hipec : stopgap chemo

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Comments

  • Chelsea71 said:

    Hi Cynthia,
    When Steve had

    Hi Cynthia,

    When Steve had Hipec his cancer at that time was contained to his abdominal cavity.  Surface cancer, with the exception of two retro-peritoneal lymph nodes discovered during his first surgery (colectomy-removal of the primary tumor).  I can remember the surgeon saying that this surgery was ideally done when there is only surface cancer.  The surgeon was very aggressive.  He targeted the affected lymph nodes and removed many others as a precaution.  Steve lost the tail of his pancreas, spleen, some small intestine, some abdominal wall, his rectal stump.....big, big surgery.  Clear margins.  Four months later there were tumors in the liver.  Prior to hipec the liver appeared fine.  So, we don't know if it spread there during surgery or if there were seedlings present prior to hipec that were too small to be detected.  Shortly before he died there were small spots on his lungs, as well.  I don't have huge regrets about hipec.  We knew going into it that it was risky and that it would involve a long recovery.  We knew the chances of him being cured were a longshot but we had hoped that such a big surgery would have bought him more time. His cancer did not return to the peritoneal cavity and for this I am grateful.  As we all know, the peritoneal cavity is not the best place to have tumors.  As the tumors grow they cause blockages and really affect ones QOL.  Basically, I am glad that at the end he was suffering from liver metastasis vs. peritoneal spread.  I do regret not having him use cimetidine before and after surgery.  I have really never heard of hipec curing anyone with MCRC.  Appendix cancer is more successfully treated by hipec.  In hindsight would we have done the hipec?  Likely not.  I actually spend a lot of time thinking about what we would have done differently.  Steve's cancer was very very aggressive.  A lot went wrong along the way.  He developed a lot of unusual complications.  I suspect that huge clot that developed by his port that completely blocked his superior vena cava played a big role in his downward spiral.  I think it prevented the chemo from being as effective as it should have been.  It seems like it all went downhill after the clot formed.  Anyways, Steve's anesthesiologist told him that hipec is the roughest surgery a person can have.  (It's nick name is MOAS for mother of all surgeries). It certainly shouldn't be entered into lightly.  As I stated earlier, I have not heard of any cc cures from hipec.  I think it's been proven to extend people's lives by six months to a year.  It takes some people close to a year to fully recover.  Is it worth the risk and brutal recovery?  In my opinion, probably not.

     

    Chelsea

     

     

    Chelsea,
    My mom had HIPEC

    Chelsea,

    My mom had HIPEC surgery in July and had her first post op CT scan.  I'm pretty nervous as it showed an ill-defined hypodense lesion on the surface of her liver that wasn't there before.  However, my mom's CEA level has always been an excellent indicator of mestasis and it went down to 1.4 from 2.0 a month before.  Her onco. said that he's not getting overly alarmed at the CT scan results due to most of her organs seem inflamed and irritated due to the Mytomycin C wash from the HIPEC surgery.  I was just wondering when Steve received the news 4 months after his HIPEC that the cancer had spread to his liver do you know if his CEA was elevated? It seems as though the majority of people have an elevated CEA reading.  I know CEA readings aren't 100%, but so far in my mom's 3 year colon cancer journey her CEA levels are an excellent indicator of mestasis.

    Thanks,

    Julie

     

     

     

  • thxmiker
    thxmiker Member Posts: 1,278 Member
    Most Doctors want an eight

    Most Doctors want an eight week window from the last time one had conventional chemo to receiving HIPEC.   HIPEC is exceptionally strong and residual effects from previous chemo can be an issue.  Some more aggresive Docs will do HIPEC 4 weeks after chemo.  (It is not recomended.)

     

    HIPEC is mot to be taken lightly. It is a very serious and risky procedure.  I was for it for me, because of the reoccurences I have had.  After surgery, I was not a good candidate for HIPEC, and it did not happen for me. At the same time, I am in a slight remission.  So, everything worked out for me.

     

    We are sending our thoughts and prayers for your father's health! 

    Best Always,  mike

     

  • pete43lost_at_sea
    pete43lost_at_sea Member Posts: 3,900 Member
    thxmiker said:

    Most Doctors want an eight

    Most Doctors want an eight week window from the last time one had conventional chemo to receiving HIPEC.   HIPEC is exceptionally strong and residual effects from previous chemo can be an issue.  Some more aggresive Docs will do HIPEC 4 weeks after chemo.  (It is not recomended.)

