UPDATE: New here -- questions about HAI pump

Please feel free to read, share your thoughts, your stories and connect with others!
Foggyocean
Posts: 17
Joined: Wed Aug 30, 2017 12:31 pm

UPDATE: New here -- questions about HAI pump

Postby Foggyocean » Wed Aug 30, 2017 2:22 pm

Hi All,

I've visited this board a few times in the past year and have found the information on here so helpful. Here's some background: My husband was diagnosed with colon cancer March '16 at 44 years old (sigmoid colon). A CT scan at diagnosis showed no metastases and after his colon resection we were told there were 6/42 lymph nodes involved -- Stage 3b. A week before starting chemo, he had a baseline CT and MRI done which showed 4 mets to the liver. He did 4 rounds FOLFOX, liver resection 8/16 and then 8 more rounds of FOLFOX (some delayed b/c of low white counts). After chemo he did 28 sessions of radiation/xelox and finished March '17. PET scan in March was clear, clear CT scan 5/17. Another clear CT scan this month, but his CEA was up (it was 45 and it is a good indicator for him) so they ordered a PET scan. Got the results today -- a single met to the liver. Next up is an MRI for the surgeon to see if it is resectable, otherwise the radiation oncologist said he could treat it (didn't get into details about how exactly he would treat it).

I've been reading about the HAI pump at Sloan Kettering and it sounds like they are getting amazing results. We are in the Boston area (getting treatment at MGH) so getting to NYC isn't too difficult for us. However, we have 2 kids ages 14 and 12 so any time we leave town it takes a lot of juggling to make it work. Has anyone on this board traveled to MSK to get the HAI pump? How often do you have to go there? Do you continue to receive treatment at your local cancer center? It is overwhelming to think about navigating a new hospital and system, but it seems like it would be worth it. Does anyone have a liver surgeon they can recommend?

Thanks for any and all input.

(Oh, I should add, he is KRAS mutant and MSS -- I will work on adding a sig. line).
Last edited by Foggyocean on Mon Sep 18, 2017 10:38 am, edited 1 time in total.
45 year old caregiver to Husband
DX 3/16: 3cm Adenocarcinoma of sigmoid colon, Grade 2
4/16: colon resection; Stage IIIc (at diagnosis), 6/42 nodes, CEA: 11, MSS, KRAS
5/16: Baseline CT & MRI show 4 liver mets, CEA: 99
5/16-1/17: 4x FOLFOX, liver resect, 8x FOLFOX
8/17: 1 liver met, CEA 46.5
10/17: HAI pump; FUDR + Folfiri Oct-Mar '18 w/Dr. K @MSK
1/18: SBRT to liver met; CURRENTLY NED CEA < 1

