenging cancers to diagnose and treat.

Ovarian cancer is notoriously difficult to detect in its early stages.

“Many women experience nonspecific symptoms for over a year before being accurately diagnosed, and by the time they come to us, they’re often at stage 3 or stage 4,” said Dr. Diaz-Montes.

The advanced stage of ovarian cancer at diagnosis makes treatment more complex, as the cancer often spreads throughout the abdomen. HIPEC serves as a vital tool. Surgeons first remove visible tumors from the abdomen, then administer heated chemotherapy to target any remaining microscopic cancer cells. This aggressive treatment reduces the chances of recurrence and improves survival rates for patients with late-stage cancers.

“Most patients with ovarian cancer have disease spread throughout the abdomen,” Dr. Sardi said. “Our goal is to remove all visible tumors. The standard of care is to remove tumors down to one centimeter, but we go further to remove everything we can see because that gives the best chance for long-term survival.”

When Diaz-Montes met Sardi, a HIPEC pioneer for over 30 years, she saw an opportunity to collaborate after recognizing their complementary surgical skills.

“When I came to Mercy, I realized how much we have in common, not just in our views, but also regarding how we see this process and how we can take it to the next level,” said Dr. Diaz-Montes. “We’ve combined our expertise to give our patients the best outcomes.”

Sardi specializes in treating cancers of the upper abdomen, including the liver and spleen, while Diaz-Montes brings her expertise in gynecologic oncology and lower abdominal cancers. Together, they ensure thorough tumor removal, regardless of location, which is critical in treating ovarian cancer successfully.

Unlike traditional chemotherapy, which circulates throughout the body, HIPEC delivers heated chemotherapy directly to the abdominal cavity, allowing higher drug concentrations at the cancer site. Sardi explained that this targeted approach increases the chances of survival and reduces systemic side effects by focusing treatment where it’s most needed. The heat enhances the chemotherapy’s ability to penetrate tissues and destroy remaining microscopic cancer cells, offering patients a stronger defense against recurrence.

Despite its promise, HIPEC is not widely used, especially for ovarian cancer.

“Unfortunately, many physicians or gynecologists don’t follow the data supporting HIPEC, and some insurance companies don’t cover the treatment for ovarian or uterine cancers,” Sardi said.

As a result, some patients must pay out of pocket for HIPEC, creating financial barriers that limit access to the treatment despite its potential to improve survival rates. Sardi and his team continue to advocate for increased awareness and insurance coverage through initiatives like the Abdominal Cancer Alliance, which promotes broader acceptance of HIPEC as a treatment option.

Sardi and Diaz-Montes’ efforts are paying off. Over 16 years ago, Helen Szablya was diagnosed with stage 4 peritoneal carcinomatosis, a rare cancer that spreads through the abdominal area. Patients with this diagnosis are usually given two to nine months to survive. Szablya contacted Dr. Sardi after knowing him socially, and he helped schedule her for surgery. In 2008, just as she was put under, a tumor in her fallopian tube burst. Szablya said that Dr. Sardi and HIPEC are why she’s still here today.

“HIPEC saved my life. Had I been anywhere other than the operating table when it happened, I would have bled out and died,” Szablya said.

Many more patients like Szablya celebrate yearly by attending Mercy Medical Center’s “Heat It to Beat It” event, a patient-led walk to generate awareness for the lifesaving procedure. Szablya emceed this year’s event. To date, the event has raised over $2.5 million to support research.

“I have been an advocate for HIPEC ever since. I was on the inaugural committee to establish the walk to raise money for educating the medical community and doing research. I have mentored numerous patients who were afraid of the surgery, made many friends, and received many thanks from them for convincing them to go ahead with it,” Szablya said.

Many patients come to Mercy from across the country and abroad, seeking HIPEC as a second chance. The hospital treats about three to four patients weekly, with individuals traveling from 65 cities and 12 countries. Diaz-Montes noted that ovarian cancer is particularly complex and often requires a multidisciplinary approach.

“These types of cancers are surgically challenging,” she said. “As surgeons, we need to constantly collaborate and learn from each other to benefit our patients.”

Both Sardi and Diaz-Montes stress the importance of early detection and patient advocacy. Ovarian cancer symptoms, such as abdominal distension, bloating, constipation, and frequent urination, are often nonspecific.

“It’s irresponsible to tell people to check every symptom, but we need to educate the public to recognize when something is persistently wrong,” Diaz-Montes said.

She also advocates for genetic testing, particularly for those with a family history of cancer, as many cases of ovarian cancer have a genetic component. Knowing your family history is key, she said.

For patients diagnosed with ovarian cancer, Diaz-Montes advises seeking care at centers of excellence like Mercy.

“Take your time and look for a center that specializes in managing these cancers,” she said.

Mercy now has six surgeons collaborating to provide comprehensive care for women with gynecologic cancers, making it a top destination for patients seeking advanced treatments like HIPEC.