     

    HIPEC is mot to be taken lightly. It is a very serious and risky procedure.  I was for it for me, because of the reoccurences I have had.  After surgery, I was not a good candidate for HIPEC, and it did not happen for me. At the same time, I am in a slight remission.  So, everything worked out for me.

     

    We are sending our thoughts and prayers for your father's health! 

    Best Always,  mike

     

    maybe consider removab

    it worked very well for my perioneal disease, still is and over 12 months down the track.

    I am still on the hipec waiting list, the lung rfa waiting, but my aggressive surgeon said go back to germany, keep on doing whats working so well for you.

    prof morris has done 650 hipec's,  so my strategy was tace and removab to control minimal disease.

    clearly I was blessed with an immediate and extreme immune response, many factors in this, but it might might be worth a try.

    the my initial hipec alternative therapy took 10 weeks which was 3 course of removab, 3 tace peritoneam, liver, lymph nodes.

    email me if any questions.

    protecting immune function aka no chemo seems commonsense to me, but its a minority view here!

    I think what makes all the differene is if you are a vaccine responder, this is known by analysing your hla sub types. this is clear for dendritic cell efficacy but not really analysed for trifunctional antibodies responsive. I suspect hla also explains my great removab response.

     

    but this is all speculation on my part, but based on my clinical results.

    email me if you want more details.

     

  • Chelsea71
    Chelsea71 Member Posts: 1,169 Member

    Chelsea,
    My mom had HIPEC

    Chelsea,

    My mom had HIPEC surgery in July and had her first post op CT scan.  I'm pretty nervous as it showed an ill-defined hypodense lesion on the surface of her liver that wasn't there before.  However, my mom's CEA level has always been an excellent indicator of mestasis and it went down to 1.4 from 2.0 a month before.  Her onco. said that he's not getting overly alarmed at the CT scan results due to most of her organs seem inflamed and irritated due to the Mytomycin C wash from the HIPEC surgery.  I was just wondering when Steve received the news 4 months after his HIPEC that the cancer had spread to his liver do you know if his CEA was elevated? It seems as though the majority of people have an elevated CEA reading.  I know CEA readings aren't 100%, but so far in my mom's 3 year colon cancer journey her CEA levels are an excellent indicator of mestasis.

    Thanks,

    Julie

     

     

     

    Hi Julie.  I believe Steve's

    Hi Julie.  I believe Steve's CEA was 29 at the time the liver lesions were discovered.  Try not to worry.  Keep us updated!  Best of luck to you and Mom.

     

    Chelsea

  • NYMarc
    NYMarc Member Posts: 1

    There is one guy on the Colon Club

    who had HIPEC and has been NED for a while now, I think 2-3 years.  But he was in his late 20s when he had it done, and in exceptionally good health.  One person out of the many I've seen on the forums who have had this done is a pretty sad "success" rate.

    We're just so desperate to live, and the doctors truly do want to save us...it's not surprising that we all try just about anything to survive.  The instinct and will to fight for life is just so strong.

    My sister had surgery two months before she died (not HIPEC just tumor debulking).  She spent two weeks of those two months in the hospital instead of at home with her husband and kid.  It wasn't the right decision, but when you're in the heat of the moment, it seems impossible to make the right decision.

    I'm so sad for all of us who lost people we loved to this beast.  Although I shouldn't call it that, I guess...that's an insult to beasts everywhere.

    HIPEC

    I was diagnosed with Stage 4 Colon Cancer in July 2012, had a total coloectomy with ileostomy and then a HIPEC with reversal in January 2013. I had 11 rounds of Folfox pre-surgery and 7 post. HIPEC was an incredibly tough and painful surgery, but for me it was worth it. So far I am NED and happy I had the surgery. I was back home after 5 days, back at work in 3 weeks and actually went skiing in March.  I think the decision to have a HIPEC should be individual and many people are having the surgery inappropriatly leading to complications. A lot of people have the surgery as a last resort with large amounts of disease and a high PCI score. The surgery is effective, but mostly on people with a lower PCI and people who are in good enough health that they can handle a surgery of this nature. Personally, I would rather have another surgery than have another 6 months of chemo. I believe HIPEC is a good option for the right candidate, but not the miracle cure that some are hoping for.