mariane
Posts: 704
Joined: Sun Sep 13, 2015 6:16 pm

Re: New here -- questions about HAI pump

Postby mariane » Wed Aug 30, 2017 4:34 pm

Hi!
I am originally from Poland but I live in Atlanta, GA, now.
I moved to the US for cancer treatment. My husband had been working for American company for years when I got diagnosed. His insurance made treatment in NY available for me.
I had 10+ mets to the liver when I began treatment. My largest met was 7.5cm. I came to see Dr. Kemeny for the first time in August, 2015.I had already my primary tumor removed in Poland and sent to CARIS for genetic tests. My tumor was, what oncologists called sometimes quadruple negative - KRAS, NRAS, BRAF, PIK3CA negative, MSS. It was APC and p53 positive.
My husband had job in Atlanta area so I was destined to travel for treatment. Dr. Kemeny contacted local cancer center in Atlanta and scheduled my first appointment . Since then I had chemo treatments every 2 weeks: once in NY and once in Atlanta. Dr. Kemeny coordinated the whole process. I had to fly with 5FU pumps what meant additional tests at the airport in NY. Not all the devices at the airports detect HAI pump. Now, ( I am off chemo) they mostly do not see my HAI pump and port ( I still keep my port).
I had all scans in NY. First scan was after 3 chemo treatments. I had very advanced disease, when I started. My first oncologists gave me only about 3 months to liver failure. On the first scan after beginning chemotherapy I got 50% shrinkage and I met surgeon to discuss the pump placement. Next month I had my first surgery in NY - I had the pump placed and 1 met removed to check the pathological response.
The HAI pump with chemo needs to be flushed with saline or steroids (if liver enzymes go up) after 2 weeks. Dr. Kemeny allows chemo treatments only in NY. It means travelling to NY every 4 weeks. Then there is pump flush at local cancer center.
Dr. Kemeny rescanned me after 2 months (I did not get sufficient shrinkage at that time).
In your case, since there is only 1 met, the whole process should be easier.
The resectability depends on metastasis' location and size. The location close important anatomical structures like veins, arteries or bile ducts makes the surgery more difficult and dangerous. However the MSKCC surgeons are brilliant and dedicated to help. I will never be grateful enough to my fantastic surgeon: Dr. D'Angelica.
I many times posted here the research studies and statistics after HAI pump treatment I was able to find on-line.
I also discussed the statistics with Dr. D'Angelica during my appointments. Dr. Kemeny is usually super busy ( she sees sometimes even 60 patients per day). Dr. D'Angelica told me that even after surgery and HAI pump treatment 70% of their patients have recurrences. However, they watched their patients very closely and act fast. The liver recurrence after pump treatment is usually local recurrence, detected early and is being immediately removed. Thanks to this approach their statistics is almost 80% survival for stage 4 patients, often pretreated. It is unbeatable.
If you have more questions please let me know.
Good Luck!
mom of now 14 years old twins, dx @ 40 in 6/2015 with upper rectal cancer, 10+ liver mets, CEA 140
chemo: 8/2015 - 10/2016 - 4xFOLFIRINOX, 2xFOLFOX, 8xFOLFIRI, 10x5FU, HAI pump -12xFUDR
4 surgeries, complete pathological response
CEA<2 since 10/2015
NED since May 2016

I praise God for every day with my family!

Lee
Posts: 6207
Joined: Sun Apr 16, 2006 4:09 pm

Re: New here -- questions about HAI pump

Postby Lee » Wed Aug 30, 2017 5:24 pm

Foggyocean wrote:Hi All,. Has anyone on this board traveled to MSK to get the HAI pump? How often do you have to go there? Do you continue to receive treatment at your local cancer center? It is overwhelming to think about navigating a new hospital and system, but it seems like it would be worth it. Does anyone have a liver surgeon they can recommend?

Thanks for any and all input.

(Oh, I should add, he is KRAS mutant and MSS -- I will work on adding a sig. line).


Hi and welcome, sorry for the reason you are here. I never had a liver met, butt many people here are NED today thanks to Dr Kemny and assoc with MSK. I know there are some return follow ups, just not sure how many. Other will come along with more info. Butt I do know many people get there chemo local and I assume some follow up care can be done local also. Butt I believe any scans, etc must be done a MSK.

Would you be taking your kids with you to MSK? There are many hotels near MSK, maybe a bit on the expensive side from what I understand. I also believe some people have rented an apartment nearby and took the train into New York city. Maybe something to consider.

Good luck, hope this helps some,

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 - 16 years and counting!

