Hi all,
I am the primary caregiver to my wife. Age 48, diagnosed last month with Stage IV rectal cancer. Multiple mets in both lobes of liver. We have been told by our oncologist (at Kaiser in Bay Area) that she is not a candidate for surgery. All treatment is with palliative intent. No curative intent.
Course of treatment is 6 cycles of FOLFOX, followed by 6 weeks of chemo/radiation, then surgery. Then, chemo for life. This appears to be the standard, based on multiple opinions.
I've spent hundreds of hours online (I know, I know) since then trying to learn as much as I can. These boards have been so helpful and educational. I've found that I've gotten the most value from reading and learning from everyone's experiences. Thank you.
So...I now know that resection is the goal for our situation. Kaiser doesn't appear to support this for us. Based on what I've read, the HAI pump therapy gives us our best shot at eventual liver resection. So we will go out of network if we have to, to get this treatment.
The clear #1 choice is Dr. Kemeny and MSK. However, we live in CA. We have a young family. Although I'm certainly willing to move temporarily across country to get treatment at MSK, there will be an emotional and mental toll on my wife to be away from home.
We *may* have an option closer to home. Dr. Yuman Fong is a world-renowned liver surgeon now at City of Hope in Southern California. He came from MSK and has written papers on HAI. Presumably, he can perform the procedure. We are working on an appointment to see him in two weeks.
Certainly based on reputation, I have no qualms with receiving care from Dr. Fong. He appears to be at least as accomplished (and really, more so) as the liver specialist counterparts at MSK (Janargin and Kingham). However, if the colon resection surgery is done at the same time, are CoH colorectal surgeons as good as the top MSK colorectal surgeons (Paty, Weiser)?
In other words, is the overall team superior at MSK? Will the followup (i.e. FUDR administration) at CoH be as good as MSK?
And if so, are they superior enough to justify us moving across the country for 6 months? When our support system (which has been wonderful) is here on the west coast? Is it a clear case of #1 and #2...or is it more #1A and #1B? I know that expertise, both in implantation and FUDR treatment/monitoring, is key to a positive outcome.
I realize this may be totally subjective, but am hoping to hear your thoughts.
And yes, I know I may be putting the cart before the horse...we may not be viable candidates for the procedure. But I've got to try. I now believe that, while I do like our Kaiser oncologist and she's very caring, Kaiser as a whole may be limited. I do want to be seen at a NIH-designated Cancer Center.
Thanks again for any feedback.
Felix