hipec : stopgap chemo

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 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

annalexandria said:

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.

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.