Thanks guys for your stories, support.
Her location is Portland, OR area = OHSU (Oregon Health Sciences University) which is a designated NCI comprehensive cancer center, however some locals liken the in-hospital after-care to that of a VA hospital. HIPEC is in its infancy there, only 4 yrs. She is willing to travel, however insurance networks are always a problem state to state in the USA. If tx is available within 50 miles of your home, then that's where you go unless she decides to go out of network or challenge it.
She's healthy aside from this, yet asks herself if @ 64 is she up to this (HIPEC) + what else? QOL important to her.
I am getting crosseyed from all the reading. Here's the bottom line:
Medical Establishment, Research all the way through Pathology confused about dx of the multitude of appendix cancer cell biologies (I'll put it that way) = pick a grade, pick a tx! Uniformity = 0. Somewhere I read new grading guidelines published "who knows where" this Sept......I guess b/c this is a rare cancer, some using 2 stages, some using 3 to stage...some combining well-differentiated w/moderately differentiated, some combining moderately-differentiated w/poorly differentiated
When she receives path report, my recommendation to HER is to ask her doc about 2nd path opinion, especially if done @ an independent lab, as per the below article, preferably @ a teaching institution.
For those of you interested:https://health.ucsd.edu/news/releases/P ... nosis.aspx
It took 2 months to get a dx, test after test, doc after doc. Nobody saw something on her appendix except the liver/pancreatic surgeon. Not the 2 gastro docs, 1st surgeon, not even the surgical gynecological oncologist who has accepted a professorship or assistant professorship (not sure) @ University California, Davis (UC Davis!). He did tell her he thought she had something else going on (gastro doc did dx gastritis, so he was correct), but he did not think she had cancer. He recommended she have another CT in 6 mos & if she did need surgery to go to a liver surgeon as one of the lesions was in close proximity to the liver. So that was good advice, but waiting 6 months = not so good.
I found these links which may be helpful for some of our appendix patients:https://www.uptodate.com/contents/cance ... -peritoneihttps://acpmp.org/about-acpmp
This Inspire Community thread helpful in aftercare to HIPEC, though nobody tells the whole truth, nothing but the truth:https://www.inspire.com/groups/appendix ... ga=freshen