Peri met and liver mets

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Trying
Posts: 250
Joined: Sun May 13, 2018 10:11 pm

Peri met and liver mets

Postby Trying » Thu Feb 14, 2019 10:33 pm

Im curious how many or if any of you had liver mefs with a peri met at the same time and what your treatment plan is or was.

Thank you all
38 yr old single mom of almost 2 year old at the time
April 2018 colon cancer stage IV 10 liver mets and peri met. Folfox and 12 rounds oxyplatin
Fec 2018 Down to 2 mets in liver. 8 dissapeared
July 2019 switched to xeloda pills as I prefer to 3 day infusion. Also on avistan
Oct 2019 emergency colostomy due to perforated bowel. ( unreal pain)
Feb 2020 show 2mm tumor increase.
Plan to go back on oxy
Oxy failed- irinotecan as of of Sept 2020

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

Re: Peri met and liver mets

Postby Lee » Fri Feb 15, 2019 8:08 pm

So sorry for all you are dealing with.

Where are you getting treatment? My advice if you are not already doing so, please get opinions from major cancer hospitals or cancer treatment centers. You are young, you want an aggressive team on your side.

This is something you might want to check out

viewtopic.php?f=1&t=49736&hilit=celine

Have you looked into Keytruda?

Good luck,

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!

Trying
Posts: 250
Joined: Sun May 13, 2018 10:11 pm

Re: Peri met and liver mets

Postby Trying » Fri Feb 15, 2019 8:32 pm

Hi lee

Im at a major cancer center. Just dont hear much on peri mets and thought someone might have some experience with them

Thanks for your reply
38 yr old single mom of almost 2 year old at the time
April 2018 colon cancer stage IV 10 liver mets and peri met. Folfox and 12 rounds oxyplatin
Fec 2018 Down to 2 mets in liver. 8 dissapeared
July 2019 switched to xeloda pills as I prefer to 3 day infusion. Also on avistan
Oct 2019 emergency colostomy due to perforated bowel. ( unreal pain)
Feb 2020 show 2mm tumor increase.
Plan to go back on oxy
Oxy failed- irinotecan as of of Sept 2020

Pyro
Posts: 305
Joined: Mon Oct 12, 2015 7:40 pm
Location: Tucson, AZ

Re: Peri met and liver mets

Postby Pyro » Sat Feb 16, 2019 6:35 am

Aug 2015- Stage 4 CC with liver Mets(38/m)
Sep 2015- Avastin/Folfox/Iron
Dec 2015-Not liver surgery candidate
Jan 2016- Erbitux/Folfiri, 2nd opinion at MDA in TX
Feb 2016 -MDA liver surgery
Mar 2016 -30% of left lobe rem, PVE
May 2016 - 70% of liver rem
Jun 2016-Rad
Jan 2017-perm colost @MDA
Jul 2017-Erb/FOLFURI
Nov 2017 -Lung & Liver ablations@MDA
Jan 2018 -Xeloda & Avastin mx
Jul 2018-Avast/FOLFURI
Sep 2018-Rad
Mar 2019 - Keytruda fail
Jun 2019 - FOLFURI
Aug 2019 - No more, quality time!

Trying
Posts: 250
Joined: Sun May 13, 2018 10:11 pm

Re: Peri met and liver mets

Postby Trying » Sat Feb 16, 2019 10:36 pm

This is great
Thank you
38 yr old single mom of almost 2 year old at the time
April 2018 colon cancer stage IV 10 liver mets and peri met. Folfox and 12 rounds oxyplatin
Fec 2018 Down to 2 mets in liver. 8 dissapeared
July 2019 switched to xeloda pills as I prefer to 3 day infusion. Also on avistan
Oct 2019 emergency colostomy due to perforated bowel. ( unreal pain)
Feb 2020 show 2mm tumor increase.
Plan to go back on oxy
Oxy failed- irinotecan as of of Sept 2020

