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Malignant Ascites (Fluid overload)

Tonio
Posts: 5
Joined: Apr 2011

My brother is in the throws of esophogeal/stomach cancer, has had chemo and radiation but was not allowed to receive surgery due to low albumin levels. He began experiencing abdominal bloating, and during evaluation they did a CT scan indicating spots around the abdomen lining and a potential spot in the liver and determined the fluid to be Malignant Ascites.

He had a feeder tube placed in his stomach to improve nutrition intake since he has continued to have swallowing problems and even bleeding at the esophagus/stomach sphincter. They plan to put a fluid drainage tube into his abdomen tomorrow, 4-5-2011.

I have heard no good news as to treatment of the ascites fluid and wondered if chemo will help assuming he is strong enough for more chemo. He is 63 normally weighs about 153 lbs. but is down to about 110 lbs. with considerable muscle loss. (If you know of anything that has helped to cure malignant ascites please let me know.)

Of those who have had chemo after having ascites, did the ascites respond positively to the chemo, by killing or shrinking the cancer cells?

Also, I have seen where trials have been done using albumin to treat cirrhosis related ascites which represents about 80% of all ascites. Also, when drawing the fluid from the abdomen (parentasis) they are suppose to give albumin to restore some system balance.

It is my understanding that albumin helps to bind the blood cells and protect against leakage of blood fluids through vessels and arteries, which makes low albumin appear to be the main culprit for liver ascites and malignant ascites (cancer in the abdomen lining).

What would be the risk of trying albumin supplementation? Is it too expensive? I suppose this would be more appropriately directed to the medical community, but our doctor seemed to think I was off base but gave no reason why it should not work. She only said the "fluid is coming from the cancer cells in the abdomen lining".

Tony (Tonio)

neverquit
Posts: 221
Joined: Oct 2010

Hi Tony (Tonio). I can tell you what my husband's experience was with the Ascites, but please do not give up hope. Unfortunately, my husband Mike (54 when diagnosed June 21, 2010) had stage IV stomach cancer with mets to the bones (not extreme mets and never really gave him any pain, thank God). The doctor said because Mike was very fit, "young" and had a great fighting attitude, that he had a chance to beat this beast. Mike had some ascites in his abdomen and some in the right lung when he was first diagnosed. When diagnosed, we immediately began to eat/drink organic foods/drinks and really worked on the juicing and maintaining a more alkaline environment internally.

Mike fought an amazing fight and initially responded pretty well to the chemo. The tumors in his stomach began to shrink, his ascites lessened and his markers were going down (one almost got to the normal level). His weight went from 186 to a low of 123 lbs, but he even began to gain weight and got back up to 142 lbs. He was able to eat much better and never had to have a feeding tube. Mike remained fairly active, including continuing to volunteer as a Ski Patroller in the first aid room at the start of the ski season. Mike kept a positive attitude and was in it for the win throughout the battle.

Unfortunately, as with this cancer, suddenly, things started to go downhill quickly towards the end of December. Mike's Oncologist was fantastic and she would not give up hope (she has a great victory rate). She used state of the art techniques (molecular targeted testing) to try and stay one step ahead of this very aggressive cancer from the very beginning. She also had Mike tested early on to see if he was hurd 2 positive, but he was not (only 10% are hurd 2 positive, but if you are, they can give you herceptin which becomes very effective against this cancer).

Mike's ascites got pretty bad at the end, where they had to tap him about 2 times per week and give him the Albumin. It did help, but eventually, he got so weak that they had to stop the chemo. Unfortunately, I lost the love of my life (31+ years of a great marriage and I knew him since first grade) and the world lost a fantastic soul on Jan. 23, 2011 at the age of 54.

I know what my husband would tell you if he could. He would say DO NOT give up hope and look into all of the options. We knew several stage IV survivors his Oncologist was working with that had extreme cases of ascites and had been given no hope by other doctors. They have improved tremendously and are doing well (including having the ascites get to the point where there is little or no tapping needed). One has stage IV gall bladder cancer, one has stage IV colon cancer and the other has stage IV liver cancer.

