Lymph Nodes, How Many Taken

 Hi DrienneB:

 Here are my answers with some links referencing Peritoneal and Ovarian Cancer, plus a personal note at the *bottom.

1. Primary tumor location: Peritoneal Carcinomatosis/First Opinion –

   Second Opinion revealed Ovarian Cancer as well.

2.  Month/year of cancer diagnosis:  November 2012

3. Stage determined when cancer first discovered: Stage IV

4. Stage determined at time of or after initial debulking surgery July 1, 2013:  Still Stage IV

5. Grade/Type of tumor:  Grade 3 – Poorly differentiated

 6.      Quantity of Lymph Nodes Removed: - Not sure

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1.   http://teachmeanatomy.info/abdomen/areas/peritoneum/

 “The peritoneum is a continuous transparent membrane which lines the abdominal cavity and covers the abdominal organs (or viscera).

 It acts to support the viscera, and provides a pathway for blood vessels and lymph. In this article, we shall look at the structure of the peritoneum, the organs that are covered by it, and its clinical correlations.

 Structure of the Peritoneum

 The peritoneum consists of two layers which are continuous with each other; the parietal peritoneum and the visceral peritoneum. They both consist of a layer of simple squamous epithelial cells, called mesothelium…”

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  2. http://www.foundationforwomenscancer.org/types-of-gynecologic-cancers/primary-peritoneal/

 “Primary Peritoneal Cancer

 Cancer occurs when cells in an area of the body grow in an abnormal way. Primary peritoneal cancer (PPC) is a relatively rare cancer that develops most commonly in women. PPC is a close relative of epithelial ovarian cancer, which is the most common type of malignancy that affects the ovaries. The cause of primary peritoneal cancer is unknown.

 It is important for women to know that it is possible to have primary peritoneal cancer even if their ovaries have been removed.

 The abdominal cavity and the entire surface of all the organs in the abdomen are covered in a cellophane-like, glistening, moist sheet of tissue called the peritoneum.

 It not only protects the abdominal organs, it also supports and prevents them from sticking to each other and allows them to move smoothly within the abdomen. The cells of the peritoneal lining develop from the same type of cell that lines the surface of the ovary and fallopian tube for that matter. Certain cells in the peritoneum can undergo transformation into cancerous cells, and when this occurs, the result is primary peritoneal cancer. It can occur anywhere in the abdominal cavity and affect the surface of any organ contained within it. It differs from ovarian cancer because the ovaries in PPC are usually only minimally affected with cancer…”

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3. http://www.cancer.net/cancer-types/ovarian-fallopian-tube-and-peritoneal-cancer/stages-and-grades

 “…Cancer stage grouping for ovarian, fallopian tube, and peritoneal cancer

 The stage of ovarian, fallopian tube, and peritoneal cancer is determined by the FIGO (International Federation of Obstetrics and Gynecology) staging system. There is a TNM (tumor-node-metastasis) system that correlates with the FIGO system, and this system is applied to the pathology report after a surgery…”

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 4.  http://www.healthline.com/human-body-maps/

 “Pick your organs” and take the video tour.  You can see the amazing body as God created it.  I’m glad that we have some doctors smart enough to know how to look inside and in many cases, fix what’s going on.  When you move the bar along, you can view that body part from a different angle.” 

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 5.   http://www.mayoclinic.org/diseases-conditions/ovarian-cancer/basics/definition/con-20028096

 “Ovarian cancer is a type of cancer that begins in the ovaries. Women have two ovaries, one on each side of the uterus. The ovaries — each about the size of an almond — produce eggs (ova) as well as the hormones estrogen and progesterone.

 Ovarian cancer often goes undetected until it has spread within the pelvis and abdomen. At this late stage, ovarian cancer is more difficult to treat and is frequently fatal. Early-stage ovarian cancer, in which the disease is confined to the ovary, is more likely to be treated successfully. Surgery and chemotherapy are generally used to treat ovarian cancer…

 Staging ovarian cancer

 Doctors use the results of your surgery to help determine the extent — or stage — of your cancer. Your cancer's stage helps determine your prognosis and your treatment options.

 Stages of ovarian cancer include:

 Stage I. Cancer is found in one or both ovaries.

Stage II. Cancer has spread to other parts of the pelvis.

Stage III. Cancer has spread to the abdomen.

Stage IV. Cancer is found outside the abdomen.

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*(Notes from Loretta about my specific cancer.    Doctors were not certain of my primary source.  Peritoneal Carcinomatosis can originate in the Peritoneum.  Ovarian cancer could have been the primary source that then spread to the Peritoneal fluid in the abdominal cavity.  But once it is found in two different places, it is in the advanced stages. 

 Although my primary source was not established it wasn’t really necessary since one of the traditional treatments that have been used for quite some time now is Carboplatin/Taxol.  It is used to treat both PC and OV cancers.  So first I had a neoadjuvant (before) treatment of this combination drug, and then Cytoreductive (CRS) (debulking) at the University of Pittsburgh Med. Ctr. on July 1, 2013. Cytoreductive Surgery (CRS) isn’t “foolproof”, but it can eliminate some non-essential organs to which the cancer could likely infiltrate.  So CRS was profitable for me.  It has given me a longer Progression Free Survival (PFS) period for which I thank my God.

 Now I will be praying about what next step to take.  It will require a lot of research over the weekend.  I will make a decision by Monday.  The oncologist feels that since it has been a year since my last chemo treatment, and that my body will be more apt to benefit by another round of treatments.  He has mentioned two clinical trials relative to immunotherapy, however the one he would have preferred will not have an opening till the first of the year.  He doesn’t want to wait for that one.  There is another one that requires repeated biopsies during the time of the treatment.  The other two consist of Carbo/Taxol and Doxil.  If the immunotherapy drug isn’t working out for me, I would know that in a couple of months.  If that fails to show improvement and reduce the number and size of tumors, then he will not continue.  But he says in the beginning, it can be a time of intense discomfort!  My “body” is saying “No I’m feeling rather good right now thank you.”  My mind is saying, “Yes but the PET/CT scan is saying things are worsening.”  So I am not quite certain which way to go, but by Monday I will have made a choice with the Lord’s help. 

 But we all know that just as with anti-biotics, with continual habitual use the body builds up a resistance to the drug that was designed to help.  So consecutive chemo treatments is not always going to be a “plus”.  Time will run out.  That’s when I liken the old Kenny Rogers song, “The Gambler”, to my own case.  I gotta’ know when to “hold ‘em—when to fold ‘em—when to walk away—and when to run!”  That day will come sooner than I would wish.  So these are choices I had rather not have to make now, but ones that I must.  And I always say that my times are in God’s hands.  I’m not going to die one day sooner or live one day longer than my allotted days on this earth.  So I thank all of ya’ll whom I know are praying for me.  Will keep you updated from time to time.)