Foggyocean
Posts: 17
Joined: Wed Aug 30, 2017 12:31 pm

Re: New here -- questions about HAI pump

Postby Foggyocean » Thu Aug 31, 2017 7:18 am

mariane wrote:Hi!
I am originally from Poland but I live in Atlanta, GA, now.
I moved to the US for cancer treatment. My husband had been working for American company for years when I got diagnosed. His insurance made treatment in NY available for me.
I had 10+ mets to the liver when I began treatment. My largest met was 7.5cm. I came to see Dr. Kemeny for the first time in August, 2015.I had already my primary tumor removed in Poland and sent to CARIS for genetic tests. My tumor was, what oncologists called sometimes quadruple negative - KRAS, NRAS, BRAF, PIK3CA negative, MSS. It was APC and p53 positive.
My husband had job in Atlanta area so I was destined to travel for treatment. Dr. Kemeny contacted local cancer center in Atlanta and scheduled my first appointment . Since then I had chemo treatments every 2 weeks: once in NY and once in Atlanta. Dr. Kemeny coordinated the whole process. I had to fly with 5FU pumps what meant additional tests at the airport in NY. Not all the devices at the airports detect HAI pump. Now, ( I am off chemo) they mostly do not see my HAI pump and port ( I still keep my port).
I had all scans in NY. First scan was after 3 chemo treatments. I had very advanced disease, when I started. My first oncologists gave me only about 3 months to liver failure. On the first scan after beginning chemotherapy I got 50% shrinkage and I met surgeon to discuss the pump placement. Next month I had my first surgery in NY - I had the pump placed and 1 met removed to check the pathological response.
The HAI pump with chemo needs to be flushed with saline or steroids (if liver enzymes go up) after 2 weeks. Dr. Kemeny allows chemo treatments only in NY. It means travelling to NY every 4 weeks. Then there is pump flush at local cancer center.
Dr. Kemeny rescanned me after 2 months (I did not get sufficient shrinkage at that time).
In your case, since there is only 1 met, the whole process should be easier.
The resectability depends on metastasis' location and size. The location close important anatomical structures like veins, arteries or bile ducts makes the surgery more difficult and dangerous. However the MSKCC surgeons are brilliant and dedicated to help. I will never be grateful enough to my fantastic surgeon: Dr. D'Angelica.
I many times posted here the research studies and statistics after HAI pump treatment I was able to find on-line.
I also discussed the statistics with Dr. D'Angelica during my appointments. Dr. Kemeny is usually super busy ( she sees sometimes even 60 patients per day). Dr. D'Angelica told me that even after surgery and HAI pump treatment 70% of their patients have recurrences. However, they watched their patients very closely and act fast. The liver recurrence after pump treatment is usually local recurrence, detected early and is being immediately removed. Thanks to this approach their statistics is almost 80% survival for stage 4 patients, often pretreated. It is unbeatable.
If you have more questions please let me know.
Good Luck!


Thank you for your response, Mariane! It sounds like you had a great experience at MSKCC, and I guess I shouldn't be worried about a 4 hour drive to get there if you were flying back and forth! It sounds like I should just set up an appointment with them to hear how they would proceed with my husband's treatment. I think I would have a lot of regret if we didn't explore the HAI pump at this point while his disease is treatable. Congrats on your continued NED status!!
45 year old caregiver to Husband
DX 3/16: 3cm Adenocarcinoma of sigmoid colon, Grade 2
4/16: colon resection; Stage IIIc (at diagnosis), 6/42 nodes, CEA: 11, MSS, KRAS
5/16: Baseline CT & MRI show 4 liver mets, CEA: 99
5/16-1/17: 4x FOLFOX, liver resect, 8x FOLFOX
8/17: 1 liver met, CEA 46.5
10/17: HAI pump; FUDR + Folfiri Oct-Mar '18 w/Dr. K @MSK
1/18: SBRT to liver met; CURRENTLY NED CEA < 1

Foggyocean
Posts: 17
Joined: Wed Aug 30, 2017 12:31 pm

Re: New here -- questions about HAI pump

Postby Foggyocean » Thu Aug 31, 2017 7:23 am

Lee wrote:
Foggyocean wrote:Hi All,. Has anyone on this board traveled to MSK to get the HAI pump? How often do you have to go there? Do you continue to receive treatment at your local cancer center? It is overwhelming to think about navigating a new hospital and system, but it seems like it would be worth it. Does anyone have a liver surgeon they can recommend?

Thanks for any and all input.

(Oh, I should add, he is KRAS mutant and MSS -- I will work on adding a sig. line).


Hi and welcome, sorry for the reason you are here. I never had a liver met, butt many people here are NED today thanks to Dr Kemny and assoc with MSK. I know there are some return follow ups, just not sure how many. Other will come along with more info. Butt I do know many people get there chemo local and I assume some follow up care can be done local also. Butt I believe any scans, etc must be done a MSK.

Would you be taking your kids with you to MSK? There are many hotels near MSK, maybe a bit on the expensive side from what I understand. I also believe some people have rented an apartment nearby and took the train into New York city. Maybe something to consider.

