A friend called today and asked for advice. I said this one’s over my head, and we should ask the wider community. Here you go.
Our family has a very new and serious situation, and are reaching out to the e-patient community for advice. Here is the situation:
- For several weeks, a morbidly obese woman (5’9″, ~250 lbs.) in her mid-70’s has been in a great deal of pain, centralized in her abdomen, leading to an impaired ability to think clearly or make decisions.
- Late Friday 5/27 she was taken to the ER of a large research hospital, where they discovered that she has ascites (fluid in the abdomen), and they tapped 2 liters of fluid from there, estimating that there were an additional 2 liters remaining.
- Blood work shows non-hematopoietic cells circulating in her blood, indicative of metastatic cancer. Analysis has yet to come back from the lab (so we don’t know if cancer cells are GI or GYN in origin).
- CT scans and trans-vaginal ultrasound reveal multiple tumors in the peritoneal cavity and on the omentum. The tumors vary in size, with the largest being 5 cm in diameter. Largest tumor is on or near small bowel.
As we say, definitive results have yet to come in to help determine the type of cancer, the extent of it, or even the location of the origin of the cancer — although it is suspected to have originated in the reproductive system, specifically in the endometrium or ovaries. Right now, however, this is just speculation. So we’re in the dark as to the nature of the cancer, and thus how best to treat it.
And that leads to our questions.
Doctors at the research hospital where she was admitted are recommending surgery in a few days — currently scheduled for Friday 6/3/11 — to remove tumors. Doctors also expect some form of chemotherapy to follow once removed tumors have been fully analyzed and staged.
Surgery is anticipated to be tricky due to a large ventral (belly) hernia repair in the past with reinforcement of the abdomenal wall with a large piece of mesh. It seems the surgery to remove tumor tissue would be done through the mesh, and then the mesh repaired.
We would dearly appreciate knowing if others have been in similar situations — and if so, where they were able to receive successful care (in particular for metastasizing cancer that is gynecological in origin, and/or discovered due to something like ascites), as well as institutions where they (or loved ones) felt they were well cared for.
The woman lives roughly between New York City and New Haven, CT, but has family in the greater Boston area. We are also looking for recommendations for best approaches, best practitioners as well as places to have such cancer treated. Brigham & Womens? Dana Farber? Yale New Haven? Elsewhere?
Our family has dealt with life-foreshortening disease before, but we would also welcome and appreciate any other relevant advice that others who have been in similar situations might offer. The ascites is rebuilding quickly, so time is (of course) of the essence.