No to Hipec

[Apple1291]

My dad was diagnosed with a recurrence in June of 2016 after an original 2b diagnosis in 2011. I will figure out how to update my signature today, I promise. He completed 12 tx of Folfiri and Avastin at the end of November 2016 in hopes he would be a candidate for Hipec, since his cancer has only spread to the peritoneum. The ct scan he had in November showed no evidence of disease so we were very hopeful. Unfortunately his doctor at Mt Sinai in Toronto told us today after his laparoscopy that although the cancer is responding to chemo it is too widespread for Hipec. We are devastated and really unsure of our next step. He is 62 years old and in great shape. Does this mean that Hipec is off the table forever? I've just spoken to someone at Cancer Treatment Centres of America. What else should I do? Just looking for some advice and maybe a little encouragement as I am so very sad right now. Thanks in advance.

[Lee]

So sorry to read about your dad's recurrence, especially so far out. Usually at the 5 yr mark, the chances of anything happening is slim. Are you in Canada?

Because he is dealing with a recurrence, get 2nd opinion(s) at major cancer treatment centers. It sounds like your dad is mostly in good health, thus they can treat him aggressively. Yes Cancer Treatment Centers of America would be a good choice. Not sure where you are, butt Sloan Kittering in NYC might also be a good place. Mayo Clinic in Minnesota might be another place. MD Anderson in Texas.

If you are in Canada, hopefully others will chime on places to see there.

DON'T give up the hope. Others have made it to NEDville after a recurrence. Yes surgery is his best option, which is why you want to get him to major cancer treatment center. Get several opinions.

Good luck,

Lee

[Maia]

Does this mean that Hipec is off the table forever? I've just spoken to someone at Cancer Treatment Centres of America. What else should I do? Just looking for some advice and maybe a little encouragement as I am so very sad right now. Thanks in advance.

He might continue responding to chemo and become resectable, a candidate for CRS/HIPEC : ) Also, you could look for an immunotherapy trial, in case he's lucky to respond to it with a more durable response (like this, with a remarkable immunotherapy that is in trials in Canada only: https://clinicaltrials.gov/ct2/show/NCT02285816). You can look for more immonotherapy trials filling with "Canada" the search box in the clinical trials finder in my signature (not mine! I'm just linking to it). And since you consulted in other country and you might be willing to travel, you might want to take a look at this new procedure (sadly, not available in Canada neither the States, but very relevant for his situation): viewtopic.php?f=1&t=56641&p=448006
I'm sorry you had such news but hopeful that you'll find a course of action that will help your dad!

[Maia]

Since Lee mentions Mayo... apparently, PIPAC will be FDA approved and available first in Mayo this year. So, strategically, it might be a good place where to consult.

[Apple1291]

I'm so glad to be a member of this forum! Thanks Lee and Maia for responding so quickly. This morning's news was a big blow to my family and I still feel a little like I've been punched in the stomach. However, you taking the time to offer advice is very reassuring. I've since been in touch with Roswell and Mayo. I guess keeping busy and taking action is helping me feel a lot better. Thank you Maia for the link, I am going over it now, but I wanted to say thank you first. I have 2 daughters who love their grandfather so much and I love him more than I can properly express in words. We are not giving up.

Anne

[Maia]

Good luck, Anne. It's not easy but there is very much that can be done and things are changing for good, since a couple of years ago, and even more faster since past year. Keep us posted!

[Lee]

Good luck, Anne. It's not easy but there is very much that can be done and things are changing for good, since a couple of years ago, and even more faster since past year. Keep us posted!

Ditto to what Maia said.

Lee

[SEWHAPPY]

Good luck and prayers for your whole family! Your Dad is lucky to have your support and advocacy on his side.

[Canada777]

My boyfriend had a similar situation. Toronto told him no to hipec after 12 Rounds of FOLFOX that showed stability. He only had peritoneal mets too. We had our oncologist on board for second opinions. Calgary has apparently accepted patients that Toronto said no to. Roswell did my boyfriends hipec successfully. HIPEC is very expensive so we applied to the ministry of health for funding. Luckily we got approved. Please send me a pm if you need more details. I would be happy to answer more questions.