I hope your brother finds help that works for him. I wish both him and you a good outcome. Take care and please let me know how things are going.

rohan312
Posts: 2
Joined: Apr 2011

Thank you for your reply to tonio's query. My aunt was diagnosed with Stage stomach carcinoma in June'10. She had her stomach removed and was on chemo + radiation. Things were looking except the Feb'11 CT showed that her left adrenal had lesions. The April'11 paints an even somber image. She has ascites and her ovaries also have lesions. I am so far away from her, I feel so terrible that she is going through so much pain. I just pray to God that she doesn't have to suffer. I am going to suggest that her doctor check if herceptin can work on her.

Thanks once again neverquit.

neverquit
Posts: 221
Joined: Oct 2010

Hi rohan312. I think I saw another post from you about your Aunt traveling to the US for a possible clinical trial? If that was you, I think there may be a trial going on at Sloan Kettering in NYC that is an inhibitor versus a chemo. (inhibitors attack cancer cells only whereas chemo attacks good and bad cells). I think it was called the Hedgehog trial (or something like that). My husband passed too soon but they may be taking patients now. I would check to see what trials are going on globally and what the requirements are. I know at the time, my husband's circumstances were such that they wanted to try one of the "normal" treatments first, since the targeted molecular therapy showed that he should respond well. Keep looking and please never lose hope. I wish you and your Aunt the best. Take care.

ana16
Posts: 1
Joined: Dec 2012

Dear neverquit,

 

Thank you for your post.  Can I just ask the name of the onocologist of whom you speak?  especially if she treated someone with stage iv gallbladder cancer.  my mom as it and developed ascites about a month ago.  she had her first tap a week ago and has already needed another just one week later.  any info would help.

 

thank you so much.

stacy

Lilllly
Posts: 16
Joined: May 2009

Hello. Sorry to hear about the difficulties. My father had ascites appearing about 4 months after completion of his treatment, which was chemo, total gastrectomy chemo and radiation, then more chemo when fluid was found. The ascites showed to deplete on ct scan when he was on chemo, and reports showed fluid in his abdomen had reduced slightly, and this allowed him to be able to eat more comfortably. It was effective (difficultly) for approximately one year, before ascites created a blockage, leading to hospitalization and no chance of surgery, and a rapid spread of fluid, whereby he passed away eventually. We had almost 3 years after diagnosis with him, though. The chemo was a great help, but it is a delicate option that needs to be weighed properly to be worth the strain it puts on the body. Doctors can help make that decision. Treatment options seem so limited with stomach cancer, and it is a constant battle of potential pros in the face of such difficult and risky circumstances. I sincerely wish you the best and hope that you are able to find a plan to combat the ascites for your brother. With so few resources out there, my story is all I can offer. God bless. My dad was also 54 when he passed away, and he never gave up fight or hope either. Those that have heard stories of cancer know that anything can happen, and miracles do happen. I know I have witnessed a few, and that is what keeps me going.

ADE
Posts: 3
Joined: Feb 2013

Hi Tony,

My mum was diagnosed with advanced stomach cancer in August 2012 - she had ascites - so much of it that her stomach was like a baloon. We were told she was not operable but she was put on chemo. Her ascites vanished about 10 days after chemo was administered for the first time - really hope it will work that well for your brother too.

Best, xx

mwong147
Posts: 2
Joined: Apr 2013

Hi,

 

My mom has ascites in her stomach as well but they said it's not that much fluids. How is your mom doing now ADE? My prayers are to your family.

 

pregnya143
Posts: 6
Joined: Jul 2013

Hi ADE.Hope youe Mom is recovering.Ill add ur Mom in my prayers.

My husband(33 yrs) had undergone total gastrectomy(entire stomach removed) in oct,2012.His treatment of chemos and radiation has been completed in feb,2013.After 3 months of treatment he suffered with pain in his chest.After PET scan the reports showed that there was formation of fluid in his abdomen, nothing but ascites.He is undergoing the 2nd chemo now.Im very much worried that is it curable or not?Any suggessions please..

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