Emergency HIPEC, possible?

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Wewillfight
Posts: 15
Joined: Sun Mar 03, 2019 5:27 am

Emergency HIPEC, possible?

Postby Wewillfight » Mon Oct 14, 2019 10:59 am

In the setting of locally advanced CRC which has spread to a small/medium part of the peritoneum but nowhere else in the body and is causing local small bowel issues, partial blockage.

Are there options for HIPEC in this setting considering there are no other metastases.

Can emergency HIPECs be arranged at short time instance, as in within 1-2 weeks.

All the best.
40 y/o
Diag Nov 2016 stage IIIc, surgery, colostomy, 2 lymph involved
6 months FOLFOX
NED
Nov 2018 recurrence , surgery , some spread to pertineum
Jan-June 2019 Folfiri+Cetux
Clear scans
August 2019: small bowel inflammation, partial blockage symptoms

Lee
Posts: 5971
Joined: Sun Apr 16, 2006 4:09 pm

Re: Emergency HIPEC, possible?

Postby Lee » Mon Oct 14, 2019 5:58 pm

How old is the person who needs to have this procedure done? How healthy is the person? Is the person currently on chemo? HIPEC surgery is MAJOR surgery. It's not something that can be done at a local hospital. It would have to be done at a major cancer hospital. Do you have access to that type of hospital? If you do that would be the first step, get a consult with them.

On a side note, could you provide info below your signature line, Generally info about the person who is dealing with the cancer. I'm not sure if it's you, or a possible parent, or maybe a sibling. You can see mine to get an idea. Good luck,

Lee

P.S. to add, sometimes Dr(s) can do a temporary colostomy to relive symptoms.
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 - 10 years and counting!

Wewillfight
Posts: 15
Joined: Sun Mar 03, 2019 5:27 am

Re: Emergency HIPEC, possible?

Postby Wewillfight » Tue Oct 15, 2019 1:29 am

40 y/o
Diag Nov 2016 stage IIIc, surgery, colostomy, 2 lymph involved
6 months FOLFOX
NED
Nov 2018 recurrence , surgery , some spread to pertineum
Jan-June 2019 Folfiri+Cetux
Clear scans
August 2019: small bowel inflammation, partial blockage symptoms
40 y/o
Diag Nov 2016 stage IIIc, surgery, colostomy, 2 lymph involved
6 months FOLFOX
NED
Nov 2018 recurrence , surgery , some spread to pertineum
Jan-June 2019 Folfiri+Cetux
Clear scans
August 2019: small bowel inflammation, partial blockage symptoms

inorganic8
Posts: 50
Joined: Mon Feb 27, 2017 6:13 pm

Re: Emergency HIPEC, possible?

Postby inorganic8 » Wed Oct 23, 2019 1:27 pm

Can you get HIPEC within a few weeks? I expect so. Is it an option for you? There's no way for me to know. Selecting patients is very complicated. My husband had his done by an amazing and compassionate surgeon at the Moffitt Cancer Center in Tampa, Florida. His name is Dr. Sean Dineen. Dr. Dineen is very aggressive, so he's more likely to take more difficult patients. As a result, he can't brag about the same success rates as other surgeons, who take the easier cases. I can't say enough good things about him. I hope this is helpful.

Hang in there. Get through another day. We don't know how your story ends so don't let any of those doctors give you an expiration date. (Some of them love to do that. I think they have betting pools.)
Wife to DH with CRC
Stage IV Diagnosis 1/27/17, Mets to Liver, Omentum, Peri
KRAS Mutation, G12, MSS
Folfirinox 2/8/17
Folfiri 6/14/17
Nov. scan - disease progression
1/24/18 15-hour HIPEC surgery.
June 2018 It's back, starting Stivarga
Aug. 2018 stopping Stivarga
Sep. 2018 clinical trial of Keytruda and ibrutanib
Dec. 2018 disease progression, stopped trial
Jan. 2019 small bowel obstruction and surgery
Mar. 2019 clinical trial TAK-164
May 2019 deteriorating rapidly
June 12, 2019 At Peace

Pyro
Posts: 303
Joined: Mon Oct 12, 2015 7:40 pm
Location: Tucson, AZ

Re: Emergency HIPEC, possible?

Postby Pyro » Wed Oct 23, 2019 1:41 pm

Wewillfight wrote:In the setting of locally advanced CRC which has spread to a small/medium part of the peritoneum but nowhere else in the body and is causing local small bowel issues, partial blockage.

Are there options for HIPEC in this setting considering there are no other metastases.

Can emergency HIPECs be arranged at short time instance, as in within 1-2 weeks.

All the best.

Are you positive it’s the peri-mets causing the blockage? My blockage was caused by scar tissue from colostomy surgery, I had no peri Mets,
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!

Wewillfight
Posts: 15
Joined: Sun Mar 03, 2019 5:27 am

Re: Emergency HIPEC, possible?

Postby Wewillfight » Tue Oct 29, 2019 1:09 pm

Looks likely to be diffuse cancer causing blockage but no definitive answer yet. Still mostly blocked with NG tube in now for 5 days, complete bowel rest, TPN and just about managed pain.

Scans indeterminate but not resolving conservatively which points to cancer.

Patient had some peritoneal involved 6 months ago.

Thanks
40 y/o
Diag Nov 2016 stage IIIc, surgery, colostomy, 2 lymph involved
6 months FOLFOX
NED
Nov 2018 recurrence , surgery , some spread to pertineum
Jan-June 2019 Folfiri+Cetux
Clear scans
August 2019: small bowel inflammation, partial blockage symptoms


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