Peritoneal Stripping

wanttogetwellsoon

westie66 said:

HIPEC
Yikes! trying to visualize organs stuck together - sounds awful! I'm not sure what my chances of getting the treatment would be given only one place in Canada does it. To me, it makes sense - get the chemo to where it needs to be, particularly as the peritoneum nodules are not connected to the blood system. How painful can a procedure like that be? (Well, it is always worse than it sounds!).
Cheryl

HIPEC
Hi Cheryl....
I hadn't realised that the nodules aren't connected to the blood system by direct means. I think the cells travel through the body (if they ever do) via the lymph nodes. And, yes, it does seem sensible that the drug can get to where it's needed. I think the surgeons use the chemo bath when they take away the uterus etc. during debulking surgery, but I've heard that they can also put in a port on the abdomen and administer the drugs that way post debulking. It does sound as if it could be a painful procedure, but I'm not sure if it is or not. The drug is a lot more effective though and it can't be worse than what we've been through already, can it?
Take good care Cheryl.

abrub

wanttogetwellsoon said:

HIPEC
Hi Cheryl....
I hadn't realised that the nodules aren't connected to the blood system by direct means. I think the cells travel through the body (if they ever do) via the lymph nodes. And, yes, it does seem sensible that the drug can get to where it's needed. I think the surgeons use the chemo bath when they take away the uterus etc. during debulking surgery, but I've heard that they can also put in a port on the abdomen and administer the drugs that way post debulking. It does sound as if it could be a painful procedure, but I'm not sure if it is or not. The drug is a lot more effective though and it can't be worse than what we've been through already, can it?
Take good care Cheryl.

The belly port is not bad
tho it sounds awful. If they give you Emla cream or another numbing agent, you don't feel the needle going into your belly at all. Then you lie there for a couple of hours while they infuse the chemo. You roll around for an hour (change sides every 15 minutes) to spread the chemo around, and you go home. Most people feel bloated after. My husband and I used to go for walks after (and I bought myself the sexiest dress I ever owned on a chemo afternoon! Husband was thrilled!) That said, I did have residual meds (see below) still fogging my mind for a few hours, tho I didn't realize it. (No driving involved - we went to NYC for the IP.)

Due to other reasons, I had to be pre-medicated with IV ativan and dilaudid for the IP chemo. The IV was much more painful than the needle in the belly port. (No one else I know who had the IP chemo like I did, post-op via belly port, needed the IVs - I was just "special".)

At the end, the belly port was removed in an outpatient setting, with local anesthetic, and I was sent home.

My port did rub my diaphragm a bit, which made me gasp occasionally, not in pain, just a reflexive gasp. It startled people, but once the port was gone, the gasping stopped. It also made me more prone to hiccups.

However, the IP chemo was definitely easier to tolerate than the systemic.
Alice

westie66

abrub said:

The belly port is not bad
tho it sounds awful. If they give you Emla cream or another numbing agent, you don't feel the needle going into your belly at all. Then you lie there for a couple of hours while they infuse the chemo. You roll around for an hour (change sides every 15 minutes) to spread the chemo around, and you go home. Most people feel bloated after. My husband and I used to go for walks after (and I bought myself the sexiest dress I ever owned on a chemo afternoon! Husband was thrilled!) That said, I did have residual meds (see below) still fogging my mind for a few hours, tho I didn't realize it. (No driving involved - we went to NYC for the IP.)

Due to other reasons, I had to be pre-medicated with IV ativan and dilaudid for the IP chemo. The IV was much more painful than the needle in the belly port. (No one else I know who had the IP chemo like I did, post-op via belly port, needed the IVs - I was just "special".)

At the end, the belly port was removed in an outpatient setting, with local anesthetic, and I was sent home.

My port did rub my diaphragm a bit, which made me gasp occasionally, not in pain, just a reflexive gasp. It startled people, but once the port was gone, the gasping stopped. It also made me more prone to hiccups.

However, the IP chemo was definitely easier to tolerate than the systemic.
Alice

Intra-peritoneal chemo
Hi Alice: So, it is done once or over a period of days or regularly over a longer period?
Cheryl

abrub

westie66 said:

Intra-peritoneal chemo
Hi Alice: So, it is done once or over a period of days or regularly over a longer period?
Cheryl

Post-op IP chemo
Cheryl,
It is a 3 day cycle, repeated every 2 weeks for X number of cycles (I was supposed to have 8 cycles.) The first cycle is started 24-48 hours post-op.

Day 1: 2 liters of chemo is infused in your belly, over about 2 hours.
Days 2 & 3: 1 liter each day is infused into your belly over about 1 1/2 hours.

The chemo is left to resorb on its own. It is not run through and drained. After the infusion, you roll from side to side every 15 minutes for an hour to ensure that your belly gets fully treated.

I only completed 5 cycles, as the level of pain indicated that I had developed a chemical peritonitis (very rare). The damage was confirmed when my surgeon did my hernia repair last year, and found that an erstwhile clean belly, while still clear of cancer, was now "a spider-web of massive adhesions" (his words.) Probably residual scar tissue from "chemical burns".

westie66

abrub said:

Post-op IP chemo
Cheryl,
It is a 3 day cycle, repeated every 2 weeks for X number of cycles (I was supposed to have 8 cycles.) The first cycle is started 24-48 hours post-op.

