Turned down for HIPEC

[mrsv]

I was turned down for HIPEC after a small node showed up on my lung. I have 4 nodes in my peritoneal area and it was recommended by the NIH that I have the surgery. Does anyone know of a doctor on the west coast who might perform the surgery in my situation. I have already had 10 rounds of FOLFOX.

[dudette]

PIPAC might be an option for you. It's a relatively new, minimal invasive procedure for peri mets. Maybe surgeons are more willing to work with you if the surgery is less challenging for the patient?!?

The following link can get you started with finding a clinic/hospital that performs this surgery:

http://www.newswise.com/articles/mercy-medical-center-in-baltimore-hosts-3rd-international-pressurized-intraperitoneal-aerosol-chemotherapy-pipac-symposium

[Maia]

But that was only a simposium, dudette... PIPAC is not performed on the States yet. I'm in touch with the doctor who invented this, Prof Marc Reymond (I met him personally on September, he came to Argentina! : ), precisely waiting to hear from him if things have changed. I have a post/ whole thread prepared about PIPAC. I'll post in the next days.

In the meantime:
"The method of Pressurized IntraPeritoneal Aerosol Chemotherapy (PIPAC) allows the dispersion of chemotherapeutic agents within the peritoneal cavity by means of minimal-invasive techniques. Even if PIPAC represents a new treatment modality, it is not an experimental treatment. Over a thousand applications have been performed in few specialized centers in Europe rendering promising results.PIPAC is a surgical procedure that can only be applied by laparoscopy. The fumigation as a gas allows a homogeneous dispersion of chemotherapy within the peritoneal cavity; the administration under pressure (standard in laparoscopic surgery) increases the local tissue penetration of the molecules allowing high intratumoral concentrations. The procedure is performed under general anesthesia. Two trocars are inserted via two small incisions (5-12 mm) into the peritoneal cavity; the subsequent air insufflation grants the necessary workspace (schema). First, small tissue samples of the tumor knots are retrieved (biopsy). Then, the chemotherapy is dispersed as pressurized aerosol inside the peritoneal cavity, acting during 30 minutes. At the end of the procedure, the pressure is released and the gas aspirated, and the skin incisions are closed. The whole procedure lasts about 90 minutes. The length of hospital stay is usually 3 days. Today, 3 applications are recommended within 3 months (delay between the applications: 6 weeks). "

Prof. Reymond: https://www.youtube.com/watch?v=daxKArtpjtQ (German)
http://www.capnomed.de/
A folder with documentation here: https://drive.google.com/open?id=0Bwc5k ... nNsdkZuN1U

[tigerpaw]

I had HIPEC in Norway and was accepted with one lung met, so practice varies. I still have 2 small lung mets, but no peritoneal recurrence and enjoying life treatment free. There must be some surgeons who will accept you for HIPEC with one lung met.

[dudette]

D'oh! Of course you are right, Maia. I thought that the US was already on board with this new technique.

[Stanfordmom]

Hi There,

Dr. alessio Pigazzi at UC Irvine performed HIPEC for one of my friends who also had a lung nodule at the time. He is supposedly VERY good.

Best wishes for your upcoming treatment.

Sha

[ktwmn]

I had not heard of the PIPAC procedure before, it sounds very promising. Thanks for sharing, dudette. I look forward to reading your update on this procedure and its potential in the US, Maia!