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Are there new techniques for peritoneum cancer treatment?

westie66's picture
westie66
Posts: 642
Joined: Jun 2010

Hi all: As far as I can tell from this board and others out there, the two standard treatments for either primary or secondary peritoneal cancer are:

(1) chemotherapy (the chemicals used depend on whether the cancer is primary or secondary, e.g. primary peritoneal cancer and that arising from ovarian cancer usually use some combination of taxol and carboplatin; secondary peritoneal cancer from say colon cancer or gallbladder cancer use the chemos used to treat those cancers, e.g. folfox); and

(2) HIPEC (intra-peritoneal chemotherapy) preceded by debulking with primary or ovarian cancer origin or peritoneal stripping with secondary origins like from colon, appendix, gallbladder. (Note: these procedures on peritoneal cancer from gallbladder cancer are rarely done for some reason.)

As far as I can tell, chemotherapy may stabilize or reduce peritoneum cancers but doesn't "cure" it (is this right?), and not many people outside of origins from ovarian cancer are approved for the quite nasty debulking/stripping/HIPEC surgeries, especially if there are mets to another place like the liver. What I've also noted is that it is the mucilogenous (spelling!) type (with ascites) that seems to be favoured for the surgery route.

What I would like to find out is this - are there other, innovative, treatments out there that have been tried to get rid of the peritoneum tumours? Unfortunately, the condition isn't common, but I was thining of things like cryoablation, HIPEC done without debulking/stripping, etc.

I'll pose the question if I can on the colon club board too.

Thanks!

Cheryl

abrub's picture
abrub
Posts: 1531
Joined: Mar 2010

Cheryl, I had Intraperitoneal Chemo that wasn't HIPEC (not heated, and given in a series of treatments over several months.) However, I did need a complete debulking, as the chemo can only penetrate a couple of mm at best. The chemical agent used in my IP chemo was a form of 5FU; not the standard mitomycin or oxaliplatin used in HIPEC. FUDR (5FU) was administered at about 300 times the strength used in systemic chemo.

Alice

dorothymarion's picture
dorothymarion
Posts: 28
Joined: Apr 2012

Hello Cheryl, I'm a new memeber of these forums and can only relate my own personal experience of treatment for PPC. I was diagnosed with Stage IV Primary Peritoneal Cancer in February of 2011 (diagnosis was received on day of my 50th wedding anniversary!) My ovaries were also affected. My gynecological oncologist and my cancer treatment centre decided to start a course of chemotherapy first (taxotere and carboplatin). After 7 treatments, administered once every three weeks, my CA125 levels dropped from over 4,000 to 69. My gynecologist then scheduled surgery, which included removal of both ovaries and the omentum. After a brief period of recovery I began another round of chemotherapy, this time using Gemzar (two weeks on and one week off).

Unfortunately my CA levels started to rise and because my red and white blood counts had dipped way down, it was decided to take me off Gemzar and put me on Avastin (once every three weeks) in conjunction with a daily oral chemotherapy, Cytoxan. I had three courses of this treatment, but my CA125 levels still continued to rise. They went up over 3,000. So, yet again, my treatment was changed. I am currently on a once a month infusion of Doxil (just had my second treatment). Because it's only administered once a month it will be at least 3-4 months before we know if this one is working. I certainly hope so!

I hope this information will help you a little. I don't know what the HIPEC treatments are, or if they have a good success rate. I do know that my particular cancer has no "cure" per se, but my wonderful team of doctors keep reassuring me that it can be managed. We just have to find the right chemo "cocktail"!

Tina Brown's picture
Tina Brown
Posts: 1054
Joined: Nov 2009

Your story is similar to mine. I am PPC stage 4 and was diagnosed November 2009. My mets were around my lungs which catergorised my stage 4. Surgery was not an option as my lungs were involved and here in the UK (or just in my case) they don't do surgery as I had mets elsewhere. My starting CA125 was 1,098 and after the standard carbo/taxol chemo dropped to 35. However I only went 6 months before the numbers started going back up and I was back on chemo.

I am now on my 4th chemo as my numbers went up to 1,727 last October. I am on Doxorubicin whcih is an alternative to Doxil as it is not available in the Uk at the moment. My numbers went up (by 400) after the 1st one but I was told this is normal.

I look at my cancer as something that has to be managed and I will live my life in and out of chemo with the hope it works and I am well enough to cope with it. There are lots of different cocktails of chemo out there and they can always go back to one you had in the first place after your body has had a rest from it.

Tina

dorothymarion's picture
dorothymarion
Posts: 28
Joined: Apr 2012

It's reassuring to know that others out there are also dealing with similar issues to my own. I too realise that my cancer diagnosis has been life changing, and that I am going to be in and out of chemo probably for the rest of my life. I'm 70 now, but have always been active and so it's frustrating sometimes when I don't feel well enough to get "out there" and do the things I love to do! However, at least on Doxil I'm not having any debilitating side effects, other than the occasional mouth sores which my doctor treats with his magic mouthwash.

Thank you again for your input. It's very helpful and informative.

Dorothy

jt25741
Posts: 23
Joined: Apr 2012

My wife's condition seems to mirror yours very closely. She is on Lipodox now (Doxil equivalent). CA125 not showing a declining trend yet, but it has been 2 cycles. Still giving it some time. Some hand/foot syndrome and mouth sours starting....trying to deal with that.

The once a month frequency would be relatively nice to maintain if it both works and can be tolerated.

wanttogetwellsoon
Posts: 147
Joined: Apr 2011

I was wondering too about cryoablation and whether this treatment is useful for the treatment of PPC. It'd be interesting to see if anyone has any knowledge of it. :)

westie66's picture
westie66
Posts: 642
Joined: Jun 2010

Me, too. Somehow it seems so simple but there must be a reason they still go with the very painful debulking or peritoneal stripping followed by HIPEC. I did ask once why they just couldn't cut out the nodules that are visible but they don't do that because it means there are also likely to be many micro sized ones that aren't visible. As well, the cutting out can stimulate more growth. But I keep hoping as chemo doesn't work well on these critters given they are not well connected to our body's blood system where the chemo goes.
For mouth sores, I gargle every time I think of it using either a can of club soda or a mixture of salt and water and baking soda (but I don't like that taste). I also use a very soft toothbrush and gentle toothpaste. I do get some stuff from the cancer centre that is a mixture of 2 things for swishing and spitting but I don't have any on hand right now to share the name. It works very well.
If you mean by hand/foot syndrome, neuropathy, that is a tough one. I'm lucky as I don't get it very badly - just one spot on my foot arch on one foot. It seems to be the one thing that eludes fixing for most except wearing soft shoes and keeping well creamed up. I also get a goutlike feeling in my right big toe as a result of the chemo and I take organic black cherry juice for that - seems to help. If it is cold sensitivity you mean, then I take daily L-Glutamine powder 5-10 grams in juice, 3 alpha lipoic acid pills per day with meals, a VitB6 pill, and a calcium:magnesium pill. Works for me.
Cheryl

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