Look inside the abdomen of a patient suffering from PMP — a rare, slow-growing cancer — and you’ll find layers of mucus-producing tumors.
Abdominal conditions, such as appendiceal/PMP, peritoneal mesothelioma, colon and ovarian cancers, are often difficult to recognize and sometimes misdiagnosed. By the time doctors cut open a patient’s belly and find gobs of the jelly-like tumors, it can be too late.
“In the past, there was very little we could offer for patients who presented with advanced surface malignancies,” said Wilbur Bowne, MD, a surgical oncologist and associate professor in the Drexel University College of Medicine.
But now, Bowne and a multidisciplinary cancer team at Drexel are some of the few physicians in the region who perform a life-saving treatment for such patients. The procedure is called HIPEC (hyperthermic intraperitoneal chemotherapy). It involves a combination of surgery to remove tumors found in the abdominal cavity, followed by the delivery of high doses of targeted, heated chemotherapy to destroy the remaining cancer cells. The entire process requires a dedicated, multi-disciplinary approach based on evidenced-based data, according to Bowne.
“Data is starting to come out for patients with peritoneal surface malignancies,” he said. “Patients who were previously supposed to live for six months or less are now living for years, even decades. It’s really a remarkable advance.”
Now, the surgeon is spearheading efforts to raise awareness about PMP diagnosis, care and research, so more patients will have a greater chance of survival.
On Saturday, April 9, oncologists, surgeons, radiologists, nurses and other health care professionals will come together at the “PMP/Appendiceal Cancer Multidisciplinary Symposium” hosted by Bowne, the College of Medicine and Hahnemann University Hospital. The event’s mission is to discuss current guidelines for diagnosing and managing PMP, as well as emerging research in the field.
Speaking at the conference will be Daniel Kugler, a patient of Bowne’s, who recently shared his cancer journey in a Reading Eagle story.
“What I’m trying to do is bring awareness for others,” Kugler told the newspaper. “If there’s something I could do for somebody else, I’d like to do that.”
Kugler received HIPEC in November. Bowne discussed the benefits of the specialized procedure in a video for MD Magazine in March.
While HIPEC has revolutionized care for patients who have advanced abdominal cancer, doctors still face challenges when treating PMP. The biggest barrier is the thick mucin, which surrounds epithelial cancer cells, and, researchers believe, acts as a protective shield against anti-cancer drugs.
Bowne is now collaborating with Hao Cheng, PhD, assistant professor in the College of Engineering, on a project that would break past that hurdle. Together they are developing a nanoparticle drug delivery system that would better target and direct chemotherapy through the mucin and to the tumor.
This spring, Bowne and Cheng received funding from the PMP Research Foundation to begin the project.
Separately, Drexel surgical resident Elizabeth Gleeson is investigating the biomarkers of PMP that could be targeted by existing drugs.
“So Liz is identifying the target and Dr. Cheng is figuring out how to reach it,” Bowne said.
With diseases like breast cancer, oncologists can often deliver different types of drugs depending on the genetic makeup of a patient’s specific tumor.
“But with less common cancers, like PMP, there are not enough patients in clinical trials to identify the molecular profile that might lead to the disease,” Gleeson said.
In a forthcoming study, Gleeson looked at a small sample of PMP patients and discovered the protein markers that could be contributing to PMP. She is hoping that raised awareness about the rare cancer will help to further research and eventually lead to more effective treatments.
“We need more patients, and we need more tissue samples. Once we’ve been able to study them, I think we’ll get a much better idea of how these tumors behave,” Gleeson said.
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