HIPEC vs EPIC Experience and Thoughts Please

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DeeMeee
Posts: 19
Joined: Sun Apr 04, 2021 8:03 pm

HIPEC vs EPIC Experience and Thoughts Please

Postby DeeMeee » Mon Apr 26, 2021 8:49 am

Hi All,

Looking for personal experience with HIPEC or EPIC, whether you have had the surgery or been presented with the options.

My brothers initial blockage surgical oncologist,spoke of the plan , if he were to become a candidate shortly after treatment start.

His medical oncologist now is strongly in favor of a surgery. His surgical oncologist first consult is this Thu 4/28. The caveat is, if they feel more definitively it is colon origin, and he is at or soon to be at candidate for surgery, it will be EPIC.

Any thoughts are appreciated.

Here’s to a Healthiest Week for All !
Dee
sister to 57yo m
3/21 CT blockage susp of ileal adenocarcinona mass w nodal mets & perit carcinomatosis
3/21 lap R hemi innumeral mets peritoneal nod 9.5 cm ileocecal mass. Remvd mass, apnx,12i sm int 6i l int nodules CEA 7.8
3/21 Path:Stage 3c pt4b pn2b signet ring cell carcinoma prly diff close mrg 18/28 n
4/21 CEA 3.9 FOne MSI H TMB 13mb KRAS G13D NRAS wt
4/21 Endsc Rules out UGI prmy: bpy:mild peptic duodenitis
4/29 surgeon consult; reassess 6mth for surgery candidate
5/3 Start of Pembrolizumab

MCT2021
Posts: 6
Joined: Mon Mar 15, 2021 12:27 pm

Re: HIPEC vs EPIC Experience and Thoughts Please

Postby MCT2021 » Mon Apr 26, 2021 11:53 am

Hi Dee, my brother has not had HIPEC or EPIC, but in case it is helpful, it was presented to us as an option at MDA if his tumors remained stable for 6 months (I believe) on a systemic chemo regimen, and it was presented as part of CRS. Their explanation to us was that CRS/HIPEC is most likely to be beneficial in situations where his tumors were not actively growing and where his peritoneal carcinomatosis index (PCI) was below a certain number. The plan was laparoscopic exploratory surgery to get a grasp on the exact location and extent of tumors and then go from there.

Not much information and likely what you have already gotten from your surgeons, but just in case it provides a comparison from another set of doctors. Sending you thoughts!
Sister to age 26 M Stage 4 (25 at dx)
08/2020: Hemicolectomy to remove SRC/mucinous adenocarcinoma in right side, Stage 3C (T4a, N2b, M0)
10/2020: FOLFOX/CAPOX
01/2021: Peri mets on liver capsule, CEA 100, FOLFIRI-BEV
03/2021: "Significant progression" of mets throughout peritoneum, CEA 900+, FOLFIRINOX-BEV
04/2021: Immunotherapy trial targeting WNT pathway/RSPO3 fusion gene. Scan showed relatively stable since 03/2021, ascites, CEA 400
05/2021: At peace; missing him always

DeeMeee
Posts: 19
Joined: Sun Apr 04, 2021 8:03 pm

Re: HIPEC vs EPIC Experience and Thoughts Please

Postby DeeMeee » Tue Apr 27, 2021 11:11 am

Hi there MCT2021,

I appreciate your taking the time to share your brothers discussion on HIPEC with his oncologist team. Yes, his blockage oncology surgeon explained it similarly, all based on shrinkage and good reaction to first 2 months of treatment. Surgeon consult Thursday is with a surgeon highly specialized in this surgical procedure. I want to understand EPIC more, as HIPEC is more documented and spoken from patients who received or hoped to have it, being HIPEC is not being offered to him.


Sending good vibes for a healthiest and brightest week, for your brother and for you.

Take Care
Dee
sister to 57yo m
3/21 CT blockage susp of ileal adenocarcinona mass w nodal mets & perit carcinomatosis
3/21 lap R hemi innumeral mets peritoneal nod 9.5 cm ileocecal mass. Remvd mass, apnx,12i sm int 6i l int nodules CEA 7.8
3/21 Path:Stage 3c pt4b pn2b signet ring cell carcinoma prly diff close mrg 18/28 n
4/21 CEA 3.9 FOne MSI H TMB 13mb KRAS G13D NRAS wt
4/21 Endsc Rules out UGI prmy: bpy:mild peptic duodenitis
4/29 surgeon consult; reassess 6mth for surgery candidate
5/3 Start of Pembrolizumab

User avatar
Green Tea
Posts: 451
Joined: Mon Oct 24, 2016 10:48 am

Re: HIPEC vs EPIC Experience and Thoughts Please

Postby Green Tea » Tue Apr 27, 2021 12:50 pm

DeeMeee wrote:... I want to understand EPIC more, as HIPEC ... is not being offered to him...

If you want to understand the differences between EPIC and HIPEC, here is a short overview of the differences:
https://diagnosticdetectives.com/hipec-vs-epic-comparison-of-metastatic-peritoneal-cancer-treatment-3/

To better understand Peritoneal Metastases in general and how they are diagnosed and treated, you can read this review article:
https://www.statpearls.com/articlelibrary/viewarticle/27027

DeeMeee
Posts: 19
Joined: Sun Apr 04, 2021 8:03 pm

Re: HIPEC vs EPIC Experience and Thoughts Please

Postby DeeMeee » Tue Apr 27, 2021 1:46 pm

Thank you Green Tea, for the articles, they are very informative.

My brother would fall into EPIC protocol if his cancer is deemed colon origin. Not based on which may medically be more effective for him, which I always want for him what will give him his best outcome. But, solely on what is offered based on a clinical trial. I am hoping to hear perspectives from anyone who had their oncologist team choose EPIC over HIPEC or even PIPEC, solely based on medical scientific basis.

I have a list of questions for his surgical consult, I want to include what I don’t even know to ask. My thinking is if definitive origin of cancer isn’t decided, there are a number of general identifiers such as signet ring cell adenocarcinoma of unknown origin or peritoneal carcinomatosis, can take my brother completely out of the clinical trial guidance and HIPEC can be his surgeons choice, if he deems him a surgical candidate.

Thanks
Take Care
Dee
sister to 57yo m
3/21 CT blockage susp of ileal adenocarcinona mass w nodal mets & perit carcinomatosis
3/21 lap R hemi innumeral mets peritoneal nod 9.5 cm ileocecal mass. Remvd mass, apnx,12i sm int 6i l int nodules CEA 7.8
3/21 Path:Stage 3c pt4b pn2b signet ring cell carcinoma prly diff close mrg 18/28 n
4/21 CEA 3.9 FOne MSI H TMB 13mb KRAS G13D NRAS wt
4/21 Endsc Rules out UGI prmy: bpy:mild peptic duodenitis
4/29 surgeon consult; reassess 6mth for surgery candidate
5/3 Start of Pembrolizumab


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