User avatar
henry123
Posts: 218
Joined: Sun Oct 08, 2017 3:25 am

Re: Peri met and liver mets

Postby henry123 » Sun Feb 17, 2019 12:59 pm

I had peritoneal cavity Mets alongwith those in liver and lungs.
They are difficult to treat as there's low supply of blood . Hipec is an option . I was not a candidate for that due to my advanced stage.
So we tried immunotherapy.
46yo M msi-high Lynch +ve
5/16 lap AR 14/21 L nodes +ve
T4N2M1
7/16 Capox 9 cyc
9/16 cea 2
1/17 550
PET CT mets in lung & peri
iri+ avast fail
3/17 10577
4/17 regro fail
5/17 cea 28800
5/17 CT inc in size of mes nodes ,onset of multi nodules in liver
6/17 Opdivo start
7/17 26754
8/17 5623
9/17 497
10/17 52
CT all clear exc a nodule in Lung. liver norm
1/18 3.6
Aspirin start
6/18 1.5 CT clear
12/18 1.1 NED
1/20 NED Opdivo stop
8/23 1.0 All ok

rp1954
Posts: 1853
Joined: Mon Jun 13, 2011 1:13 am

Re: Peri met and liver mets

Postby rp1954 » Sun Feb 17, 2019 1:10 pm

We seem to have had unusually good experience for peri+liver mets but I don't think it was rare happenstance.

Round 1. Our experience with destruction of the peri mets was first - earliest, by mild chemistry cocktail and immune processes alone, before surgery, before chemo. One of the things that I didn't know then was that the peritoneum was a precursor rich environment, in addition to the blood high levels of neutrophils (granulocytes) typical at diagnosis or recurrence. Between chemically altering the cancer cell life cycles and/or simply switching the granulocytes' and their cytocidal abilities, "ON", the extra chemistry was very destructive to my wife's peri mets in 1-3 weeks. My wife represents common fairly bad markers but no one else reports with the timely combination of markers and chemistry.

Round 2. We got a second surgery (inoperable then, for PALN) because we plausibly showed that we had stopped metastasis. What we did different was keep up the extra immune and mild chemo attack daily, with no gaps.

Round 3. We dramatically shrank (unbiopsied) liver masses while on immunochemo, after turning up the immune components in the immunochemo (and after a surgical reduction of PALN met load elsewhere).

Some fundamental, underlying issues to surgery on the peri + liver met, that the surgeons are missing (in my opinion), is how to bridge the perioperative chemo gap, and reduce immune suppression from surgery itself. I've discussed "how to" on the chemo gap before. Our address of the immune suppression from surgery was a more aggressive version of Life Extension's first aid formula from 2010.

Between you and my wife, differences might be matching marker phenotype features, post chemo altered cancer cells and cytokines, with lower immune function and fewer WBC available. Our initial time and money commitments were low, and they can be done while everything else is in chaos or suspense, waiting for a call or interview.
watchful, active researcher and caregiver for stage IVb/c CC. surgeries 4/10 sigmoid etc & 5/11 para-aortic LN cluster; 8 yrs immuno-Chemo for mCRC; now no chemo
most of 2010 Life Extension recommendations and possibilities + more, some (much) higher, peaking ~2011-12, taper chemo to almost nothing mid 2018, IV C-->2021. Now supplements

