New tumor 10 mths after recurrence

[msjazz]

I have stage 3c ovarian, I posted you last about burning stomach and reflux after beginning doxil. My ca after 3ed doxil went to 400 +,after dropping on the 1st 2 rounds to 276.I have a tumor between the stomach and liver now. It is the 1st tumor since recurrence. She thinks maybe the pressure is causing the not able to eat large amts, but doesn't think it is in the stomach. I have postponed further chemo until sept 3rd, and she mentioned taxotere. I am to have an upper gi by then, and have the ct on a disc. If I knew how I would post it for you, but I don't. I called her nurse back the next day to ask if radiofrequency ablation was an option, and they only do it on the lung, also said radiation not an option. I am wondering if this is something that can or should be removed. Any insight, or do you think taxotere might reduce it. Thanks Donna

[Annekathryn Goodman, M.D.]

Dear Donna,
I am sorry you are going through a tough situation.
No , surgery will not help this.

The peritoneum is the  lining of the abdomen - the membrane that normally is 0.3 mm to 1.1 mm in thickness and covers all the organs in the abdomen - stomach, intestine, liver, gallbladder, the abdominal walls.

This lining gets covered with cancer cells and becomes thickened and stiff. This process can causes areas of the peritoneum to restrict the covered organ such as the bowel/intestine and the bile ducts.

The porta hepatitis is the area under the liver where blood vessels and bile ducts are. There is a nice picture in wikipedia
http://en.wikipedia.org/wiki/Porta_hepatis

Anyway it is not possible to surgically resect this peritoneal thickening. It is too diffuse and would require removing important major organs that you need to function.
But this disease puts you at risk for blockages in your bowels and bile ducts.

The strategy should be chemotherapy. Taxotere is very reasonable.  Ask your doctor about whether there is any role for chemotherapy directly into the abdomen (IP or intraperitoneal chemo). That would only be appropriate and possible if there were no major adhesions.

Finally ask your doctor about the option of avastin plus chemo. The risk of avastin is increased chance of bowel perforation. That risk is higher in the setting of a bowel blockage.
Please keep in touch
take care

[Annekathryn Goodman, M.D.]

Dear Jazz
how are you doing
see previous notes for my reply
take care

[Sharon2714]

just wondering ... did u ever get the answer to this ?
love
sharon

[msjazz]

I got the written report after posting it says, since last examination peritoneal disease has developed on the peritoneal surface on the left side of the liver. There is also disease in the porta hepatis. The findings are compatible with progressive disease. The spleen, pancreas, and both kidneys are normal. No periaortic adenopathy or retroperitoneal mass is seen. There is dialated small bowel in the mid pelvic area. There is an anastomosis regional to the ileocecal valve. No bulky masses are seen in the pelvis to suggest an etiology of  patient obstruction. There is slight thickening of the peritoneum just above the vaginal cuff, which has been present on previous exams and assumed to represent fibrosis from previous surgery.
Is this something that might go away with taxotere or is there any way to remove it, thanks.

[Sharon2714]

A related discussion, MsJazz aka Donna was started.