Good luck, hope this helps some,

Lee


Hi Lee,
Thanks so much for your response. We have enough family around to watch our kids while we head to NYC, I am just trying to keep things as normal as possible for them. They hate when we are both away so I'm trying to balance their needs with getting the best care possible for my husband...it can be exhausting! I think for appointments we can drive there and back in one (long) day, but obviously surgeries would be another story. I like the idea of getting a place outside the sitting and taking the train in...that is definitely something to consider. Thank you for your input and congrats on beating this beast!! It is so uplifting to see so many survivors on here!
45 year old caregiver to Husband
DX 3/16: 3cm Adenocarcinoma of sigmoid colon, Grade 2
4/16: colon resection; Stage IIIc (at diagnosis), 6/42 nodes, CEA: 11, MSS, KRAS
5/16: Baseline CT & MRI show 4 liver mets, CEA: 99
5/16-1/17: 4x FOLFOX, liver resect, 8x FOLFOX
8/17: 1 liver met, CEA 46.5
10/17: HAI pump; FUDR + Folfiri Oct-Mar '18 w/Dr. K @MSK
1/18: SBRT to liver met; CURRENTLY NED CEA < 1

User avatar
juliej
Posts: 3114
Joined: Thu Aug 05, 2010 12:59 pm

Re: New here -- questions about HAI pump

Postby juliej » Thu Aug 31, 2017 3:26 pm

Foggyocean, I fly even further than Mariane to receive my HAI pump treatments. I live on the west coast so it's a coast-to-coast flight for me every few months! I was diagnosed with mets to both my liver (7 mets) and my lungs (1 large met in each lung). That's a Stage 4B. My local cancer center gave me 6 months without chemo and 18-24 months with chemo. No chance whatsoever of surgery. However, thanks to Dr. Kemeny and MSK, I'm currently NED and have been for some time! :D

Initially I moved to NYC for several months for the surgeries. However I had two "triple surgeries" so my case was much more complicated than your husband's surgery would be. The first surgery involved removing the primary tumor, resecting my liver, and implanting the HAI pump. The second one involved resecting both lungs and reversing my ileostomy. The chemo in the HAI pump is alternated with saline so you're on an alternating 2-week schedule -- first chemo, then two weeks later saline, then two weeks later chemo, etc. You can have the saline done locally so you only need to fly/drive to NYC every 4 weeks. You can fit all your appointments in a single long day if necessary, although two days are easier on the patient.

MSK is very accommodating in working with your local cancer center. My local oncologist receives Dr. Kemeny's notes and orders after every visit in NYC so he knows what to do. After your liver has been clear for awhile, you're switched to glycerol instead of saline in the pump. Glycerol lasts 8 weeks instead of 2 weeks like saline. I only have my pump refilled every 2 months. I go to NYC for a CT scan every 4 months so I have it filled there at that time and then locally two months later. As far as coordination, MSK is the most organized medical center I've ever seen. They run a tight ship but they put patients first at all times.

I would go with your instinct and get a consultation with Dr. Kemeny. My liver surgeon was Dr. D'Angelica. Your husband might just need an RFA procedure for the single liver met but Dr. Kemeny puts together her own team so you only need to get the consultation with her and then stand back and let her do her thing! The woman is a research scientist first so don't expect any hand-holding, but she is brilliant beyond belief!

A 2015 ASCO presentation showed the 5 year survival for patients with HAI pumps at 80%. That number is not only impressive, it's the difference between life and death for many of us!

http://meetinglibrary.asco.org/record/112001/abstract

Let me know if you have any more questions about HAI or commuting to NYC, etc.