Trying
Posts: 250
Joined: Sun May 13, 2018 10:11 pm

Re: Peri met and liver mets

Postby Trying » Sun Feb 17, 2019 4:14 pm

Great info. Thank you
38 yr old single mom of almost 2 year old at the time
April 2018 colon cancer stage IV 10 liver mets and peri met. Folfox and 12 rounds oxyplatin
Fec 2018 Down to 2 mets in liver. 8 dissapeared
July 2019 switched to xeloda pills as I prefer to 3 day infusion. Also on avistan
Oct 2019 emergency colostomy due to perforated bowel. ( unreal pain)
Feb 2020 show 2mm tumor increase.
Plan to go back on oxy
Oxy failed- irinotecan as of of Sept 2020

tbt4snow
Posts: 31
Joined: Sat Oct 27, 2018 3:16 pm
Facebook Username: Tina tran

Re: Peri met and liver mets

Postby tbt4snow » Mon Feb 18, 2019 2:51 pm

Hi,
I have been reading your posts with great appreciation. For my peri met, the treatment plan is to have four chemo sessions then CT scan and see if I'm a candidate for CRS/HIPEC. I'm already on the 3rd chemo session and my CEA has not lower. The surgeon that I am referred to for CRS/HIPEC is fairly young. I'm going to MSK for second opinion. My question is, if I'm not qualified for CRS/HIPEC, what other treatment option should I ask for ? I learned about CRS/HIPEC through this great forum.
Thank you so much.
DX: CC stage 4/w ovaries & omentum mets in 12/17 49/F
High grade pT3N1bM1b sigmoid Adenocarcinoma colon
MSS-h TMB=16, NRAS-mutant
Lymph nodes: 1/2 left colic; 3/8 regional
12/2017: Exploratory laparotomy & resect of sigmoid & ovaries
Folfox/avastin 12 sessions from 1/8-6/18. 6/18 CEA 2.1
1/19: CT shows peri mets;
CEA: 12/18 5.1, 1/7/19 7.9; 1/15/19 9.1; 1/30/19: 10.6
4/3/2019 CRS/HIPEC after 4 Folfiry sessions...

Trying
Posts: 250
Joined: Sun May 13, 2018 10:11 pm

Re: Peri met and liver mets

Postby Trying » Mon Feb 18, 2019 9:19 pm

Hello. Like you, im unsure of other treatments and hope some others may jump in
38 yr old single mom of almost 2 year old at the time
April 2018 colon cancer stage IV 10 liver mets and peri met. Folfox and 12 rounds oxyplatin
Fec 2018 Down to 2 mets in liver. 8 dissapeared
July 2019 switched to xeloda pills as I prefer to 3 day infusion. Also on avistan
Oct 2019 emergency colostomy due to perforated bowel. ( unreal pain)
Feb 2020 show 2mm tumor increase.
Plan to go back on oxy
Oxy failed- irinotecan as of of Sept 2020

brokenwings
Posts: 147
Joined: Mon Jan 07, 2019 1:50 am

Re: Peri met and liver mets

Postby brokenwings » Fri Feb 22, 2019 10:55 pm

Hi Trying and tbt4snow,

As I think I've already told you, I have peri mets too.

Here in France, some cancer centers practice PIPAC for patients who are not (for the time being) candidates for HIPEC. (It's also used for ovarian cancer).

The main idea is to have a laparoscopic surgery during which the surgeons will spray chemo into your abdomen. They can repeat this procedure as many times as needed. I think it's necessary to continue sistemic chemo though.

You could check if it's available in the USA.

Hugs,

Paola
DX 2019 Adenocarcinoma Sigmoid colon. PC + ovarian met.
Obstruction. Temporary colostomy.
Folfirinox + Avastin: 6 cycles. Scans: partial response.
Surgery (CRS + HIPEC) 04/29: too much disease, surgery cancelled. Right ovary removed.
2nd ptotocol: IP chemo (oxaliplatin) + IV chemo (Folfiri + Avastin). 8 cycles
10/31/2019: 11 hour-long Hipec + 6 weeks in hospital
12/30/2019: liver met
02/05/2020: reversal surgery. New peri mets discovered
March 2020: 5fu+Avastin
May 2020: fistula
Back to 1957: 5fu.

