Stage 4 progression when desease confined to peritoneum and lymph nodes

Hear alot about progression and possible cure (surgery) when colon cancer has metastisized to the liver. Little information available as to progression, prognosis and possibility of long term control (or curative approach) when cancer is confined to peritoneum (lymph nodes) and currently asymtomatic.

Would appreciate any insight. Thanks!

-Marty

Comments

  • pepebcn
    pepebcn Member Posts: 6,331 Member
    Peritoneum or peritoneum lymph nodes?
    Just not the same!
    Hugs!
  • mom_2_3
    mom_2_3 Member Posts: 953 Member
    Marty
    I am not overly familiar with that type of progression but if you Google "hipec" that may lead you in the direction you want to research.

    Amy
  • Buzzard
    Buzzard Member Posts: 3,043 Member
    mom_2_3 said:

    Marty
    I am not overly familiar with that type of progression but if you Google "hipec" that may lead you in the direction you want to research.

    Amy

    Marty............Check out SK- Sloan Kettering...
    Phillieg is all knowing about this center and with Hipec......I am sure that he will enter the scene with his expertise as well soon...Wishing the best for you is all I can do, I am more a rectal/lung patient/survivor and my knowledge base is more directed in that area....help is on the way though .......Buzz
  • kuastoi
    kuastoi Member Posts: 63
    Depends
    As stated, the peritoneum and lymph nodes are not equivalent structures.

    The peritoneum is the lining surface in you abdomen - covering all of the organs there. Lymph nodes are structures that arise along the drainage lymphatic system in your body, it allows plasma/fluid to drain back into the circulatory system while being filtered by the immune system along the way.

    That being said, treatment to the peritoneum usually includes treatments like Hi-pec as has been described already here, essentially chemo into the peritoneal space sometimes with heat etc. From what I have read here on the board - it can be very effective but no personal experience.

    With regard to the lymph nodes the treatment is usually confined to chemo (if the node is not taken out at the time of surgery on the bowel). Occasionally radiation therapy can help if the nodes is not near any vital structures and they can focus the beam there without any other local damage. this can be challenging in the chest and other places in the abdomen and there are few studies looking at the benefits of this approach.

    I have learned all this as I have had one small nodule (now removed) on my omentum (part of the peritoneum) discovered on a second surgery in my belly (when I developed a perforated bowel due to avastin) and I have several large groups of lymph nodes in my chest and neck.

    From my angle - it is almost easier to have liver or lung mets as surgeons are more amenable to resecting these when possible and Onc's radiate them if the can't be resected. They are more closed minded about nodes elsewhere due to the lack of experience with radiation and the difficulty in resecting them.

    Hope this helps some

    Tom
  • pepebcn
    pepebcn Member Posts: 6,331 Member
    kuastoi said:

    Depends
    As stated, the peritoneum and lymph nodes are not equivalent structures.

    The peritoneum is the lining surface in you abdomen - covering all of the organs there. Lymph nodes are structures that arise along the drainage lymphatic system in your body, it allows plasma/fluid to drain back into the circulatory system while being filtered by the immune system along the way.

    That being said, treatment to the peritoneum usually includes treatments like Hi-pec as has been described already here, essentially chemo into the peritoneal space sometimes with heat etc. From what I have read here on the board - it can be very effective but no personal experience.

    With regard to the lymph nodes the treatment is usually confined to chemo (if the node is not taken out at the time of surgery on the bowel). Occasionally radiation therapy can help if the nodes is not near any vital structures and they can focus the beam there without any other local damage. this can be challenging in the chest and other places in the abdomen and there are few studies looking at the benefits of this approach.

    I have learned all this as I have had one small nodule (now removed) on my omentum (part of the peritoneum) discovered on a second surgery in my belly (when I developed a perforated bowel due to avastin) and I have several large groups of lymph nodes in my chest and neck.

    From my angle - it is almost easier to have liver or lung mets as surgeons are more amenable to resecting these when possible and Onc's radiate them if the can't be resected. They are more closed minded about nodes elsewhere due to the lack of experience with radiation and the difficulty in resecting them.

