How effective is intraperitoneal chemotherapy for ovarian cancer stage 4?

[question everything]

Family member of a friend of a friend from a different country is being overloaded with information.

Apparently, in this country, it is being used... at least for localized cases. And, apparently, there is enough experience here to perform this procedure effectively.

Such experience in that other country exists, but not as wide spread. Also, from what I can find, it is more often used for localized cases.

Does anyone know anything?

Thanks.

[supernova]

1. Well localized chemo is supposed to be an improvement

over general IV chemo through a typical PICC line in the chest.

As to the specific agent, you'd have to research it specifically.

At stage 4, she would likely benefit from getting to a big research and teaching hospital that specializes in cancer, if she isn't at one already. They have access to more experimental protocols and all the latest information. It's actually good she's being inundated with info. Better more than less.

[question everything]

2. Thanks. I am doing a general search

and it appears that I/P has been recommended even for advanced stage, right after surgery.

And, yes, she has ties with a teaching hospital.

[dana_b]

3. This article came out yesterday

http://www.medpagetoday.com/HematologyOncology/Chemotherapy/2429

and I do know that at the hospital I work at (UCSF), Taxol and Cisplatin are the chemo of choice for ovarian cancer.
I have never given it for this diagnosis as I worked with pediatric oncology cases, not adult. What I remember other RNs saying and what this article seems to support is that if a person is receiving these drugs, it can lengthen a woman's life anywhere from 12 months to two years.

[question everything]

4. Thank you!

It appears that the researchers recommend both an I/P and an I/V together.

What do they mean by "surgical debulking"? Removing the ovaries and the uterus?

[dana_b]

5. debulking the tumor

removing the tumor or removing as much of it as possible. With ovarian cancer it is common to just remove the ovaries, fallopian tubes even uterus, if necessary, along with the tumor. However if it were a brain tumor, they may have to be much more selective in how much is removed.

[elfin]

6. I am so sorry - have had three dear friends

succumb to Ovarian/Peritoneal Cancer within the last ten years.

The diagnoses were problematic, given the similarity of the symptoms and treatment for both types until surgery -- then too late.,

I would recommend to go for anything aggressive and "out there'.

This is a vicious diagnosis and I am so sorry for her and hers.

"Localized" is a problem, in that this usually is so invasive, that treatment is problematic in this layman's opinion.

Hit the trials in this country and beyond and hope there is a Non-Placebo ine.

Once again, I am so sorry.

[question everything]

7. Thank you. The sad story is that now, after the diagnosis

she went to be tested and found out that she carries the BRCA gene. She already has grown children. Had she thought of being tested before - her mother died of breast cancer before 50 - she would have removed her ovaries.

Apparently there are now new guidelines (that the insurance companies follow, too): if there is even one blood relative who had breast cancer before 50, all her children should be tested for BRCA gene.

Some good news, so far, is that she underwent several cycles of chemo and that ovarian marker is down, significantly. So at least there is some effectiveness. She is now ready for the surgery to remove the ovaries and the uterus and the question arises whether to install that shunt for I/P chemo.

[Warpy]

8. I've only seen it used for pseudomyxoma

but that doesn't mean they're not starting to use the procedure for other abdominal cancers.

A quick search turned up http://www.medpagetoday.com/HematologyOncology/Chemotherapy/2429 and http://www.ovariancancercenter.org/research/ipchemo.cfm

It's new, so it's only being done in a few places.

[question everything]

9. Thanks. These two links are from 2006

the year, I think, that the NCI officially declared this as the preferred method.

And then I ran into another article, from April of this year, challenging the methodology and conclusion of the studies

http://theoncologist.alphamedpress.org/cgi/content/full/13/4/410

(I always hated when statistics determined whether a certain method or a drug was going to be available, especially for terminal patients..)