In a Canadian first, doctors at Maisonneuve-Rosemont Hospital have perfected a "heated" chemotherapy to treat and even cure those suffering from a form of colorectal cancer. The treatment is so promising that some Ontario patients are eager to travel to Quebec to undergo it, said Dr. Pierre Dubé, a surgical oncologist at the east-end hospital.

The treatment - called hyperthermic chemotherapy in combination with surgery - also has the potential to eradicate a form of ovarian cancer. One of the patients who underwent the treatment and who now has an excellent prognosis is the mayor of Hudson, 55-year-old Stephen Shaar. "I feel great, perfectly normal," Shaar said yesterday. "I feel like I could go jogging, but my doctor keeps telling me: 'No, not yet.' "I've been on an emotional roller coaster, but now I feel very positive."

Shaar learned 2 1/2 years ago that he suffers from peritoneal carcinomatosis of the colon. That means that his colon cancer had spread to his peritoneum, the membrane lining the abdominal cavity. For now, doctors at Maisonneuve-Rosemont are using the unusual technique to treat people with Shaar's condition, which affects an average of 250 Quebecers a year. However, Dubé noted that experimental trials are being conducted elsewhere on women suffering from peritoneal carcinomatosis of the ovaries. "This treatment represents a real gain for these patients," Dubé said after a video demonstration of the technique. "We're doing a lot more than improving their quality of life. We're improving their survival rate."

Studies have shown that the treatment has a 30- to 50-per-cent cure rate. To put this in context, until the advent of hyperthermic chemotherapy, doctors only attempted to palliate or comfort those suffering from Shaar's type of colon cancer.

Dubé learned the highly complex and risky treatment at the Institut Gustave Roussy in Paris. Another surgical oncologist at Maisonneuve-Rosemont is now training at the institute. The four-hour procedure involves two steps. First, the surgeon cuts open the abdomen of the patient and excises all traces of cancer. While the abdomen is open, the hyperthermic chemotherapy begins. Tubes are stuck in the abdomen, and two chemotherapy drugs are pumped inside, bathing the internal organs in liquid heated to 44 degrees Celsius for up to 45 minutes. What residual cancerous cells the surgery was unable to remove, the chemotherapy goes after, soaking the tissue of the liver, stomach, spleen, pancreas, kidney as well as the small and large intestines. "When you heat the chemicals, they are more effective in killing the cancer cells," Dubé explained. "They are better able to penetrate the cancer cells."

Pumping the chemicals directly to the site, rather than intravenously, allows for a greater concentration of the drug. Patients who undergo conventional treatment for peritoneal carcinomatosis usually have a relapse after a couple of years. However, since hyperthermic chemotherapy was pioneered in 1996, 30 to 50 per cent of patients have not had any relapses with the new treatment, Dubé observed. That led him to conclude that these patients are cured.

Dubé pointed out that a Quebec woman sought hyperthermic chemotherapy in the United States recently, paying more than $140,000 U.S. "She wasn't too happy when she found out the treatment is available here."

It's estimated that the treatment in Quebec would cost taxpayers $10,000 per patient.

Dubé has operated on five patients since last June using hyperthermic chemotherapy. The Maisonneuve-Rosemont team has continued to refine the treatment, improving its safety and efficacy. Still, the procedure carries a 5-per-cent risk of death - twice that of open-heart surgery. And during recovery, two-thirds of patients suffer from fever and abdominal infections. <

Most cases of colon cancer can be treated with conventional chemotherapy. Still, about 1,750 patients a year experience a recurrence of their disease.

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