Liver Pump

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cherryames
Posts: 24
Joined: Thu Sep 21, 2006 3:47 pm

Liver Pump

Postby cherryames » Fri Sep 29, 2006 3:56 pm

Does anyone have experience with the liver pump? I'd be interested in hearing what it is like to have it, and how it is used. I will probably have one before too long. Thanks.

Guest

Postby Guest » Sat Sep 30, 2006 10:49 pm

I have one it has been in for a year and a half. What do you need to know?

missjv
Posts: 1416
Joined: Tue Sep 12, 2006 10:38 am
Location: FLORIDA

Postby missjv » Sun Oct 01, 2006 6:43 am

hi,
wow year and a half??? are you still receiving chemo through it? or is it just still there because you havn't had it removed yet?


missjv

Guest

Postby Guest » Sun Oct 01, 2006 5:02 pm

off chemo for 6 months only had 3 treatments to the pump get it emptied and filled every 6 weeks. Not getting it removed yet few reasons Dr does not want it out yet. It is surgery to get it removed and I have a lot of scar tissue. God Forbid this beast comes back in the liver... It bothers me alot at that certain time of the month... I go off through metal detectors at the airports other than that it is not bad I have gotten use to it...

missjv
Posts: 1416
Joined: Tue Sep 12, 2006 10:38 am
Location: FLORIDA

Postby missjv » Sun Oct 01, 2006 5:58 pm

hi,
do you still get systemic chemo as well or just the liver? is it the same drugs that they use systemic for the liver pump? don't mean to be nosey i am having resection done soon on 3 mets and i was told possibly i would have the liver pump but not for sure yet.



missjv

etl
Posts: 15
Joined: Wed Nov 30, 2005 10:35 pm

Postby etl » Sun Oct 01, 2006 10:08 pm

missjv this is etl---

I got systemic chemo every 2 weeks then the pump filled for 2 weeks emptied then 10 days off systemic again then the pump on and off. The pump only hits the liver not the blood stream so you have to get the systemic as well. They use different drugs. Not sure what you are on now. I was on Oxiplation Avaistan and Folfox first rounds before the Liver Resection. After the Liver Resection I was on CPT 11 fulfurry and not sure what they put in the liver pump. Hope this helps. I e-mailed you... etl

cherryames
Posts: 24
Joined: Thu Sep 21, 2006 3:47 pm

Postby cherryames » Mon Oct 02, 2006 3:19 pm

I guess I want to know specific info like, what do they do to fill the pump, where is it done, and after it's filled what do you have to do? Is there an outside reservoir that holds the chemo? Can you shower? Do you have to be monitored every day? I really have no idea what to expect.

Holly
Posts: 537
Joined: Thu Sep 08, 2005 11:06 pm

Wow

Postby Holly » Mon Oct 02, 2006 6:31 pm

Cherryames,

For your reading pleasure, I have cut an article from www.medtronic.com website for you to peruse at your leisure. Hope this helps answer some of your questions.

Holly

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FDA Approves New Implantable Drug Pump for Use in Promising Colorectal Liver Cancer Treatment

Medtronic's IsoMed® Infusion System Also Receives U.S. Regulatory Approval for Use in Treating Chronic Pain



MINNEAPOLIS, July 24, 2000 -- A new implantable drug pump from Medtronic, Inc. (NYSE: MDT), today received approval from the U.S. Food and Drug Administration (FDA) for use in a promising colorectal liver cancer treatment that delivers cancer-fighting medication directly to the liver, the most common place for colon cancer to spread. The IsoMed® Constant-Flow Infusion System also received regulatory approval for use in delivering morphine sulfate directly into the spinal fluid as a treatment for chronic pain. For these therapies, it features the most accurate constant-flow, implantable drug pump now available to health care providers and patients.

Colorectal Liver Cancer Treatment


Colorectal cancer is the second-leading cause of cancer death in the United States, with approximately 160,000 new cases diagnosed each year. If detected early, it is highly curable; a colonoscopy remains the best and most definitive screening test. But half of the 160,000 patients will suffer recurrence; and in an estimated 70 percent of patients whose cancer comes back, the disease spreads to the liver, limiting the chances for survival beyond two years.

After surgery to remove liver tumors, direct infusion of chemotherapy agents into the liver -- a treatment called hepatic arterial infusion (HAI) therapy -- holds great promise for keeping the cancer in check. Estimates indicate that approximately 12,000 patients who develop liver tumors from colorectal cancer each year in the United States might benefit from HAI therapy.


