I am one of the HAI people on the forum.
I would contact Dr. Kemeny if possible. She likes to start patients on chemotherapy and do treatment from the very beginning. I am one of the patients who are almost completely "her own". I started treatment in hopeless situation: with 10+ mets in the liver, largest 7.5cm, tumor in rectum, and few LN around tumor affected. I was young mother of 6 years old twins at that time.
Dr. Kemeny facilitated everything from me. Within a week I saw her for the first time she put me on FOLFIRINOX chemo . I got complete pathological response and I am off chemo for over a year now with clear scans and normal life.
As you are stage 4 patient at the very beginning of your way , it is good to hit cancer strong to get the best possible response and resection.
FOLFIRINOX+ bevacizumab or FOLFIRINOX + cetuximab/panitumumab gave the greatest percentage of high grade responses to chemo and to cure at the end of the road in some cases according to the studies.
Dr. Kemeny usually opts for 3-4 cycles of chemo to check the response and then orders surgery quickly. She prefered FOLFIRINOX without other agents to follow with surgery to place HAI ASAP.
Once I started chemo I had never had chemo break longer than 2 weeks until I was completely clear of cancer. It maximized the response.
Anyway it is good to hit cancer beast with strongest combination chemo when you are strong, with good blood tests. The cancer can be hit harder and has no time to mutate into more aggressive form.
I went to Dr. K and I have been grateful every day, every minute. I am off chemo living normal life. Everything was fixed for me in no time since I started treatment there. I highly recommend it.
PS. You can PM me if you would like.
mom of 8 years old twins, dx @ 40 with upper rectal cancer, 10+ liver mets in 6/2015, 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!