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Originally Posted by TWiTCHY
I cannot tell you how much I appreciate your response. Your advice will be followed and has given me more reason reason to attend the scan with my father. I will be sure that we request a CD of both the PET and CT scans as we do intend on seeking 2nd opinion at Seattle Cancer Care Alliance before moving forward with treatment. Thank you so much!
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You're welcome. If peritoneal spread has been confirmed, you want to discuss the possibility of HIPEC. HIPEC is some times called the mother of all surgies. It's several hours long where the surgeon opens up the abdomen cuts out any visible tumors and then baths everything in a chemo wash/bath. Recovery is just as grueling. But this is an option wasn't even available not that long ago.
For any liver issues, one of the doctors I would put first on my list is Dr. Nancy Kemeny. She is at MSKCC in NYC. I know it's clear across the country for you all. But she is one of the foremost experts in treating metastatic spread to the liver. She pioneered the use of Oxaliplatin with 5FU to create the FOLFOX6 regimen which is now the standard of care for anyone dealing with CRC. She also pioneered the HAI pump where a chemo pump is implanted into the liver and chemo drugs are directly fed into the liver tumor(s). She has been able to get many patients who were told chemo for life to the point where they could have surgery. And surgery is where you want to get to as this is the only sure shot path to being cured.
What triggered the CT scan? Did your dad have a colonoscopy? Don't be surprised if your doctors want your dad to start chemo right away. Depending on what those lesions are picked up on the CT scan through the PET scan, your dad's chemo regimen will vary. 5FU will be used by default. Oxaliplatin might be added. Irinotecan, Erbitux, or Vectibix may also be added in addition to Avastin. The choice of some of the aforementioned drugs will depend on the genetic mutation of your dad's cancer...KRAS (wild or mutant). You will also want to make sure your dad is tested to determine if he is MSI high or MSS. This will determine if various immunotherapy options will be available.
If his doctors choose to start chemo immediately, your dad will be faced with a choice of either having a port installed in his chest for the chemo drugs to be introduced into his system or a PICC line in his left arm/bicep area. The other option would be to just do a standard IV which is not recommended.
You'll quickly find out you'll be versed enough to almost be a medical professional with the things surrounding cancer.