Hugs to you!
Juliej
Stage IVb, liver/lung mets 8/4/2010
Xelox+Avastin 8/18/10 to 10/21/2011
LAR, liver resec, HAI pump 11/2011
Adjuvant Irinotecan + FUDR
Double lung surgery + ileo reversal 2/2012
Adjuvant FUDR + Xeloda
VATS rt. lung 12/2012 - benign granuloma!
VATS left lung 11/2013
NED 11/22/13 to 12/18/2019, CEA<1

NHMike
Posts: 2555
Joined: Fri Jul 21, 2017 3:43 am

Re: New here -- questions about HAI pump

Postby NHMike » Thu Aug 31, 2017 6:24 pm

This is fascinating stuff. I wouldn't have known about this options if it weren't for this forum and my curiosity as to what was being discussed. And then I had to go look it up. For those that don't know, it's an implantable pump that delivers chemo directly to the tumor. It stands for Hepatic Arterial Infusion.
6/17: ER rectal bleeding; Colonoscopy
7/17: 3B rectal. T3N1bM0. 5.2 4.5 4.3 cm. Lymphs: 6 x 4 mm, 8 x 6, 5 x 5
7/17-9/17: Xeloda radiation
7/5: CEA 2.7; 8/16: 1.9; 11/30: 0.6; 12/20 1.4; 1/10 1.8; 1/31 2.2; 2/28 2.6; 4/10 2.8; 5/1 2.8; 5/29 3.2; 7/13 4.5; 8/9 2.8, 2/12 1.2
MSS, KRAS G12D
10/17: 2.7 2.2 1.6 cm (-90%). Lymphs: 3 x 3 mm (-62.5%), 4 x 3 (-75%), 5 x 3 (-40%). 5.1 CM from AV
10/17: LAR, Temp Ileostomy, Path Complete Response
CapeOx (8) 12/17-6/18
7/18: Reversal, Port Removal
2/19: Clean CT

User avatar
Robino1
Posts: 463
Joined: Fri Aug 11, 2017 12:09 pm
Facebook Username: Robin.lawthers
Location: Florida

Re: New here -- questions about HAI pump

Postby Robino1 » Thu Aug 31, 2017 6:48 pm

Is the pump permanent?
At 54 2014 1st colonoscopy colon cancer detect
Colon resect margins clear. No chemo Stage II
2017
Distend abd, pain in intestines.
CT scan seeding & Ascites
Lap diag - cancer on the omentum
CEA 217; 219
FOLFOX started 6/17
CEA 202
8/29/17 CT melting of tumor.
Latest CT scan shows 2 new tumors and return of ascites.
CEA: (2017)9/30 -109; 10/12 -99.1; 11/4 -90.7; 11/30 -70.7; 12/14 -83.4; (2018)1/4 -73.3; 2/1-84.2; 89.2; 89.8; 88.5; 81.8: 93.5; 107; 119
BRAF V600e

Lee
Posts: 6207
Joined: Sun Apr 16, 2006 4:09 pm

Re: New here -- questions about HAI pump

Postby Lee » Thu Aug 31, 2017 7:02 pm

NHMike wrote:This is fascinating stuff. I wouldn't have known about this options if it weren't for this forum and my curiosity as to what was being discussed. And then I had to go look it up. For those that don't know, it's an implantable pump that delivers chemo directly to the tumor. It stands for Hepatic Arterial Infusion.


This site is a wealth of information. The knowledge and experience here is great especially if you are new to the cancer world. I don't believe there is anything else like it out there today. This was not around when i was going through treatment, wish it had been. There were a few other site then, butt due to certain restriction, they were not very useful. There is one site I check every so often today. I believe they have a years worth of questions on the 1st page alone, they pissed off a lot of caring people including me. Most of those questions asked by new people, go unanswered. If you try to direct them here, you are banned from even being able to look at that forum ever again. All responses MUST BE POSITIVE to the person asking questions. The truth is secondary. Pushing for a colonoscopy is frowned upon, even if you have rectal bleeding.

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 - 16 years and counting!

gfpiv
Posts: 157
Joined: Tue May 25, 2010 9:24 pm

Re: New here -- questions about HAI pump

Postby gfpiv » Thu Aug 31, 2017 11:10 pm

I traveled from Central Mass once a month for 2.5 years during HAI treatment (and for occasional follow-up care afterward). My advice in a nutshell - just do it! I was able to get my pump drained and refilled with saline every other week at my local hospital, and they also gave me my bi-weekly systemic FOLFIRI. I probably wouldn't be here today if I hadn't decided to go to MSK, despite the fact that my first and second onc opinions didn't even mention HAI. I too can vouch for the fact that Dr. D is an amazing liver surgeon. MSKCC has a great team of doctors working together, and even if Dr. Kemeny is not taking new patients, other oncs (like my friend Dr R) can provide similar treatment options. Best of luck to you.

