u/Aikidoker15

Hi! To those who haven't had the chance to read my previous posts, I have a father who after apparently being surgically cured from a Stage I colon cancer, now, after 15 months, has been diagnosed with a peritoneal carcinosis as he seemed to have 2 mets.

After six weeks, before starting the chemo (he had to wait because he's been put in a trial for a new immunotherapy drug that needed the company producing it to analyze his biopsy as well), I've found out that he doesn't have 2 mets, but five, and are all growing. Slowly (2 mm at worst), but still growing. In the previous CT the three "new" mets were present but did not look like mets.

All my father has to do is start chemo as soon as possible. He'll have the port-a-cat inserted on Monday and then start within one week, I think.

Does anyone here have experience with FOLFOX + Avastin + immunotherapy? I know every patient is different, but do they work well, at least sometimes?

Thank you already.

P.s. I don't blame the radiologists since, as I said, the mets did not look like such, so I'm not gonna walk into that.

Hello! Thanks again for your comments on the previous posts. They're helping me a lot.

To those who haven't read them, my father has a colon cancer T0N0M1, with the main mass completely removed one year ago, for what we know. We believed he was cured, but one month ago he found out he has two peritoneal mets, one near the spleen and the other on the peritoneum above another part (completely separated) of the colon.

Today we've been told what will be the therapy: FOLFOX + Avastin + immunotherapy targeting a protein found on the surface of the cells of the previously removed tumor.

The oncologist told me that it would take two to three weeks to organize everything since the metastases are very small. I asked her if it's safe to wait, and she reassured me that the disease does not require immediate treatment, but it's best not to wait more than a month. Since there are some things my father needs to take care of, it's okay to wait a couple of weeks to get everything organized. Also, immunotherapy requires sending a piece of the tumor to labs where the drug is produced because it's a drug only given in clinical trials. The company needs to confirm my father's eligibility for the drug. This process, plus the EKG, cardiology visit, and additional blood tests, will take two to three weeks. Then, he'll be deemed fit to begin the trial.

And again, for those wondering, after a multidisciplinary meeting with specialists in various cancer treatment fields, it was determined that the risk of recurrence is too high for surgery to be useful at this time. I don't know if surgery will ever be an option, but I'm not going to argue with the oncologist. She has said many times that she is recommending this course of action based on the literature and the opinions of other specialists.

I know it's too early to make predictions, but still I'm very preoccupied, because small or not, are still peritoneal metastasis.

Furthermore, I know from experience that FOLFOX is associated with peripheral neuropathy, which preoccupies me even more. My father plays guitar in his free time (it's the only hobby he's willing to spend money on) and so I'm wondering not only if he'll survive, but also if he'll be able to play again if the therapy works. I haven't told him this yet because, if he knew he could eventually lose his ability to play guitar as he does now, it would be another blow to him.

Then I remind myself that, for now, the important thing is that he survives. At least live a good life for an acceptable amount of time. I only hope that amount of time is long enough.

Sorry for the fatalism, but it's very difficult for me to think otherwise right now.

Good morning.

Last week I posted in this group explaining that my 62-year-old father recently found out he has two peritoneal metastases, peritoneal carcinomatosis.

Today he had his first “new” appointment with the oncologist, who explained how things will proceed.

They are finishing the molecular analysis of the original tumor, which was (apparently) completely resected last year, in order to proceed with targeted therapy.

Today he met his new oncologist. Due to the initial stage of not only (as far as we know now) the condition, given that there are “only” two subcentimeter-sized masses, but also the treatment, for now all possibilities remain open—from death within a few months if the disease were to take a suddenly aggressive and unresponsive course, to chronic management, up to the hope (which, however, I do not feel ready to have at the moment, not because I am pessimistic, but because, since I work in the healthcare sector, I am not yet ready to take that risk) that he will be cured.

They told me that, given the high risk of recurrence, it is too early to consider surgery for now. First, he will do chemotherapy, and then they will consider whether it would be better to perform cytoreductive surgery or even just a laparoscopic exploration, based on how he responds.

As you can imagine, the idea of just waiting and seeing, despite being the only way for everyone, scares me a lot. I'm trying to strike a balance between hoping for the best and considering the possibility of a bad outcome.

Thanks again for the comments on the previous post.