Liver and Peritoneal Involvement

[janklo]

I can tell you from my daughters experience. She had peri mets, found in August 2011. She did chemo which actually was successful in shrinking them. Then she did Hipec and didn't recover well. She was off chemo from August 2012 to have the Hipec. Because of her unrelenting nausea and vomiting, she ended up aspirating on vomit and getting pneumonia. Very quickly the mets grew out of control blocking her small bowel.

But chemo can be effective on peri mets--to get you to have Hipec and be cured!

[Val*pal]

Jortega:

My husband had peritoneal mets. His colon cancer "skipped" the liver, though he did develop lung mets.

Sadly, his peritoneal mets did not respond to the chemo in the long run. They were stabilized for a time with Folfiri/Avastin (his second line of chemo), but then began to rapidly grow into small tumors that pressed into his intestines and colon. His oncologist then tried Erbitux, but it was totally ineffective. He began to experience partial colon blockages that resolved themselves but caused vomiting, discomfort, and several hospitalizations. By this time cachexia had set in. His weight began to drop dramatically, and he could not eat much of anything. It was all downhill from there, despite his refusal to believe he would die.

He did not have a lot of pain, but he did have discomfort from the ascites and the other complications that began to develop. Essentially, he passed away after his liver began to fail from all the stress the cancer was causing. His passing was very peaceful.

As far as Hipec, there is little evidence that it "cures" the cancer in the peritoneum and abdominal area. Though it's true that once in a great while the "perfect" candidate for Hipec does benefit from its use, many people are not "perfect" candidates. My husband was definitely not a candidate due to the fact that he had a very aggressive form of colon cancer and had widespread lymph node involvement. Also, my husband suffered tremendous complications from the relatively "simple" colon resection surgery, and he ended up hospitalized for 7.5 weeks. There is no way he would have considered the very invasive Hipec surgery. The major cancer center at which he was eventually treated does not endorse Hipec and will not perform it since there has been no documented studies that prove its effectiveness. At least that was their policy as of May 2014.

This is just my personal opinion, but I feel that Hipec is probably over used. I certainly understand why patients opt for it, especially when they are still quite young, but the fact of the matter is that at this time peri mets are very troublesome. Hopefully, something will be found to treat them more effectively soon.

[rp1954]

My perspective is the we should be trying to induce acute immunological response(s) several weeks before surgeries, especially if nothing else is going on (eg. neoadjuvant RT, chemo). Although there are individual factors involved, we often see here the hints of some of the immunological and molecular deficits. The chemo naive might have the best responses, but we've seen immunological treatments that have benefits post chemo for patients well recovered from chemo, as well as metronomic chemo.

common examples:
Extraordinary vitamin D deficits, unaddressed until well after surgery, if ever. There is an aggressive immunological and molecular D3-K2 protocol that is seldom used, but claims immunological dissolution of some intractable mets.
Cimetidine, associated with biomarker based, daily 5FU as chemo, can help address immune deficits before, during and after surgery.
Large scale Vitamin C can address the huge histamine buildup pretreatment (surgery, chemo) that often accompanies cancer and compromises both immune function and wound healing. Examples are people with histamine based fatigue and healing problems, severe allergies even anaphylactic reactions.
Celecoxib is both anti-inflammatory, and anti-CRC for many cell lines.
Highly purified beta glucans can shift pathological Th1/Th2 polarization leading to ineffective immune response to cancer.
Some extracts have linked biomarkers.

Many immune supplements and off label drugs appear 5FU compatible because their rare intense, combined uses were so unusually successful for some patients on 5FU or Folfiri, with much better QoL. Too often people are side tracked by doctors that are speculative and completely uninformed on these areas instead of working in tandem with more experienced support.

Even though the regimens used may have partial responses rather than curative, any such improvements are cheap and easy in comparison to the more brute force treatments, may curatively address a local or regional problem, and pave the way to multimodal successes vs left high and dry.

People need to be finding providers that have sophisticated views of biological chemistry, with more aggressive supplent and off label drug regimens (and biomarkers) than even the Life Extension protocols, which are 15+, going on 20 years old, and often conservative on the supplements (sometimes not, e.g. curcumin) to effect success.

[jortego128]

Thank you for sharing your personal experience, Val and Janklo. Im very sorry for your losses. Its also my personal opinion that HIPEC is probably not a great option for older, weaker individuals. Just watching the animation of the procedure makes me cringe. You have to be of a certain physical and mental strength to undergo such a procedure, let alone multiple ones as some have here.

Same with HAI, I think.

[DarknessEmbraced]

I'm so sorry to hear this!*hugs* I hope your third HIPEC goes well.

[midlifemom]

Same with HAI, I think.

At least for me, HAI surgery was relatively easy and chemo delivered that way had no side effects. It is rough on the liver however.

[mariane]

I would go for aggressive treatment: surgery, chemo. It is the only option at this point which gives a chance of cure or long term survival.

I have HAI pump implanted 4 weeks ago and disagree that HAI is so unpleasant. Surgery as every surgery is painful. FUDR chemo was OK for me. Nothing compared to systemic. I will learn on MOnday how my liver survived it For liver mets there is no better option than HAI at this point.

I also disagree that HIPEC is ineffective. There are many people who gained life or at least additional years with their families doing it. You can die during simple diagnostic laparascopic surgery. I personally believe in aggressive treatment and most of cured crcs pursued it since there is no better option if you are MSS at this point.

I will pray for best decisions and cure for you. I have two 6 years olds at home. It is tough to be cancer mom.

[Tanya]

So sorry. Hope,don't give up.

[Cancerislame]

Hello,

I am sorry to hear that a third HIPEC, is your next possible line of treatment. This colon cancer can be tricky. I fortunately have only had 1 HIPEC but I hope I can share my story to give hope. When I was dx, i had a big tumor on my colon and on my liver, with peritoneal involvement. I qas told that chemo couldn't get the peritoneum because it was not very vascular and that systemic chemo was the best bang for buck. (That was the oncological surgeon, who wouldn't have done my liver or HIPEC). So, after 9 months of FOLFOX and Erbitux, I got the chance for HIPEC. I walked alot before surgery to get strong and as soon as I could in the hospital. When they went in the peritoneal spots were all scar tissue. The only cancer was actually colon cancer in my right ovary. They ablated what was probably scar tissue on my liver. I have now been 3 years NED. I think the three factors that made my HIPEC successfull were my vegan diet, er itux and I did one year of maintenance xeloda after my HIPEC. I still have multiple hip, shoulder and neck issues but I finally am seeing a pelvic floor therapist and I can poop normally now. I never thought that could happen for me.

Good luck with everything, you truly are a warrior!