HIPEC therapy saves Brisbane GP's life

When Brisbane GP Dr Chamari Jayawardena was diagnosed with advanced ovarian cancer, she had only one fear — that she would never again visit the orphanages she supports in Sri Lanka.

For more than 20 years, Jayawardena has supported hundreds of children in her native country by funding their education costs.

The hours after she learned she had ovarian cancer were the ‘darkest night’ of Jayawardena’s life — but today she is in complete remission after undergoing a novel chemotherapy treatment at Mater Private Hospital Brisbane.

In HIPEC therapy, heated, high-dose chemotherapy is flushed through the patient’s abdomen for 90 minutes after their tumour is removed — slowing or even halting the return of the disease.

Her treatment meant Jayawardena was finally able to return to Sri Lanka in December to see the children who inspired her fight for life.

“When I arrived with chocolates from Australia, like I usually do when I see them every year, the children were so happy and they sang songs to bless me,” Jayawardena said.

“They were so happy to see me ... but there are no words to describe how I felt at that moment.”

This February is Ovarian Cancer Awareness Month — an opportunity to warn women of the symptoms of ovarian cancer and to raise funds for vital research.

Jayawardena said she had felt bloated and had altered bowel habits for several months in 2021, but kept delaying her ultrasound scan as she prioritised caring for her patients over herself. It was only when she could no longer fit some of her clothes that her daughter — Dr Poornima Thiruchelvam, who works as a GP alongside her mother at their practice in Tingalpa — insisted she make time to attend a CT scan.

Tests then indicated she had a large pelvic tumour and also ascites due to her cancer. “If one of my patients had the same symptoms that I did, I would have examined and organised an urgent ultrasound for them, but I had neglected myself,” Jayawardena said.

Oncologist Dr Vikram Jain ordered an urgent biopsy and recommended chemotherapy begin as soon as possible, but Jayawardena was hesitant because she feared she might die without sorting out her responsibilities to the children at the orphanages.

However, Jain convinced her to try chemotherapy. She responded well and was referred to Professor Lewis Perrin, Director of Gynaecological Oncology at Mater Hospital Brisbane.

Perrin performed Queensland’s first ovarian cancer HIPEC procedure at Mater and was confident she would respond well to the pioneering treatment.

HIPEC procedure at Mater Private Hospital, Brisbane. Image: Supplied.

“Chamari came to me and said she wanted to live long enough to be able to go to Sri Lanka to say goodbye to the orphans,” Perrin said. “I said ‘Let’s change that plan. Let me treat you and you can go to orphanage and say hi, not bye’ — and that’s what we did.”

So far 30 women have undergone HIPEC for ovarian cancer at Mater as part of Australia’s first feasibility and safety study into the treatment.

A separate Dutch study found HIPEC can provide an extra 12 months of life for ovarian cancer patients — a major improvement in outcomes for a disease with a five-year survival rate of 49%.

Mater is now commencing the HyNOVA study, in collaboration with the Peter MacCallum Cancer Centre in Melbourne and Chris O’Brien Lifehouse at Sydney’s Royal Prince Albert Hospital, to investigate whether the treatment is effective when chemotherapy drugs are used at body temperature, which would simplify the treatment.

Dr Jayawardena’s tumour was removed by Prof Perrin in a multidisciplinary procedure at Mater Private Hospital Brisbane, which was immediately followed by HIPEC therapy.

Prof Perrin said the results so far were ‘very encouraging’. “I am very happy with how Chamari responded to the treatment,” he said.

“There is no evidence of the disease. She is in complete remission and I expect that to continue.” Dr Jayawardena migrated to Darwin in 1988, where she worked with patients in the community with a particular interest in Indigenous medicine, domestic violence, and drug and alcohol medicine. She also cared for patients affected by the crisis in East Timor.

In 2000 she started her charity work in Sri Lanka, which was in the midst of a 26-year civil war, by financing the schooling fees for 65 abandoned or orphaned children at a Colombo orphanage.

Dr Jayawardena opened her general practice in Brisbane in 2006 and has throughout continued to expand her charitable work in Sri Lanka. Today she supports three orphanages and a cancer hospital, and provides 20 scholarships to first-year medical students in financial hardship.

She said she was grateful for the care she received from the Mater South Brisbane and Mater Redlands Private oncology teams.

As a result of the care she received she was able to continue working as a GP through the COVID pandemic, providing continuity of care for her patients and stability for her staff.

“I am so grateful with every extra day I have been able to live because of my treatment,” she said.

“In addition to my charity work overseas, I want to continue giving my best back to my patients and community here in Brisbane. My family, patients and my staff were very supportive of me and motivated me to heal myself.

“I am so lucky that I can help people from my lived experience as both a doctor and a patient.”

Dr Jayawardena has an important message for Queensland women. “If you suffer from persistent bloating, altered bowel habits or stomach pain, you need to seek medical attention,” she said.

“I have been very lucky, but please do not neglect your health — no matter how busy you are.”

Top image: Dr Chamari Jayawardena and Dr Lewis Perrin pre-operation. Image: Supplied.