-Chip
Chip
DX stage IV CC Jan '10, numerous unresectable liver mets
FOLFOX + Avastin Feb-Jul '10
Colon resection, HAI install Aug '10
Systemic FOLFIRI and hepatic FUDR Dec'10-May'12
Chemo break May'12-pres (tumors calcified & stable, knock on wood)
Billiary bypass surgery and SBRT on pesky liver met in 2015

mariane
Posts: 704
Joined: Sun Sep 13, 2015 6:16 pm

Re: New here -- questions about HAI pump

Postby mariane » Fri Sep 01, 2017 7:28 am

Chip, did I get it correctly? Did Dr. Kemeny stop taking new patients? Is everything all right? In July she was seeing new patients. I met 2 newbies...
mom of now 14 years old twins, dx @ 40 in 6/2015 with upper rectal cancer, 10+ liver mets, CEA 140
chemo: 8/2015 - 10/2016 - 4xFOLFIRINOX, 2xFOLFOX, 8xFOLFIRI, 10x5FU, HAI pump -12xFUDR
4 surgeries, complete pathological response
CEA<2 since 10/2015
NED since May 2016

I praise God for every day with my family!

Foggyocean
Posts: 17
Joined: Wed Aug 30, 2017 12:31 pm

Re: New here -- questions about HAI pump

Postby Foggyocean » Fri Sep 01, 2017 9:09 am

Wow, everyone, thank you SO much for your replies!! It sounds like it is quite doable and really, a 4 hour car ride is nothing compared to what some of you have gone through. Like all of you know, the sitting around and waiting is the excruciating part so after double checking with my husband I called MSK yesterday and got the ball rolling! I just need to gather all his records from MGH now and they will send them up to Dr. K's office to look over. I'm hoping the turnaround is somewhat quick as we are meeting with his MGH docs next week to talk about options. Interestingly, I asked his onc last week about the HAI pump and he said they are going to start doing it at MGH "soon"...wonderful news for those down the road. He also said he was involved in a clinical trial with HAI pumps at MGH 15-20 years ago and he honestly didn't know why they stopped doing them. He didn't think my husband "needed" a pump at this point, I think he thinks of them as something to use when there are multiple inoperable mets to the liver, but we are hoping to avoid that and avoid another recurrence.

Again, thank you for all the information you have all provided. I have learned so much on this board and you all are truly saving lives by sharing your knowledge and experiences.
Last edited by Foggyocean on Fri Sep 01, 2017 9:36 am, edited 1 time in total.
45 year old caregiver to Husband
DX 3/16: 3cm Adenocarcinoma of sigmoid colon, Grade 2
4/16: colon resection; Stage IIIc (at diagnosis), 6/42 nodes, CEA: 11, MSS, KRAS
5/16: Baseline CT & MRI show 4 liver mets, CEA: 99
5/16-1/17: 4x FOLFOX, liver resect, 8x FOLFOX
8/17: 1 liver met, CEA 46.5
10/17: HAI pump; FUDR + Folfiri Oct-Mar '18 w/Dr. K @MSK
1/18: SBRT to liver met; CURRENTLY NED CEA < 1

NHMike
Posts: 2555
Joined: Fri Jul 21, 2017 3:43 am

Re: New here -- questions about HAI pump

Postby NHMike » Fri Sep 01, 2017 9:23 am

Thanks for the information on MGH. It's nice to know that there will be local options down the road for Stage 4 patients.
6/17: ER rectal bleeding; Colonoscopy
7/17: 3B rectal. T3N1bM0. 5.2 4.5 4.3 cm. Lymphs: 6 x 4 mm, 8 x 6, 5 x 5
7/17-9/17: Xeloda radiation
7/5: CEA 2.7; 8/16: 1.9; 11/30: 0.6; 12/20 1.4; 1/10 1.8; 1/31 2.2; 2/28 2.6; 4/10 2.8; 5/1 2.8; 5/29 3.2; 7/13 4.5; 8/9 2.8, 2/12 1.2
MSS, KRAS G12D
10/17: 2.7 2.2 1.6 cm (-90%). Lymphs: 3 x 3 mm (-62.5%), 4 x 3 (-75%), 5 x 3 (-40%). 5.1 CM from AV
10/17: LAR, Temp Ileostomy, Path Complete Response
CapeOx (8) 12/17-6/18
7/18: Reversal, Port Removal
2/19: Clean CT

