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Thread: peritoneal metastisis

  1. #1
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    peritoneal metastisis

    Not good news for me My last appointment in July showed that my radiation for the enlarged lymph node was effective and my CA19-9 went down from 420 to 340. I was thrilled. Then I Started having horrible pain on my right side/rib area and had a CT scan last week. I saw my oncologist yesterday and she said the radiologist saw a soft tissue nodule in the lower left quadrant along the surface of the peritoneum and are concerened its early peritoneal metastatic disease.
    That along w/my CA19 going up to 1020, have me going back for chemo most likely for FFX, followed by a PARP inhibitor
    I am trying to be brave but do not like what im reading ( i know i shouldn't be googling)

    ALL of by bloodwork is good/normal, even my liver enzymes.
    I asked my ONC if i was going to die soon ..and she said "No, You have a lot of life to live and we have a lot of weapons in our arsenal" I really want to believe this.
    I guess I am looking for any encouraging info.
    Once again...I'm scared.
    +++++++++++++++++++++++++++++
    53 yrs old
    3/8/18 went to ER w/what i thought to be gall bladder issues...CT and MRI found 1.5 cm spot on body/neck of pancreas
    Followed up with EUS No mets/contained
    3/18 started 4 cycles of Gem/Abrax
    5/18 CT scan showed tumor shrinkage .97cm
    7/18 Pre surgery CT scan shows slight tumor growth (1.2cm) could be necrosis.
    8/3/18 distal pancreatomy/splenectomy-open procedure. No mets, 1 lymph node involvement.(distant) Staged 2B
    9/18 CA19 33 NORMAL
    10/10/18 Starting 3 mos Folfirinox adjuvant therapy.
    5/19 CT scan shows enlarged lymph node at surgical site. EUS biopsy determines cancer. Local and contained.
    6/19 Begin radiation. View Ray MRI 5 day regimen.
    8/19 CA19-9 down! no signs of lymph node!!!
    10/2 3 weeks of abdominal/right side pain. CT scan shows small (1mm) soft tissue nodule suspect for Peritoneal Mestastasis. CA 19- way up (1010)

  2. #2
    I am so sorry !

    Having only recently encountered this scurge, my knowledge is limited. But I must say that the weapons I have seen are impressive and improving every day.

    I wish and pray for all the best.

  3. #3
    Super Moderator Top User ddessert's Avatar
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    Peritoneum metastases have been handled well by some people but it always seems to rely on a successful treatment.

    Be on the lookout for ascites or fluid retention - a sign of the tumor irritating the abdominal cavity and making more fluids. The extra fluid can be hard to notice because it looks good on a patient losing weight, but there are tests to distinguish it if the medical team is on the lookout. And the fluids can be tested for cancer cells to confirm the source (tumor or not).

    They can also drain these extra fluids from the abdomen to decrease those symptoms.

    It’s still possible that this is not the source of increased CA19-9, but until the next scan it may be best to treat it like it is.
    BRCA2 3398del5
    Dec 2010 - back/abd pain
    May 2011 - Unresectable stage III, 2.5cm tumor
    Jun-Aug 2011 - Gem/Cis, 9 rounds
    Oct-Nov 2011 - IMRT+Xeloda
    Oct 2011-Sep 2012 - shrinking tumor
    Feb 2012 - National Familial Pancreatic Study
    Aug 2012 - Downgraded to stage IIA, PGP
    Sep 2012 - Whipple, T3N0M0, 0.5cm tumor, 0/16 lymph nodes
    Dec 2012 - Quebec PanCan Study
    Sep 2012-May 2019 - NED
    Mar 2013-present - NCT01088789
    Jun 2019- NCT03805919
    @pancanology

  4. #4
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    thx for the encouragement Ramblin!
    And for the info, Dave. I remember hearing these terms "acites, peritineum etc...." early on....now it s scary that it applies to ME!
    I'm just going to keep thinking about what my ONC told me....and get back on the treatment wagon.
    For now, its a beautiful fall evening...and Friday night lights at my kiddos high school!
    +++++++++++++++++++++++++++++
    53 yrs old
    3/8/18 went to ER w/what i thought to be gall bladder issues...CT and MRI found 1.5 cm spot on body/neck of pancreas
    Followed up with EUS No mets/contained
    3/18 started 4 cycles of Gem/Abrax
    5/18 CT scan showed tumor shrinkage .97cm
    7/18 Pre surgery CT scan shows slight tumor growth (1.2cm) could be necrosis.
    8/3/18 distal pancreatomy/splenectomy-open procedure. No mets, 1 lymph node involvement.(distant) Staged 2B
    9/18 CA19 33 NORMAL
    10/10/18 Starting 3 mos Folfirinox adjuvant therapy.
    5/19 CT scan shows enlarged lymph node at surgical site. EUS biopsy determines cancer. Local and contained.
    6/19 Begin radiation. View Ray MRI 5 day regimen.
    8/19 CA19-9 down! no signs of lymph node!!!
    10/2 3 weeks of abdominal/right side pain. CT scan shows small (1mm) soft tissue nodule suspect for Peritoneal Mestastasis. CA 19- way up (1010)

