At Fred Hutchinson Cancer Center and University of Washington Medical Center, we surround you with experts who focus completely on cancer, day in and day out.
A handful of people are the core of your team for cytoreductive surgery and hyperthermic intraperitoneal chemotherapy (CRS-HIPEC). You will have a surgical oncologist who has a lot of experience with this highly specialized procedure. You will also have a surgical oncology nurse with a special focus on caring for people before, during and after CRS-HIPEC. At some visits, you might see an advanced practice provider. Before surgery, you will meet with the anesthesiology team to make sure it is safe for you to get anesthesia (drugs that keep you from feeling pain during surgery). This might mean more tests. A dietitian and physical therapist are here to help you prepare and recover.
Others may join your team based on your personal needs. If you need systemic (whole-body) chemotherapy, you will have an expert medical oncologist . If you have cancer of the ovaries or fallopian tubes, a gynecologic oncologist who is an expert in CRS will be involved. If another specialist, like a gynecologist or urologist, can help with planning or giving your treatment, we call them in. We have many specialists based at Fred Hutch and UW Medical Center who know the issues that matter for people with cancer.
Supportive care services are here to help, too. You may see Fred Hutch psychologists, a stoma nurse (in case you need a colostomy or ileostomy), social workers and others. All of us specialize in caring for people during and after cancer.
Kerry McMillen is a registered dietitian who has worked with cancer patients for more than 20 years. She is the manager of Fred Hutch Medical Nutrition Therapy Services, works with patients at all Fred Hutch clinic locations and has a special interest in working with hematopoietic cell transplant patients. Kerry is a fellow of the Academy of Nutrition and Dietetics and is a board-certified specialist in oncology nutrition.
Tal Ozery is a registered dietitian who works with patients at risk of developing a gastrointestinal cancer. She also sees patients with head and neck cancers. Tal has a special interest in counseling patients with eating disorders. She cares for patients at the South Lake Union clinic, Peninsula clinic and Issaquah clinic.
Hailey Wilson is a registered dietitian who works with gastrointestinal, thoracic, head and neck cancer patients at the South Lake Union clinic and Issaquah clinic. She has eight years of experience and is a board-certified nutrition support clinician.
What each team member does
These health care professionals work closely with your physicians in the clinic. There are two types: physician assistants (PAs) and advanced registered nurse practitioners (ARNPs). They help provide and coordinate your treatment and can see you without your physician. They also help manage any effects of your disease and treatment.
Registered dietitians are credentialed food and nutrition experts. To earn this title, they must go through a lot of training and formal education, including doing an internship and passing a national registration exam. Registered dietitians provide medical nutrition therapy, which means they use an evidence-based approach to treat and help patients manage medical conditions through diet and nutrition.
For people who are having CRS-HIPEC, dietitians focus especially on these topics:
- How to get the best nutrition for strength and healing before your procedure
- What to expect and how to meet your nutrition needs after your procedure
Your dietitian closely watches and treats your nutritional needs after surgery to help with healing.
This type of surgeon specializes in diagnosing and treating gynecologic cancers. They do surgery to remove as much of the cancer as possible, plus a small amount of healthy tissue around the cancer, and they recommend chemotherapy-based treatments.
If you have cancer of the ovaries or fallopian tubes, a gynecologic oncologist will be involved in your care. They will examine you and talk with you about the best treatment options for your case. For example, even if CRS-HIPEC is a good option for you, you may need systemic (whole-body) chemotherapy first under their expert care.
A surgical oncologist may be involved in your cytoreductive surgery along with your gynecologic oncologist.
This physician oversees medicine-based treatments. Some people who are having CRS-HIPEC may have systemic (whole-body) chemotherapy , targeted therapy or immunotherapy as part of their overall treatment plan.
Your medical oncologist will:
- Recommend medicine-based treatments to match your specific case. They select the medicines, doses, schedule and sequence. They also talk with you about the benefits and risks.
- See you on a regular schedule to check how your cancer responds to treatment and how you are overall.
- Offer you ways to prevent, relieve and cope with side effects of treatment, like medicine to help with nausea.
- Work with the rest of your care team if you need other types of treatment.
- Coordinate care with your local oncologist if you plan to get chemotherapy closer to home.
If you are from outside the Seattle area and are coming to Fred Hutch only for CRS-HIPEC, a Fred Hutch medical oncologist can coordinate with your local team about medicine-based treatments you may receive there.
If you have cancer of the ovaries or fallopian tubes, your CRS-HIPEC team will also include a gynecologic oncologist, a physician who specializes in surgery as well as chemotherapy-based treatments.
People of any age who are diagnosed with cancer can improve their strength, function and independence during and after cancer treatment with the help of physical therapy. PTs can help you with issues like weakness, balance, scar tissue, lymphedema, range of motion and rehabilitation equipment. Fred Hutch PTs have advanced training in oncology care.
Before CRS-HIPEC, they offer “pre-hab” (a twist on post-surgery rehabilitation) to help you be in the best condition for surgery with good function and endurance.
After your surgery, these experts will check on your healing, treat you and provide you with tools to continue managing symptoms on your own.
This type of surgeon specializes in diagnosing and treating cancer. They do surgery to remove as much of your cancer as possible, plus a small amount of healthy tissue around the cancer. They might also remove lymph nodes to see if the cancer has spread.
In CRS-HIPEC, your surgeon also gives the chemotherapy that is put into your abdomen to kill any remaining cancer cells.
Your surgeon will:
- See you during your first CRS-HIPEC visit to talk about the procedure and whether it is a good option for you.
- Recommend surgery to match your specific case. They explain any surgical options you have. They also talk with you about the benefits and risks.
- Answer your questions about surgery, like why you need it and what to expect.
- Do your surgery, along with a team that includes an anesthesiologist, a perfusionist (a health care professional who uses a machine to keep your blood moving during surgery) and nurses. Gynecologic oncologists may also be involved in your surgery, especially if you have cancer of the ovaries or fallopian tubes.
- See you after surgery to check on your healing.
- Offer you ways to prevent, relieve and cope with side effects of surgery.
- Work with the rest of your care team if you need other types of treatment.
This person may see you when you come in for surgery-related visits. They work closely with your physician to provide your care. They explain your treatment, check your health, answer your questions and help you prepare, recover and deal with side effects.
Many types of supportive care team members are here to help you and your family. Along with dietitians and physical therapists, they can include pain medicine specialists, psychologists, social workers, spiritual health staff, palliative care specialists, naturopaths and acupuncturists.