HIPEC for para aortic nodes: Surgery consult: what questions to ask??????

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CLD
Posts: 206
Joined: Fri Mar 27, 2015 7:16 pm

HIPEC for para aortic nodes: Surgery consult: what questions to ask??????

Postby CLD » Sat Aug 25, 2018 7:35 am

My husband has a surgery consultation with dr. David Bartlett on Thursday. I don't even know where to begin with what questions we should ask him. If anybody has had the hipec procedure done or has had a consult if you could please tell me what questions do you suggest I ask I would greatly appreciate it! thank you!
Wife to DH/ Father of 6 (age 42 at dx) diagnosed Jan 2015 stage IIIC
Tumor deposit in mesentery 13/24 lymph nodes +
CEA at dx: 5
MSS
Low Grade/Mod. Diff.
FOLFOX 6 months
N.E.D until June 2018
PET Scan 6/18
Biopsy confirms cancer in 3 Paraaortic lymph nodes
Folfiri + Avastin (6tx) and Xeloda during radiation
Cancer all over both lungs dx Jan 2019
FOLFIRI +AVASTIN presently

bitchslapped
Posts: 1534
Joined: Tue Sep 09, 2014 3:23 pm
Location: PNW/USA

Re: HIPEC for para aortic nodes: Surgery consult: what questions to ask??????

Postby bitchslapped » Sat Aug 25, 2018 11:53 am

CLD, You can read my BFF's CRS/HIPEC experience here:
http://coloncancersupport.colonclub.com ... ec#p473261

Reading up on HIPEC may help you formulate some qx's. I did provide some links on that post.

Basically @ first appt you are trying to find out if DH is a candidate for HIPEC which w/b determined by PCI (Peritoneal Cancer Index) most likely via laparscopic surgery if he hasn't already had it.

Some example qx's might be:

1. Tx options: 1 line, 2nd line.
2. Targeted immunologic therapies, newly approved or upcoming
3. Where best to find recent studies/breaking news for future
4. Prognosis, Recurrence rate, QOL w/recommended tX
5. If approved for HIPEC, then overall vs progression-free survival specific to DH's dx
6. Timing of tx
7. Tumor profiling


Certainly, you are going to one of the most experienced HIPEC docs in the nation w/Bartlett. I would encourage you to really focus on listening more than anything. These docs are so proficient @ this, they know what patients want to know. JMO

http://hillman.upmc.com/cancer-care/sur ... metastases

Let us know how your appt goes.

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, diverticulitis
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

CLD
Posts: 206
Joined: Fri Mar 27, 2015 7:16 pm

Re: HIPEC for para aortic nodes: Surgery consult: what questions to ask??????

Postby CLD » Sat Aug 25, 2018 2:30 pm

You have provided me with more help than I could have hoped for!!! THANK you! I will let you all know how it goes!
Wife to DH/ Father of 6 (age 42 at dx) diagnosed Jan 2015 stage IIIC
Tumor deposit in mesentery 13/24 lymph nodes +
CEA at dx: 5
MSS
Low Grade/Mod. Diff.
FOLFOX 6 months
N.E.D until June 2018
PET Scan 6/18
Biopsy confirms cancer in 3 Paraaortic lymph nodes
Folfiri + Avastin (6tx) and Xeloda during radiation
Cancer all over both lungs dx Jan 2019
FOLFIRI +AVASTIN presently

bitchslapped
Posts: 1534
Joined: Tue Sep 09, 2014 3:23 pm
Location: PNW/USA

Re: HIPEC for para aortic nodes: Surgery consult: what questions to ask??????

Postby bitchslapped » Sat Aug 25, 2018 5:02 pm

Glad to help. Good Luck.
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, diverticulitis
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

jp81
Posts: 27
Joined: Sun Jun 04, 2017 4:45 am

Re: HIPEC for para aortic nodes: Surgery consult: what questions to ask??????

Postby jp81 » Sun Aug 26, 2018 6:25 am

Hi CLD, have you already checked if they are resectable? My mom had recurrence in the para-aortic nodes and resection is what we went with.
Dear Mom 58yrs, Stage 3 RC (T3CN2M0), CEA 9
MSS, G12D
6.5cm from verge, 30mm in Mesorectal Fascia
Xeloda+Radiation 06/17
Surgery 08/17, CAPOX 5 rounds (plan 6, but blood counts low)
CEA 6, para-aortic node in CT 01/18
CEA 5.6, PET 1 malign PALN 02/18
Pre-op CEA 4.8; Surgery (open) - 1.6cm Inferior Mesenteric Node - 26/02/18
FOLFIRI+Avast from 03/18 to 09/18 (12 cyc)
Clean PET - 23/05/18, 06/11/18 (CEA 3.6), 17/03/20 (4.5)
Cap+Avastin Maint (18/11/18)
CEA 3.6 26/01/19, 4.2 02/19, 5.1 11/04/19, 4.11 03/01/20

CLD
Posts: 206
Joined: Fri Mar 27, 2015 7:16 pm

Re: HIPEC for para aortic nodes: Surgery consult: what questions to ask??????

Postby CLD » Sun Aug 26, 2018 8:03 am

Jp81, Thanks for response. My husband's oncologist seems to think so, but we will get final answer from Dr Bartlett.
Wife to DH/ Father of 6 (age 42 at dx) diagnosed Jan 2015 stage IIIC
Tumor deposit in mesentery 13/24 lymph nodes +
CEA at dx: 5
MSS
Low Grade/Mod. Diff.
FOLFOX 6 months
N.E.D until June 2018
PET Scan 6/18
Biopsy confirms cancer in 3 Paraaortic lymph nodes
Folfiri + Avastin (6tx) and Xeloda during radiation
Cancer all over both lungs dx Jan 2019
FOLFIRI +AVASTIN presently


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