How successful is inter-peritoneal chemo therapy?

[royschach]

Hi All,

In June, my wife of 28 years was diagnosed with Primary Peritoneal Carcinomatosis.  She is 55.

Fluid build-up in the abdomen, CA-125 = 994, aches, loss of appetite, etc.  No tumors to be seen in Ultrasound, CAT, or MRI.  Lung X-Ray clean as are her Pap smears and Mammograms.  In early June, we started a chemo regimen of Taxol and Carboplatin every three weeks.  Last week she had her fourth treatment.

Her response to chemo has been good.  Feels terrible for a few days following, and then snaps back quickly.  Her white and red blood counts spring back by the next scheduled chemo session without additional medication or transfusions.  Acetes (fluid) has all but disappeared as of a CAT scan two weeks ago and she feels better than she has for almost a year (her words).  Her CA-125 after the second treatment was at 334 and I don't know what it is since last weeks treatment.  Our Oncologist seems very optimistic.

In three weeks, she is to have "debulking" surgery.  We are confident with our doctors (Oncologist and Surgeon) but a meeting with our surgeon last week prompted a discussion about "inter-peritoneal" chemo treatment.  My internet research has only produced a study dated in 2006 and before we have the surgeon implant a port for the additional chemo, I was wondering if anyone has any experience with "inter-peritoneal chemo" or if they can direct me to any information.  I don't want my wife to undergo a lot of unnecessary pain/discomfort for a procedure that is still "experimental" or has proven to be not worth the discomfort.

Thank you in advance for your help.

Roy

[royschach]

A related discussion, Can we do anymore? was started.

[Plonanon]

Good luck. I hope your wife gets good results with her chemo.

[royschach]

Thank you very much for your advice and input.  That is the study I read and heard about... I can only hope the procedure and drugs have improved in the past few years.

Nita is improving everyday since Chemo #4 last week and she inspires me.  I know we're in for a long slog, but I believe we are up to it.  While our options are limited, we are in this fight to win.  

I guess we'll know more in a few weeks from her surgery.  Since her current imaging tests don't show any tumors, we are hopeful our gyn/onc surgeon won't have a lot of work to do.  He estimates 5-8 hours for the procedure.  I say, "take your time and do it right"... pretty much a good approach to life in general.

Anyways, I guess we'll treat the IP chemo as another arrow in our quiver.  Thank you again for your advice and encouragement.  I am so glad I found this site.  KNOWLEDGE IS POWER!

Roy in California

[Plonanon]

I do not have any personal experience with it, but I remember that a study came out in January 2006 that seemed to show a large advantage for IP chemo. It is supposed to be hard for the patient, but with very good results. I am assuming that is the study to which you refer?

The NY Times had this article on it:
http://www.nytimes.com/2006/01/04/health/04cnd-cancer.html?_r=1&scp=2&sq=%22intraperitoneal%22&st=cse

Here is a quote from the article:
"Medical practice should change immediately to reflect new findings from a study being published in the New England Journal of Medicine, as well as the results of several earlier studies, cancer experts say."

Here is a link to the abstract in the New England Journal of Medicine:
http://content.nejm.org/cgi/content/abstract/354/1/34

This is from the National Cancer Institute's web site:
"According to a study published in the New England Journal of Medicine, patients who received part of their chemotherapy via an IP route had a median survival time of 16 months longer than women who received IV chemotherapy."

[jennerfennerbenner]

My sister completed the inter paritoneal chemo series last year in Minneapolis.
They were extremely hard on her, but the dr.s believe that it definitely increases the life expectancy.  A very large percent we were told are unable to complete the full series.  At the second to the last treatment my sister didnt think she could do the last one, but she rallied and did it!  My sister was stage 3c with tumors wrapped around the bowel and imbedded in the kidney.
She has had a very good year since her IPChemo and the Ca125 isstill at 5.  In the beginning it 1500.

My best wishes to you and your wife.  If you have any questions please feel free to let me know.
Jen