  5. #5
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    Quote Originally Posted by susanmac View Post
    thx for the encouragement Ramblin!
    And for the info, Dave. I remember hearing these terms "acites, peritineum etc...." early on....now it s scary that it applies to ME!
    I'm just going to keep thinking about what my ONC told me....and get back on the treatment wagon.
    For now, its a beautiful fall evening...and Friday night lights at my kiddos high school!
    Hi Susan. Iím sorry to hear that. My mom has been fighting with peritoneal mets since last year. Things were more or less under control until recently, when she complained about abdominal pain because the Mets have spread.
    She is only 57 and Iím just so afraid to lose her. Our oncologist will probably change the chemo in the next round, and I hope it will work and not be too late. My thought is with you too. Be brave and optimistic. Thereís always a chance. Best wishes.
    Oct 2017 - Mom's annual checkup found elevated CA19-9 (280 kU/L)
    Nov 2017 - Diagnosed. Pancreatic Adenocarcinoma on body/tail of pancreas, ~3cm mass
    Dec 2017 - Distal pancreatectomy, 3.5*3*2 mass removed, 2/17 lymph nodes.
    Jan 2018 - CA19-9 dropped to 30 kU/L 4 weeks after surgery.
    Feb 2018 - 3 rounds of S1
    June 2018 - CA 19-9 from 50 to 170 KU/L. CT + PET confirmed recurrence at remainder of pancreas + peritoneal mets.
    July 2018 - Started Gem/Abraxane
    Sep 2018 - Peritoneal mets disappeared on CT. CA 19-9 dropped to 35.
    Nov 2018 - Finished 4th round of Gem/Abraxane. Clear CT. CA19-9 dropped to 22.

  6. #6
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    Thanks Mel, sounds like your mom and i are in similar situations. For now my peritoneal met is quite small (1 mm) so im hoping we caught it early.
    I am starting FFX in 2 weeks, followed by a Parp inhibitor.
    I will look for your updates----plz send all my best to your mom!!
    +++++++++++++++++++++++++++++
    53 yrs old
    3/8/18 went to ER w/what i thought to be gall bladder issues...CT and MRI found 1.5 cm spot on body/neck of pancreas
    Followed up with EUS No mets/contained
    3/18 started 4 cycles of Gem/Abrax
    5/18 CT scan showed tumor shrinkage .97cm
    7/18 Pre surgery CT scan shows slight tumor growth (1.2cm) could be necrosis.
    8/3/18 distal pancreatomy/splenectomy-open procedure. No mets, 1 lymph node involvement.(distant) Staged 2B
    9/18 CA19 33 NORMAL
    10/10/18 Starting 3 mos Folfirinox adjuvant therapy.
    5/19 CT scan shows enlarged lymph node at surgical site. EUS biopsy determines cancer. Local and contained.
    6/19 Begin radiation. View Ray MRI 5 day regimen.
    8/19 CA19-9 down! no signs of lymph node!!!
    10/2 3 weeks of abdominal/right side pain. CT scan shows small (1mm) soft tissue nodule suspect for Peritoneal Mestastasis. CA 19- way up (1010)

  7. #7
    Senior User
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    Hang in there. The parp inhibitor sounds promising. I'm looking at that as well. (something to look forward to after folfirinox!)
    Mar. '18 - Diagnosed Stage IV with liver mets CA-19 124,000
    Apr. '18 - Started chemo - Gem, Abrx, Cis
    July and Sept '18 - Ct scan - all tumors shrinking
    Oct. '18 - CA-19 - 1,495
    Oct. '18 - Started Gem, Abrx 1/2 dose
    - Ca-19 up to over 6,000
    April '19 - Started 5-fu, Abraxane, Oxaliplatin
    Ca-19 down to 600, missing many doses due to
    low platelets
    Aug '19 - Started Irrinotecan, abraxane, cysplatin
    missing doses, low platelets
    Sept '19 - Ca-19 holding steady, ct scan shows 2 small
    lung nodules - 3mm, 5mm, blood clot in pulmonary
    vein, primary and liver mets stable started blood thinner
    Oct. '19 Switched back to POLF treatment - Paclitaxel,Oxaliplatin,
    Leucovorin, 5FU