"There are two reasons why patients respond better to treatment with the pump than to traditional treatment," according to Elin Sigurdson, M.D., director of surgical research at Fox Chase Cancer Center in Philadelphia. "First, the pump delivers the drug directly into the liver; it's not diluted in the blood. The second reason," explained Dr. Sigurdson, who has studied HAI therapy extensively for 20 years, "is that we can actually give much larger doses of the same type of drug than we can give systemically because the drug is cleared by the liver. As a result, response rates tend to be much higher."


For the treatment of patients with colorectal cancer that has spread to the liver, the Medtronic IsoMed® Constant-Flow Infusion System safely and accurately delivers high concentrations of floxuridine (FUDR) on a continuous basis directly to the liver through the hepatic artery, the main blood supply for liver tumors. The IsoMed drug pump is surgically placed under the skin of the abdomen and filled with the appropriate medication. A catheter that runs from the pump to the hepatic artery delivers medication at a constant rate from the pump into the liver.


Numerous studies conducted over the last 15 years suggest that HAI therapy -- administered alone or in combination with systemic chemotherapy after the surgical removal of liver tumors -- can significantly extend the lives of appropriately selected patients with colorectal liver cancer, decrease the recurrence of disease in the liver and improve quality of life.

"I'm confident that my doctor's recommendation of HAI therapy was the best course of action for me," said James Lewandowski, 58, of Langhorne, Pa., who was diagnosed with colon cancer in late 1998 and was implanted with the IsoMed Infusion System at Fox Chase Cancer Center at the end of January. "I'm still working full time; I'm still able to garden and do other chores around the house. My wife and I are looking forward to taking our boat on a cruise to the Chesapeake Bay in August."


The IsoMed Infusion System underwent clinical trials for its use in administering HAI therapy at 21 U.S. cancer centers, including Fox Chase Cancer Center in Philadelphia, Montefiore Medical Center in New York, Massachusetts General Hospital in Boston, Sinai Hospital of Baltimore, MD Anderson Cancer Center in Houston, Medical City Dallas Hospital, The Cancer Center at Century City Hospital in Los Angeles and the University of California San Francisco.

Erika
Posts: 73
Joined: Wed Oct 05, 2005 6:46 pm
Location: Blacksburg, Virginia

pump

Postby Erika » Fri Oct 06, 2006 3:31 pm

cherryames-
The pump is put in and taken out surgically. The entire thing is under the skin in the abdomen with a catheter to the liver. It is filled with a needle through the skin and a topical lidocane can be applied beforehand to numb the area so it is rather painless (if you have a port it is the same idea). The pump is primarily metal (titanium) and weighs a little less than a pound. Mine was 3-4 inches in diameter I would guess. There is a small silicone area for needle access and this part of the pump is raised so it can be identified. Inside the pump there are two chambers separated by a diaphragm and it works based off of pressure (so you'll be told not to scuba dive or sit in hot tubs) and administers a small amount each day to the liver. You'd have to ask your doctor how long you will go for each "cycle". {I received FuDR in my pump continuously for two weeks and then went for systemic treatment two weeks on an alternating schedule like that.} The pump can not be empty so when you are not receiving chemo it will be filled with heparin or a glycerol solution. The glycerol has a longer holding time (a month or so) but your doc will tell you how often you need to have it filled. They always empty it before filling it again.
So, yes you can shower. No, you don't have to be monitored every day. And, because the chemo is directly delivered to your liver, you may not have many side effects. I received a steroid, decadron, with the FuDR which caused many of the typical steroid side effects so this is something you may want to discuss with your doctor so you know what to expect ahead of time. My pump was located at my "belt line" on the left so certain pairs of pants were not comfortable. Depending on your build the pump may be more or less noticeable. I was on the thin side and you could see it very well under my skin. However, there is no reason anyone would see it if it is under your clothes. {I wore my wedding dress with it in.} I also flew on an airplane a few times with it and depending on the airport it may or may not throw the metal detector. Medtronic will give you a medical device card to carry with you and this was never a big deal. Ask your doctor to see one before they put it in! In total, I had the pump about 18 months but was not receiving chemo that whole time.
I suppose I should mention that this information is based off my experience a few years ago so there may be changes in the technology. Also, there are multiple options for which drugs you may receive so again you'll have to discuss that with your doctor.
Feel free to ask any questions and good luck,
Erika


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