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Big decision and not sure what to do

tko683
Posts: 265
Joined: Aug 2011

Well my husband just had another round of scans after completing radiation to the 2 largest tumors in his liver.  The results were favorable but now the other 2 tumors in the liver have doubled in size and he now has peritoneal mets.  We are so disappointed.  They said he needs to start back on chemo but not sure which chemo to go to.  One doctor says he should go back on FOLFIRI with Vecitiix and another new doctor says he should go back on FOLFOX with Avastin.  He only had 6 treatments of FOLFOX and had stable results to his tumors while on it.  He has been on FOLFIRI for one year and has had new lesions appear while on FOLFIRI even with a normal CEA.  We don't completely understand what the peritoneal mets mean.  Has anyone had experience with these type of mets?  Are they difficult to treat?  Is it possible that the PET scan is wrong?  It showed an uptake of around 5 and radiation doctor said it was concerning but he was not convinced it was cancer.  Any advice about these issues is very much appreciated.  Blessings, Teri

annalexandria's picture
annalexandria
Posts: 2573
Joined: Oct 2011

That's the standard treatment for peritoneal mets, as chemo doesn't seem to do much with them (surgery could also be a possibility, if there are just a few...I had several removed from my peritoneum, but i didn't have the "seeding" that seems to be more common).

And there are several options for liver involvement...you could check out Craig/Sundanceh's recent post about his own test results.  He talks about several of the treatment possibilities that don't involve systemic chemo.

Unfortunately, chemo can be pretty hit or miss.  Tumors in different areas can have very different genetic compositions (in fact, recent research has shown that a single tumor can have variations), so it's not unusual for chemo to work in one area and not in another.

Good luck, and keep us posted on your husband is doing.  I hope his docs can come up with a good tx plan for him.

PS  An SUV of 5 isn't super high, but for me, anything over 4 has always been cancer.  I don't know if this is always the case, however.

Hugs to you both~Ann Alexandria

traci43's picture
traci43
Posts: 775
Joined: Jul 2007

These are small tumors that attach or embend in the lining of the abdomen.  They can be harder to treat because they can seed all over the lining.  Mine appear to show up in the fat which has fewer blood vessels, making it more difficult for the chemo to get there. 

 

HIPEC is the way to treat them, it's a big surgery.  They call it the mother of all surgeries.  The Surgeon goes in a spends several hours checking your entire abdomen and removing any tumors or suspicious areas.  Then they sew you up but with two tubes on at the top and the other at the bottom.  They then run heated chemo through your abdomen for 90 minutes, flush and you're done.  I was in the hospital for 10 days, and that's with no complications. 

 

The most important thing when considering HIPEC, is to find an experienced doctor.  Studies show that it takes a minimum of 150 procedures to become proficient. There are several and there are quite a few of us on this board that have had this procedure.  It won't do anything for liver mets, that would have to be done separately.

Good luck to your husband.  Traci

 

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