This surgery is something my brother and I are actively researching after my father was diagnosed inoperable Stage IV cancer (large tumor 3cm from anal verge) and looks like it might be our last chance at Dad having any chance at an elongated life. Prior to the discovery of six liters of acites (all samples testing malignant) and two peritonial biopsies showing malignancies, we had him scheduled for full APR surgery followed by chemotherapy. This IPHC surgery is performed in only a few cancer centers in the states, but has shown great success in Europe for patients who were previously considered candidates for pallative treatment only. The description of the candidates for this procedure include those with or without parenchymal involvement of solid organs sugh as liver, spleen, often as an evolution of cancers of the digestive tract (stomach, small bowel, colon rectum and pancreas). The article continues, "Peritonial carcinomatosis has been regarded as a terminal condition and most oncologists would consider it a condition for pallative treatment only." Now with this treatment, "long term survival has been achieved in several studies".
Has anyone else heard of used this therapy? We have made inquiries and recieved great responses from three institutions performing this procedure in the states.
His reports show nothing but peritoneal metastases, yet the doctors still will not do his APR because of has staging (based on the peritonial mets and questions about odd pathological features that suggest perhaps the cancer is not colorectal, but upper GI in origin). Should we be going for third and forth opinions trying to find a surgion still willing to do the APR in hopes he can get this treatment (heated chemotherapy delivered directly into the peritoneal cavity), so that he might have a chance for decent recovery? We're still thinking we should find a surgeon to do the APR regardless, because he is wholly disabled from this large rectal tumor and is not "himself" as he is on so many pain medications now, and is not really a participant in his own care anymore and only looks to us for direction.
Thank you, this was a long comoplicated post but we are afraid that time is limited but brother and I are still fighting.
Re: Peritoneal Mets (Stage IV) new surgical options
This is very hard for you and your family. My mother just passed away from uterine cancer, where the tumor also invaded the peritoneal cavity. We never heard of the treatment you are describing, but my mother's cancer had metastisized to her liver and bones. She was young, but decided she couldn't go through another round of chemo. and radiation. Since you said your father's cancer hadn't spread to his liver or lungs or other vital organs, then, I'd probably check out other options. There's always hope. At some point though, like you mentioned, your family has to decide how much more your father can physically take, in terms of treatment. My heart goes out to you, because I've gone through something similar. I know there are some people, on this site, who have, or their spouses have had, advanced colon cancer, which had even spread to the liver. I don't know what treatment they've had, passed chemo. and radiation, but some of them are doing better. I know, when my mom was very sick, I was driven to get as much info. as possible. I wish I had the right words to say, but you will find a support system, at this board.