Day 1: 2 liters of chemo is infused in your belly, over about 2 hours.
Days 2 & 3: 1 liter each day is infused into your belly over about 1 1/2 hours.

The chemo is left to resorb on its own. It is not run through and drained. After the infusion, you roll from side to side every 15 minutes for an hour to ensure that your belly gets fully treated.

I only completed 5 cycles, as the level of pain indicated that I had developed a chemical peritonitis (very rare). The damage was confirmed when my surgeon did my hernia repair last year, and found that an erstwhile clean belly, while still clear of cancer, was now "a spider-web of massive adhesions" (his words.) Probably residual scar tissue from "chemical burns".

Peritoneal Stripping
Hi again: And I assume it is done only after the stripping? Which would be out for me as I can't get the stripping. Do you know of anyone that has had the intra-peritoneal chemo without the peritoneal stripping?
Cheryl

MFDM

HIPEC surgery info
Hi everybody -- I've been lurking on these boards for a while now since my mother has stage four peritoneal cancer. I joined just now and got an account because I wanted to make sure you all saw Andrew Pollack's article in today's New York Times. Here's a link (I don't know if the paste will work very well, but it's on the front page of nyt.com right now):
http://www.nytimes.com/2011/08/12/business/heated-chemotherapy-bath-may-be-only-hope-for-some-cancer-patients.html?hp

I found the article very informative about the procedure, the risks, the cost, etc.

Very best to all of you--
MFDM

Tina Brown

MFDM said:

HIPEC surgery info
Hi everybody -- I've been lurking on these boards for a while now since my mother has stage four peritoneal cancer. I joined just now and got an account because I wanted to make sure you all saw Andrew Pollack's article in today's New York Times. Here's a link (I don't know if the paste will work very well, but it's on the front page of nyt.com right now):
http://www.nytimes.com/2011/08/12/business/heated-chemotherapy-bath-may-be-only-hope-for-some-cancer-patients.html?hp

I found the article very informative about the procedure, the risks, the cost, etc.

Very best to all of you--
MFDM

Newspaper article
Thanks for the link I found it very interesting. I live in the Uk so not too sure whether it is offered over here. I've been told my cancer is "sand like" and surgery would be futile.

Tina x

westie66

Tina Brown said:

Newspaper article
Thanks for the link I found it very interesting. I live in the Uk so not too sure whether it is offered over here. I've been told my cancer is "sand like" and surgery would be futile.

Tina x

Peritoneal Stripping and Heat Internal Chemo
Hi Tina and all: In Canada you don't appear to be able to get the internal heated chemo bath without the stripping surgery which doesn't make too much sense to me but there it is. I have heard of people getting the surgery with nodules on the peritoneum and omentum which also worked for the "sand like" almost microscopic invasions as they remove the peritoneum and omentum and other things to make sure they get it all. But I have also heard that the little cancers "text message" each other to start spreading when treated. Not sure I believe that but anything is possible with cancer! I think someone on this discussion board (or maybe it was the colon cancer board) described their peritoneum cancer as like an exploded dandelion head and she had surgery for it. That was in the States though. An interesting topic to me because not sure what we'll try if the oxaliplatin/irenotcan/leucovin/5FU cocktail doesn't work! The nodules won't respond to a cocktail with taxol in it because they originated from the gallbladder.
Let us know hwat your ultrasound shows, Tina. I had ultrasound for an "unusual" ovary - it was done internally - and it was just a cyst.
Cheryl

Tina Brown

westie66 said:

Peritoneal Stripping and Heat Internal Chemo
Hi Tina and all: In Canada you don't appear to be able to get the internal heated chemo bath without the stripping surgery which doesn't make too much sense to me but there it is. I have heard of people getting the surgery with nodules on the peritoneum and omentum which also worked for the "sand like" almost microscopic invasions as they remove the peritoneum and omentum and other things to make sure they get it all. But I have also heard that the little cancers "text message" each other to start spreading when treated. Not sure I believe that but anything is possible with cancer! I think someone on this discussion board (or maybe it was the colon cancer board) described their peritoneum cancer as like an exploded dandelion head and she had surgery for it. That was in the States though. An interesting topic to me because not sure what we'll try if the oxaliplatin/irenotcan/leucovin/5FU cocktail doesn't work! The nodules won't respond to a cocktail with taxol in it because they originated from the gallbladder.
Let us know hwat your ultrasound shows, Tina. I had ultrasound for an "unusual" ovary - it was done internally - and it was just a cyst.
Cheryl

Hello Cheryl
My ultra-sound did include a TV (Trans vaginal) probe. That is how they were able to see the abnormal ovary. I am seeing my oncologist Thursday 18th (tomorrow) and hopefully get some sort of plan of action. Will post as soon as I know.

Tina xx

westie66

Tina Brown said:

Hello Cheryl
My ultra-sound did include a TV (Trans vaginal) probe. That is how they were able to see the abnormal ovary. I am seeing my oncologist Thursday 18th (tomorrow) and hopefully get some sort of plan of action. Will post as soon as I know.

Tina xx

Ovary
Hi Tina: Please let us know!
Good luck!
Cheryl