IP Chemo for ovarian cancer

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October 18, 2014 at 8:21 pm  #1266564    

lynne003

Hello,
I was wondering if anyone out there has any experience with IP chemo for ovarian cancer.
I have had 2 IV treatments with Taxol/Carboplatin three weeks apart. I just had and IV and IP port put in and will have my 4 remaining treatments both IV/IP. I tolerated the first 2 treatments well, other than being tired the first week and a bit of neuropathy. I start IV/IP next treatment next week, any ideas on what to expect?

Thanks

October 18, 2014 at 9:27 pm  #1266565    
JimC Forum Moderator
JimC Forum Moderator

Hi lynne,

We don’t currently have any experts on ovarian cancer, but here is some information from the American Cancer Society:

“Intraperitoneal chemotherapy

In intraperitoneal (IP) chemotherapy for ovarian cancer, in addition to giving the chemo drug paclitaxel IV, the drugs cisplatin and paclitaxel are injected into the abdominal cavity through a catheter (thin tube). The tube can be placed during the staging/debulking surgery, but sometimes it is placed later. If it is done later, it can be placed by a surgeon using laparoscopy, or by an interventional radiologist under x-ray guidance. The catheter is usually connected to a port, a half dollar-sized disk topped with a pliable diaphragm. The port is placed under the skin against a bony structure of the abdominal wall, such as a rib or pelvic bone. A needle can be placed through the skin and into the port to give chemo and other drugs. Over time, problems may rarely occur with the catheter. ‚ąí it may become plugged or infected or even damage the bowel.

Giving chemo this way gives the most concentrated dose of the drugs to the cancer cells in the abdominal cavity. This chemo also gets absorbed into the bloodstream and so can reach cancer cells outside the abdominal cavity. IP chemotherapy works well, but the side effects are often more severe than with regular chemo. In a study of women with advanced ovarian cancer, women getting the IP chemotherapy had more abdominal pain, nausea, vomiting, and other side effects than the women getting chemo through the vein. These side effects actually made some women stop their treatment early. Still, the women getting IP chemotherapy lived longer than the women getting regular chemo.

[continued]


Jul 2008 Wife Liz (51/never smoker) Dx Stage IV NSCLC EGFR exon 19
4 cycles Carbo/alimta, 65% shrinkage
Tarceva maintenance
Mar 2010 progression, added Alimta, stable
Sep 2010 multiple brain mets, WBR
Oct 2010 large pericardial effusion, tamponade
Jan 2011 progression, start abraxane
Jun 2011-New liver, brain mets, add Tarceva
Oct 2011-Dx Leptomeningeal carcinomatosis; pulsed Tarceva
At rest Nov 4 2011
Since then: http://cancergrace.org/blog/jim-and-lisa

October 18, 2014 at 9:28 pm  #1266566    
JimC Forum Moderator
JimC Forum Moderator

[continued]

“IP chemotherapy currently is only given to some of the women with ovarian cancer that has spread to the inside of the abdomen. It was only studied in women whose cancer had not spread outside the abdomen (stage III) and who had no tumors larger than 1 cm after surgery (optimally debulked). Also, because it can be so toxic, women must have normal kidney function and be in good overall shape for their doctor to be willing to try IP chemo. They also cannot have a lot of adhesions or scar tissue inside their abdomen because this can prevent the chemo from spreading well.” – http://www.cancer.org/cancer/ovariancancer/detailedguide/ovarian-cancer-treating-chemotherapy

Good luck with your new treatment plan.

JimC
Forum moderator


Jul 2008 Wife Liz (51/never smoker) Dx Stage IV NSCLC EGFR exon 19
4 cycles Carbo/alimta, 65% shrinkage
Tarceva maintenance
Mar 2010 progression, added Alimta, stable
Sep 2010 multiple brain mets, WBR
Oct 2010 large pericardial effusion, tamponade
Jan 2011 progression, start abraxane
Jun 2011-New liver, brain mets, add Tarceva
Oct 2011-Dx Leptomeningeal carcinomatosis; pulsed Tarceva
At rest Nov 4 2011
Since then: http://cancergrace.org/blog/jim-and-lisa

October 18, 2014 at 10:34 pm  #1266567    
Dr West
Dr West

Jim already noted that we don’t have faculty here with an expertise in ovarian cancer or intraperitoneal chemotherapy. I suspect that there aren’t any patients who can comment here. There may be some on other websites, perhaps SmartPatients or Inspire or some other ovarian cancer website, and I think it could be helpful to hear of their experiences. However, those experiences are very individualized — some women do well, and others have a much harder time. It’s fair to note that it can be difficult, with more nausea and vomiting than with IV chemo, sometimes belly pain, sometimes catheter infections or other infections as a complication, but the evidence for it improving survival is consistent and meaningful, really justifying at least trying it. Because it can be challenging, it does help to have it done at a center with good support and experience in IP chemo — even if that’s not the closest center.

Good luck.

-Dr. West

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