  8. #8
    Senior User
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    Mar 2018
    Posts
    152
    jamiepat,
    How are you handling the chemo/side effects from all of those different drug combos. I started Folfox (no irinotecan) and its been great not having the gastro intestinal problems. but i still have nausea from the 5-fu. And doc may add in irinotecan next time so my reprieve may be short lived.
    My one little nodule turned out to be 3 or 4. So much for that. THey are in between the peritoneal lining and the surface of the liver....but not ON the liver. My radiologist said he NEVER saw this before. WTF. I'm an anomoly
    I think about you and hope you are doing well my friend
    +++++++++++++++++++++++++++++
    53 yrs old
    3/8/18 went to ER w/what i thought to be gall bladder issues...CT and MRI found 1.5 cm spot on body/neck of pancreas
    Followed up with EUS No mets/contained
    3/18 started 4 cycles of Gem/Abrax
    5/18 CT scan showed tumor shrinkage .97cm
    7/18 Pre surgery CT scan shows slight tumor growth (1.2cm) could be necrosis.
    8/3/18 distal pancreatomy/splenectomy-open procedure. No mets, 1 lymph node involvement.(distant) Staged 2B
    9/18 CA19 33 NORMAL
    10/10/18 Starting 3 mos Folfirinox adjuvant therapy.
    5/19 CT scan shows enlarged lymph node at surgical site. EUS biopsy determines cancer. Local and contained.
    6/19 Begin radiation. View Ray MRI 5 day regimen.
    8/19 CA19-9 down! no signs of lymph node!!!
    10/2 3 weeks of abdominal/right side pain. CT scan shows small (1mm) soft tissue nodule suspect for Peritoneal Mestastasis. CA 19- way up (1010)

  9. #9
    You've got a great attitude, Susan. Do you know what the difference is between a nodule and a tumor?
    Last edited by jackieb501; 10-30-2019 at 01:35 PM. Reason: added a question.
    February 2016- diagnosed with PC
    March 2016- inoperable due to arteries, also liver mets suspected
    March 2016-January 2017 -Gemzar/Abraxane
    February 2017 surgery-PC tumour and liver mets removed at same time
    July 2018 Back on Gemzar/Abraxane due to rising CA 19-9. Scans were clear.
    January 2019 Tried FOLFIRINOX after G/A became ineffective. FFX doesn't work. CA 19-9 rising
    February 2019 two small tumors appear on liver
    May 2019 - CA 19-9 skyrocketing. Started IMRT radiation treatment.
    August 2019 MRI done. No Evidence of Disease (NED). CA 19-9 dropped significantly. Still not normal range.

  10. #10
    Senior User
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    Quote Originally Posted by jackieb501 View Post
    You've got a great attitude, Susan. Do you know what the difference is between a nodule and a tumor?
    Jackie, Thx doll! and
    Nope! I use them intermittently depending on my mood. I think my nodules/soft tissue are all tumors. Tumor Schoemor! XO
    +++++++++++++++++++++++++++++
    53 yrs old
    3/8/18 went to ER w/what i thought to be gall bladder issues...CT and MRI found 1.5 cm spot on body/neck of pancreas
    Followed up with EUS No mets/contained
    3/18 started 4 cycles of Gem/Abrax
    5/18 CT scan showed tumor shrinkage .97cm
    7/18 Pre surgery CT scan shows slight tumor growth (1.2cm) could be necrosis.
    8/3/18 distal pancreatomy/splenectomy-open procedure. No mets, 1 lymph node involvement.(distant) Staged 2B
    9/18 CA19 33 NORMAL
    10/10/18 Starting 3 mos Folfirinox adjuvant therapy.
    5/19 CT scan shows enlarged lymph node at surgical site. EUS biopsy determines cancer. Local and contained.
    6/19 Begin radiation. View Ray MRI 5 day regimen.
    8/19 CA19-9 down! no signs of lymph node!!!
    10/2 3 weeks of abdominal/right side pain. CT scan shows small (1mm) soft tissue nodule suspect for Peritoneal Mestastasis. CA 19- way up (1010)

 

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