Exploring HIPEC Surgery and How to Choose A Surgeon

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inorganic8
Posts: 42
Joined: Mon Feb 27, 2017 6:13 pm

Exploring HIPEC Surgery and How to Choose A Surgeon

Postby inorganic8 » Sun Mar 19, 2017 11:08 am

Good morning all,

I hope you are all having as good a day as you can. My husband was diagnosed with Stage 4 CRC about 2 months ago. He has metastases to his omentum and peritoneum. He is 42 years old and otherwise in good health. He has completed 3 rounds of Folfirinox and is tolerating them reasonably well. Blood work is still good. We are very interested in getting some opinions on HIPEC so I'm trying to decide where to take him. These are my options:

1. Moffitt Cancer Center in Tampa Florida - this one is closest to home and there is a surgeon that does HIPEC for peritoneal mesothelioma, but not for CRC.
2. UM Sylvester Comprehensive Cancer Center - I see one surgeon on their website that does HIPEC.
3. Cancer Treatment Centers of America, Philadelphia - It's a long way from home, but they have a Peritoneal Surface Malignancy program and seem to have extensive experience with CRC.
4. Wake Forrest - A long way from home, but they have well published and respected surgeons who seem to have lots of HIPEC experience.

Please share with me any thoughts or experiences you have with these locations, or others.

One more thing I am worried about. I understand that chemo can seriously suppress the immune system. There are lots of people with colds and flus in airports and on planes. Any ideas on how to best protect my husband when exposed to the germy public?
Wife to wonderful man with CRC
Stage IV Diagnosis 1/27/17, Mets to Liver, Omentum, Peri
KRAS Mutation, G12, MSS
Folfirinox 2/8/17, completed 9 rounds
Follow-Up PET 4/13/17 - Very encouraging. Definite shrinkage and 2/3 liver mets resolved.
Follow-Up PET 6/13/17 - Very encouraging. Even more shrinkage.
Folfiri 6/14/17
November Scan - disease progression
Looking for clinical trial

Lee
Posts: 5293
Joined: Sun Apr 16, 2006 4:09 pm

Re: Exploring HIPEC Surgery and How to Choose A Surgeon

Postby Lee » Sun Mar 19, 2017 5:30 pm

inorganic8 wrote:One more thing I am worried about. I understand that chemo can seriously suppress the immune system. There are lots of people with colds and flus in airports and on planes. Any ideas on how to best protect my husband when exposed to the germy public?


Don't have any real answer regarding HIPEC or choosing a surgeon except maybe consider 2 surgeons doing the surgery at Moffitt at the same time. One surgeon for HIPEC, colon rectal surgeon for primary tumor.

Butt regarding colds & flu. Make sure your husband is up to date on flu shots. Make sure everyone at your house, washes there hands, use lots germ killing wipes on counters and around the house.

Hope others will come along with expert advice regarding HIPEC surgery,

All the best,

Lee
rectal cancer - April 2004
46 yrs old at diagnoses
stage III C - 6/13 lymph positive
radiation - 6 weeks
surgery - August 2004/hernia repair 2014
permanent colostomy
chemo - FOLFOX
NED - 10 years and counting!

Jacques
Posts: 408
Joined: Sun Dec 28, 2014 10:38 am

HIPEC surgeons, and HIPEC topics on ColonTalk

Postby Jacques » Mon Mar 20, 2017 4:08 am

To choose a surgeon for HIPEC you might want to have a look at the directory of the American Society for Peritoneal Surface Malignancies (ASPSM). There are several members in Florida and southeast USA:

ASPSM Directory
http://www.americansocietypsm.org/Directory.html

HIPEC topics on ColonTalk:
https://coloncancersupport.colonclub.com/viewtopic.php?f=1&t=53554&p=424674#p424674
DX(2012): RC
Stage IIc,T4b N0 M0 L0 PN1 H0 D0 P0 I1
LAR
MSI: not tested
Chimio-radiothérapie
Chimiothérapie adjuvante : capécitabine + oxaliplatine
CEA < 1.0,
5 years NED,
End of 6-month follow-ups: 7/2017
----
Info links:
Create Your Signature
How to Select a Surgeon
List of Forum Features
Colorectal Cancer Stages (TNM)

ilovemyfrenchie
Posts: 2
Joined: Fri Nov 03, 2017 9:20 pm

Re: Exploring HIPEC Surgery and How to Choose A Surgeon

Postby ilovemyfrenchie » Sun Nov 12, 2017 10:22 pm

Hi Inorganic,

New to this board and can’t message you for some reason. My moms story is very similar to your husbands and I don’t know where to turn to for advise. The oncologist is calling it “palliative chemo” but I can’t accept that. We just went along with the local hospital oncologist and was wondering how you like it at Moffitt Cancer Center? The local surgeron says she’s inoperable but we only had one chemo treatment so far so I’m hoping for the next CT scan to be better. Any advice is appreciated! Did you end up getting any second opinions for HIPEC? And when did you make that step?
Daughter to 59 yo w/ Stage 4 Mets to liver & peritoneal
10/1/17 ER trip for GI bleed found rectal tumor
10/2/17 emergency colostomy (no resection, told tumor inoperable due to Mets found)
10/30/17 started Folfiri with Avastin

inorganic8
Posts: 42
Joined: Mon Feb 27, 2017 6:13 pm

Re: Exploring HIPEC Surgery and How to Choose A Surgeon

Postby inorganic8 » Wed Nov 15, 2017 1:54 pm

Email me. Use my handle followed by gmail. We have lots to talk about. It sounds like I can help.
Wife to wonderful man with CRC
Stage IV Diagnosis 1/27/17, Mets to Liver, Omentum, Peri
KRAS Mutation, G12, MSS
Folfirinox 2/8/17, completed 9 rounds
Follow-Up PET 4/13/17 - Very encouraging. Definite shrinkage and 2/3 liver mets resolved.
Follow-Up PET 6/13/17 - Very encouraging. Even more shrinkage.
Folfiri 6/14/17
November Scan - disease progression
Looking for clinical trial

User avatar
bitchslapped
Posts: 1360
Joined: Tue Sep 09, 2014 3:23 pm
Location: PNW/USA

Re: Exploring HIPEC Surgery and How to Choose A Surgeon

Postby bitchslapped » Thu Nov 16, 2017 3:09 pm

inorganic8,
Certainly I would read the forum links for HIPEC Jacques listed + type hipec in the search box which will bring up additional threads. I did all of that while assisting my BFF in search of qualified surgeons for HIPEC due to appendix cancer. I did notice a post where you had a negative experience w/Wake Forest which not only surprises me, but also that it is on your list, considering. Otherwise it seems Dr. Edward Levine is quite experienced there & would take note if they do not recommend HIPEC in your DH's case. That would also lead to 2nd or 3rd opinions most definitely w/other well-known hipec surgeons IMO. Through my reading it appears that colon cancer is on the higher end for recurrence statistically post hipec.

There is a great learning curve for hipec w/the cyto reductive surgery being paramount to success, so look for an experienced surgeon who has performed @ least 150-200 of them. This is not easy to find if hospitals/cancer centers don't list their stats. Only a couple do that I was able to find. Read the docs bio carefully re: their clinical experience & research interest, reviews from various websites, publications, or go on Pubmed to find them by doc's name. If a hospital had little info on their website re: hipec, I moved on.

In the airport I'd take along some sanitary wipes & gel, try to use my own pens whenever possible & remember money is pretty dirty (not to be confused w/dirty $ :D )
https://www.cdc.gov/flu/consumer/prevention.htm

Best Wishes
BS
DSS,35YO,unresect mCRC DX 7/'14,lvr,LN,peri,rib
FOLFOX+Avstn 4 Rnds d/c 10/'14
Stent 9/'14
FOLFIRI+Avstn 10/'14
Gone From My Sight 2/20/15
Me:garden variety polyps + precancerous polyp
Carergver x2 DH,DM dbl occupancy,'03-'10
DH dx 47YO mCRC,'04-'07 fried x HAI
DM dx CC 85YO,CC,CHF,stroke,dementia,aphasia


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