User avatar
juliej
Posts: 3114
Joined: Thu Aug 05, 2010 12:59 pm

Re: New here -- questions about HAI pump

Postby juliej » Fri Sep 01, 2017 5:10 pm

Robino1 wrote:Is the pump permanent?

No, it's not permanent. It's about the size of a hockey puck and made out of titanium. It's really amazing technology. It doesn't require batteries; it uses your own body temperature to release a slow flow of chemo to your liver. The best part is there are no side effects since the chemo goes directly to the liver, bypassing the rest of the body altogether. The pump is usually filled with a concentrated form of 5FU, a much stronger dose than the rest of the body can handle.

After the liver is clear of tumors, the pump is filled with saline instead of chemo, and then eventually with glycerol, which is thicker, and allows an even longer time between pump refills. After 5 years, it is removed. I'm planning to keep mine as a paperweight! :D

Hope this helps!
Juliej
Stage IVb, liver/lung mets 8/4/2010
Xelox+Avastin 8/18/10 to 10/21/2011
LAR, liver resec, HAI pump 11/2011
Adjuvant Irinotecan + FUDR
Double lung surgery + ileo reversal 2/2012
Adjuvant FUDR + Xeloda
VATS rt. lung 12/2012 - benign granuloma!
VATS left lung 11/2013
NED 11/22/13 to 12/18/2019, CEA<1

User avatar
juliej
Posts: 3114
Joined: Thu Aug 05, 2010 12:59 pm

Re: New here -- questions about HAI pump

Postby juliej » Fri Sep 01, 2017 5:16 pm

Foggyocean wrote:Wow, everyone, thank you SO much for your replies!! It sounds like it is quite doable and really, a 4 hour car ride is nothing compared to what some of you have gone through. Like all of you know, the sitting around and waiting is the excruciating part so after double checking with my husband I called MSK yesterday and got the ball rolling! I just need to gather all his records from MGH now and they will send them up to Dr. K's office to look over. I'm hoping the turnaround is somewhat quick as we are meeting with his MGH docs next week to talk about options. Interestingly, I asked his onc last week about the HAI pump and he said they are going to start doing it at MGH "soon"...wonderful news for those down the road. He also said he was involved in a clinical trial with HAI pumps at MGH 15-20 years ago and he honestly didn't know why they stopped doing them. He didn't think my husband "needed" a pump at this point, I think he thinks of them as something to use when there are multiple inoperable mets to the liver, but we are hoping to avoid that and avoid another recurrence.

Again, thank you for all the information you have all provided. I have learned so much on this board and you all are truly saving lives by sharing your knowledge and experiences.

Foggyocean, make sure you mention that you're meeting with his MGH docs next week to talk about options. Dr. K's office is very good about expediting appointments when necessary.

Also, his onc's opinion about the pump only being used for multiple inoperable mets to the liver isn't exactly right. In my case, my liver was resected at the same times as the pump was implanted. The pump worked as an "insurance policy" to decrease my odds of recurrence. The pump isn't used just to get patients to resection -- although it works like a dream for many in that position.

Hope this helps!
Juliej
Stage IVb, liver/lung mets 8/4/2010
Xelox+Avastin 8/18/10 to 10/21/2011
LAR, liver resec, HAI pump 11/2011
Adjuvant Irinotecan + FUDR
Double lung surgery + ileo reversal 2/2012
Adjuvant FUDR + Xeloda
VATS rt. lung 12/2012 - benign granuloma!
VATS left lung 11/2013
NED 11/22/13 to 12/18/2019, CEA<1


Return to “Colon Talk - Colon cancer (colorectal cancer) support forum”



Who is online

Users browsing this forum: No registered users and 9 guests

cron