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Snowdrop18

Hipec and pipac

My close friend has bowel cancer . She was originally diagnosed last year and it had spread to her liver. Following an operation on her bowel, 2 on her liver and a course of chemo she had a few months before it returned to her peritoneal lining along with a tumour on her ovary. She was told it is terminal. Her oncologist put her on palliative chemo and immunotherapy which is working. He also told her about the hipec operation which he said she wasn't suitable for as her cancer was too advanced and it wasn't a curative situation. She sought 2nd opinions and another doctor is prepared to carry it out. He explained what a major operation it is though and said she would continue the immunotherapy after. He said he would be prepared to take anything out.. He also said it wouldn't be a cure. As an alternative he said he could offer pipac but there are few studies on this. I think it is the chemo bath part of hipec. As my friend's original doctor still feels the hipec is not the right option for her she is confused as to what to do.. I wondered if anybody had any experience of the pipac or could offer their experience (positive or negative) of hipec so she has more knowledge. She does know I am asking here. Thank you and best wishes

Snowdrop18

I just phoned cancer research to ask them about pipac and I think it is high pressure chemo maybe rather than the heated chemo bath. The nurse thought it might be given to patients who were less suitable for the hipec. I think I have 2 questions really.... One is about how people found the hipec, if it kept cancer at bay and how they recovered and a second one about what pipac is. I think I will post that second question on the nurse board in this forum. I have probably posted all this in the wrong place and I am sorry if I have confused people about pipac. But please do comment if anybody else has any experiences of hipec.. Many thanks :x:

Baxter2

@Snowdrop18

If I had my time again, I'd definitely go for CRS and HIPEC! I have ansoutely no regrets whatsoever. I really did feel at the time that I had nothing to lose by going for it!

Karen💜💛💙❤️💚

P.S. I believe PIPAC is high pressure/aerosol type of chemo introduced into the abdominal cavity through little holes rather than an open surgery but I could be wrong!

Chelts

A consultant spoke to us about PIPAC today at our HIPEC meet-up at the Good Hope. Basically it is thought that PIPAC could be more effective than HIPEC in that with HIPEC chemo is sloshed around the abdomen in the hope that it gets into every crack and crevice. With PIPAC the chemo is sprayed into the abdomen under pressure with the belief it is forced, via the pressure to all areas of the abdomen.
Another benefit is that PIPAC can be delivered via laparoscopy rather than opening up the abdomen and the hospital stay can be a little as 24 hours as opposed to the 2 weeks for HIPEC.

Highkaren

@Snowdrop18 I have researched pipac extensively . There are one good explanations on line but in a nutshell it is chemothetapy given into the abdomen laparoscopically and is a fine mist . It’s a small procedure in hospital for a couple of days and is usually given 3 times at 6 week intervals. Many places in Europe do it and it was designed for peritoneal disease. Christie’s are setting it up for a trial do I would certainly ask for a referral to discuss as it’s not clear at this stage what the criteria would be. Where us the surgeon that’s offering this from ?

It certainly is s minimally invasive procedure and designed to target the peritoneum better than iv chemo does

I went to se Christie’s about it but as art if the assessment was advised to take s surgical route with hipec, this was great news as I was previously inoperable.

If you need more info check the search button for pipac as I think I’ve posted links before it drop me s message :x:

Karen :x:

Snowdrop18

Baxter2 thank you for your opinion on hipec. I am glad it was the right decision for you. That is really interesting chelts that you got that information today. Things are developing all the time. High Karen thank you for your info... I have put pipac into the search engine like you suggest and read some of that. I don't know where my friend would potentially have the pipac if she went for it. It is the London doctor who said it was an option. I have posted on the ask a nurse board asking for more information on pipac. Thank you all so much for taking the time to read this and add your comments, wishing you all the very best. If there's anything else you feel my friend should know about hipec please could you add. I will pass this information on to her :x:

Snowdrop18

Just to let people know the pipac my friend has been offered as alternative to hipec would be to reduce tumours to make the surgery (that normally happens before hipec) less extreme. I hadn't realised pipac was done before surgery like that. I think chelts said that was possibly the model in Europe. I haven't had a response from the nurse here or information from the macmillan nurse yet. Best wishes to you all.

deanskipsey

@Snowdrop18 can I please ask which hospital offered you this?

So happy for you :x:

deanskipsey

@Snowdrop18 sorry, I have just re read your posts. Jamie Murphy you say, yesterday I went and picked my mums scans up from Sarah cannons place and dropped them over to st marys hospital at his request! ( trying to speed it up as my poor mum is struggling )

:x:

Snowdrop18

Good luck deanskipsey. Fingers crossed your mum will be offered something. You're doing a great job making sure no stone is left unturned.

deanskipsey

@Snowdrop18 thank you. Much appreciated, she’s my mum and I can’t imagine my life without her! I have to try everything. She hasn’t had the rub of the green over the last few years and I really hope that changes. Let’s hope Mr Jamie Murphy has a different opinion to the others.

Bridget55

It looks like there is a pipac conf at Christies 31 Jan 2019. Can't copy the link. Will ask about it next week re whether treatment relevant Best regards Bridget

HH79

Thank you for tag @Bridget55. Really interesting and gives me optimism for other routes to attack Peri mets other than hipec coming to U.K. xx @soph86

Bridget55
Quote from @HH79:
Thank you for tag @Bridget55. Really interesting and gives me optimism for other routes to attack Peri mets other than hipec coming to U.K. xx @soph86

Will keep you posted @HH79. Have already fired off question to onc. :x:

Baxter2

@Bridget55

I see my consultant surgeon who led my surgery at Basingstoke is speaking. Dr Faheez Mohamed. I have huge respect for this guy!

Karen💜💛💚💙❤️

Highkaren

Francesco Polignano will be my surgeon. My sister met mr Wilson at Christie’s last week after I insisted she have a colonoscopy which thankfully was all clear. She said mr Wilson is lovely

Bridget55
Quote from @Highkaren:
Francesco Polignano will be my surgeon. My sister met mr Wilson at Christie’s last week after I insisted she have a colonoscopy which thankfully was all clear. She said mr Wilson is lovely

Yep he’s brilliant @Highkaren. Glad it was all clear.,we’ll encouraged :x:

Bridget55
Quote from @Baxter2:
@Bridget55

I see my consultant surgeon who led my surgery at Basingstoke is speaking. Dr Faheez Mohamed. I have huge respect for this guy!

Karen💜💛💚💙❤️

Hi yes see all the top surgeons are there which gives me confidence. I’m on the case to understand what is in the pipeline. I know @Highkaren has been closely monitoring it too.

Love B :x::x::x::x::x:

Chelts

I see my consultant surgeon from the Good Hope; Haney Youssef is a speaker

Snowdrop18

The nurse has answered my question about pipac on the nurse forum. Best wishes to you all seeking possible referrals to this route.