When to do the HAI Pump?

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Annmont
Posts: 9
Joined: Thu Jun 04, 2020 2:00 pm

When to do the HAI Pump?

Postby Annmont » Fri Jul 24, 2020 12:58 pm

Hello all, this is my very first post here. My DH was diagnosed with colorectal cancer in August 2018. He had chemo/radiation prior to surgery, removal of part of colon/rectum and then pump chemo every other week for 4 months. We were so happy to have two clear scans after that. Then due to COVID, a scan was pushed back. Last scan in June showed a 2cm mass I his liver. Luckily the tumor was able to be surgically removed with clear margins. The plan is to start Xeloda next week. My question is when should the HAI pump be considered? We love our oncology team and they are an hour away. MSK is many states away from us. I just want to make sure we make the right decisions. Is an HAI pump mainly to get you to surgery or should it be chosen as a maintenance? Any experience with similar situation, Xeloda, etc. is appeciated. Thank you all for your help. This forum is a Godsend, so full of hope and inspiration.
DH diagnosed August 21, 2018 with colorectal cancer
6 weeks chemo/radiation
Surgery December 2018/ileo
4 Months Chemo pump
July 1, 2019 Ileo reversal
two clear scans then boom June 2020 mass in liver
Liver resection July 1, 2020, scheduled to start Xeloda

User avatar
CRguy
Posts: 10473
Joined: Sun Feb 10, 2008 6:00 pm

Re: When to do the HAI Pump?

Postby CRguy » Sat Aug 01, 2020 8:39 pm

I am not an HAI pumper here BUTT .....
just wanted to "bump you up" in case some other members may have missed your post

I know we do have some members who could give you more info !

Cheers and best wishes on the Journey
CRguy
Caregiver x 4
Stage IV A rectal cancer/lung met
17 Year survivor
my life is an ongoing totally randomized UNcontrolled experiment with N=1 !
Review of my Journey so far

Rock_Robster
Posts: 1027
Joined: Thu Oct 25, 2018 5:27 am
Location: Brisbane, Australia

Re: When to do the HAI Pump?

Postby Rock_Robster » Sat Aug 01, 2020 9:49 pm

I’m also not HAI myself as I’m not in the US, but from everything I’ve observed I think the best answer is “as soon as a reputable hospital would be prepared to offer you one”.
41M Australia
2018 Dx RC
G2 EMVI LVI, 4 liver mets
pT3N1aM1a Stage IVa MSS NRAS G13R
CEA 14>2>32>16>19>30>140>70
11/18 FOLFOX
3/19 Liver resection
5/19 Pelvic IMRT
7/19 ULAR
8/19 Liver met
8/19 FOLFOX, FOLFOXIRI, FOLFIRI
12/19 Liver resection
NED 2 years
11/21 Liver met, PALN, lung nodules
3/22 PVE, lymphadenectomy, liver SBRT
10/22 PALN SBRT
11/22 Liver mets, peri nodule. Xeloda+Bev
4/23 XELIRI+Bev
9/23 ATRIUM trial
12/23 Modified FOLFIRI+Bev
3/24 VAXINIA (CF33 + hNIS) trial

User avatar
juliej
Posts: 3114
Joined: Thu Aug 05, 2010 12:59 pm

Re: When to do the HAI Pump?

Postby juliej » Fri Aug 07, 2020 1:41 pm

An HAI Pump can be used for both purposes - to get liver tumors reduced in size/number enough for a patient to be able to have surgery OR after surgery to lessen the chance of a recurrence. (Approximately 50% to 75% of patients develop a recurrence of the disease within two years after a liver resection.)

In my case, I had the liver resection and at the same time they implanted an HAI Pump. I then had several cycles of FUDR in the pump. Like your husband, I was also on Xeloda both pre-surgery and post-surgery. Since my HAI pump treatment my liver has remained completely clear. :D

Soooo.... in terms of your question, since your DH already had a a liver resection, it is vitally important they monitor him for a recurrence. Make sure he is getting frequent scans and CEA tests (assuming CEA is a good marker for him). Personally, if I were you, I'd have a consultation about the pump now. But, due to Covid travel issues + living farther away from NYC + the fact that he had only a single tumor in his liver, I can understand waiting. But ONLY if he is heavily monitored. And at any sign of a recurrence, I would immediately arrange for a consultation with Dr. Kemeny.

MSK was also "several states" away for me - I live on the west coast. But sometimes you have to do what you need to do. So don't hesitate to call Dr. Kemey's office if you want a consultation. I hope your DH stays clear now and everything turns out fine. But the HAI pump is a Godsend if you need it. Trust me on this. I wouldn't be alive to be writing you now if it wasn't for it!

Hope this helps!
Juliej
Stage IVb, liver/lung mets 8/4/2010
Xelox+Avastin 8/18/10 to 10/21/2011
LAR, liver resec, HAI pump 11/2011
Adjuvant Irinotecan + FUDR
Double lung surgery + ileo reversal 2/2012
Adjuvant FUDR + Xeloda
VATS rt. lung 12/2012 - benign granuloma!
VATS left lung 11/2013
NED 11/22/13 to 12/18/2019, CEA<1

Annmont
Posts: 9
Joined: Thu Jun 04, 2020 2:00 pm

Re: When to do the HAI Pump?

Postby Annmont » Mon Aug 10, 2020 9:03 pm

Thank you all So much for your input. He meets with oncologist monthly for blood results and scans are scheduled every 3 months. My DH thoughts are to remain on the Xeloda and if a tumor should appear back in his liver, to explore the HAI pump option. Of course we are hoping and praying we will be the percentage that it doesn’t come back. I will say his oncologist and team have been on top of everything from the start. We have nothing but pure respect and gratitude for all they have done thus far.
DH diagnosed August 21, 2018 with colorectal cancer
6 weeks chemo/radiation
Surgery December 2018/ileo
4 Months Chemo pump
July 1, 2019 Ileo reversal
two clear scans then boom June 2020 mass in liver
Liver resection July 1, 2020, scheduled to start Xeloda


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