Trying
Posts: 250
Joined: Sun May 13, 2018 10:11 pm

Re: Peri met and liver mets

Postby Trying » Sat Feb 23, 2019 12:06 pm

Thanks!
38 yr old single mom of almost 2 year old at the time
April 2018 colon cancer stage IV 10 liver mets and peri met. Folfox and 12 rounds oxyplatin
Fec 2018 Down to 2 mets in liver. 8 dissapeared
July 2019 switched to xeloda pills as I prefer to 3 day infusion. Also on avistan
Oct 2019 emergency colostomy due to perforated bowel. ( unreal pain)
Feb 2020 show 2mm tumor increase.
Plan to go back on oxy
Oxy failed- irinotecan as of of Sept 2020

brokenwings
Posts: 147
Joined: Mon Jan 07, 2019 1:50 am

Re: Peri met and liver mets

Postby brokenwings » Sat Feb 23, 2019 5:18 pm

Hi again Trying,

I took the liberty of asking our genius member Maia Walker about PIPAC in the US and to my surprise, she told me it's not yet available in the US!!

I paraphrase more or less what she said: the only place in the Americas were there is PIPAC is in Argentina. There are several places in Europe and Singapore.
All the trials with PIPAC that admit CRC patients are in the Late Stage MSS CRC trials Finder ^^
She thinks it's a good idea to contact Dr Reymond (the creator of the procedure), who is head of the program at Univeristy of Tübingen. His office may guide the patient about which location might be an option.

I hope this information is useful and that you get PIPAC in the US as soon as possible. It's yet another useful tool to fight against peri mets.

Hugs,

Paola
DX 2019 Adenocarcinoma Sigmoid colon. PC + ovarian met.
Obstruction. Temporary colostomy.
Folfirinox + Avastin: 6 cycles. Scans: partial response.
Surgery (CRS + HIPEC) 04/29: too much disease, surgery cancelled. Right ovary removed.
2nd ptotocol: IP chemo (oxaliplatin) + IV chemo (Folfiri + Avastin). 8 cycles
10/31/2019: 11 hour-long Hipec + 6 weeks in hospital
12/30/2019: liver met
02/05/2020: reversal surgery. New peri mets discovered
March 2020: 5fu+Avastin
May 2020: fistula
Back to 1957: 5fu.

Trying
Posts: 250
Joined: Sun May 13, 2018 10:11 pm

Re: Peri met and liver mets

Postby Trying » Sat Feb 23, 2019 5:53 pm

I am in canada. That treatment sou ds great and hope its available here soon. I really appreciate your info!
38 yr old single mom of almost 2 year old at the time
April 2018 colon cancer stage IV 10 liver mets and peri met. Folfox and 12 rounds oxyplatin
Fec 2018 Down to 2 mets in liver. 8 dissapeared
July 2019 switched to xeloda pills as I prefer to 3 day infusion. Also on avistan
Oct 2019 emergency colostomy due to perforated bowel. ( unreal pain)
Feb 2020 show 2mm tumor increase.
Plan to go back on oxy
Oxy failed- irinotecan as of of Sept 2020

tbt4snow
Posts: 31
Joined: Sat Oct 27, 2018 3:16 pm
Facebook Username: Tina tran

Re: Peri met and liver mets

Postby tbt4snow » Thu Feb 28, 2019 6:32 am

Thank you brokenwings for great info.
DX: CC stage 4/w ovaries & omentum mets in 12/17 49/F
High grade pT3N1bM1b sigmoid Adenocarcinoma colon
MSS-h TMB=16, NRAS-mutant
Lymph nodes: 1/2 left colic; 3/8 regional
12/2017: Exploratory laparotomy & resect of sigmoid & ovaries
Folfox/avastin 12 sessions from 1/8-6/18. 6/18 CEA 2.1
1/19: CT shows peri mets;
CEA: 12/18 5.1, 1/7/19 7.9; 1/15/19 9.1; 1/30/19: 10.6
4/3/2019 CRS/HIPEC after 4 Folfiry sessions...


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