    Hope this helps some

    Tom

    Lynph nodes!
    I been treated successfully of my retroperitoneum Lymph with a combination of Irinitecan-avastin and 45 days of radio and 5fu! It worked for the moment!.
  • vodkamarty
    vodkamarty Member Posts: 17
    kuastoi said:

    Depends
    As stated, the peritoneum and lymph nodes are not equivalent structures.

    The peritoneum is the lining surface in you abdomen - covering all of the organs there. Lymph nodes are structures that arise along the drainage lymphatic system in your body, it allows plasma/fluid to drain back into the circulatory system while being filtered by the immune system along the way.

    That being said, treatment to the peritoneum usually includes treatments like Hi-pec as has been described already here, essentially chemo into the peritoneal space sometimes with heat etc. From what I have read here on the board - it can be very effective but no personal experience.

    With regard to the lymph nodes the treatment is usually confined to chemo (if the node is not taken out at the time of surgery on the bowel). Occasionally radiation therapy can help if the nodes is not near any vital structures and they can focus the beam there without any other local damage. this can be challenging in the chest and other places in the abdomen and there are few studies looking at the benefits of this approach.

    I have learned all this as I have had one small nodule (now removed) on my omentum (part of the peritoneum) discovered on a second surgery in my belly (when I developed a perforated bowel due to avastin) and I have several large groups of lymph nodes in my chest and neck.

    From my angle - it is almost easier to have liver or lung mets as surgeons are more amenable to resecting these when possible and Onc's radiate them if the can't be resected. They are more closed minded about nodes elsewhere due to the lack of experience with radiation and the difficulty in resecting them.

    Hope this helps some

    Tom

    Lymph nodes
    Thanks Tom!

    Good to get your experiences. CEA slowly rising (checked monthly) from low of 5 then 7 and now 17. PET shows very small suspicious node in lower left pelvis. Wife feels pretty good with just a little cramping in the area when exercising (might possibly be adheasions from previous surgery in area).

    Agree, seems if you had to pick mets (who would?!) the liver would be the site for best chance of cure.

    All the best to you!

    -Marty
  • vodkamarty
    vodkamarty Member Posts: 17
    pepebcn said:

    Lynph nodes!
    I been treated successfully of my retroperitoneum Lymph with a combination of Irinitecan-avastin and 45 days of radio and 5fu! It worked for the moment!.

    Lymph nodes
    Hi Pepebcn,

    Sent a response earlier, don't think it went through. If so, pardon the doubling up. Again, thanks for your feedback.

    Did you have any cramping associated with your node? Had you been on either of these chemo regimes previously?

    Glad you're doing well!

    Best,

    Marty
  • kuastoi
    kuastoi Member Posts: 63

    Lymph nodes
    Thanks Tom!

    Good to get your experiences. CEA slowly rising (checked monthly) from low of 5 then 7 and now 17. PET shows very small suspicious node in lower left pelvis. Wife feels pretty good with just a little cramping in the area when exercising (might possibly be adheasions from previous surgery in area).

    Agree, seems if you had to pick mets (who would?!) the liver would be the site for best chance of cure.

    All the best to you!

    -Marty

    I agree
    Sometimes I long for a simpler situation where they could just go in and hack them out and be done with it - but I'll push on and annoy the doc's until they come up with something I like.

    With what your are describing above - it sounds like the node could be irradiated if it continued to be a problem. Good luck

    Tom
  • pepebcn
    pepebcn Member Posts: 6,331 Member

    Lymph nodes
    Hi Pepebcn,

    Sent a response earlier, don't think it went through. If so, pardon the doubling up. Again, thanks for your feedback.

    Did you have any cramping associated with your node? Had you been on either of these chemo regimes previously?

    Glad you're doing well!

    Best,

    Marty

    I was on 5 rounds of folfiri /avastin then we stoped it to can
    start with 5FU 24 h a day 45 days and 45 round of radio! For the moment no more chemo since everything has gone.
    Hugs!