Peritoneal Carcinomatosis ("Peri What?")

Dr. Z removed a 7.8 mm mass from my husband’s colon, along with 2 feet of his colon. After the surgery, he came to me, my mother and Ron’s sister, who by this time had come to join me while waiting for him to come out of surgery. Dr. Z explained that he removed the mass and the 2 feet of his colon and said that Ron should be just fine. I don’t remember much about the morning after Ron went to surgery. But I do remember hugging the doctor when he gave us the news. I remember getting the sense that yes, Ron did have cancer. But the doctor had just told us that he removed it all. I was so thankful and felt like we had definitely dodged a bullet.

Imagine my surprise the next day when Dr. Z came to Ron’s hospital room and told us that he didn’t actually get all the cancer during his surgery. Dr. Z said that he did remove the blockage in his colon and it was about the size of a peach. He said he had also removed about 25 cancerous lymph nodes. But that wasn’t all. The part that Dr. Z had neglected to tell us the day before was that he had also seen a “sprinkling of seedlings”, cancer cells, in Ron’s abdomen, an area that is called the peritoneal cavity.

This manifestation of cancer is called peritoneal carcinomatosis and is considered extremely resistant to chemotherapy treatment. Because of the location of the cancer cells, it was expected that chemotherapy would not reach them. These cells typically hide behind organs and often tend to spread beyond the reach of chemotherapy. And because these were cancer cells that have not yet combined to form a cancerous tumor, radiation is not an appropriate treatment. This type of cancer was automatically considered stage IV and very resistant to treatment. So, in essence, Dr. Z had just handed us a death sentence.

He then told us about one treatment that he was aware of. He explained that he knew of two doctors – one in Pittsburgh and another in Maryland who performed a type of surgery that consisted of heating chemotherapy and bathing the abdominal organs with the chemotherapy solution. Dr. Z explained that he thought Ron had a good chance to qualify for this surgery because at 47 he was considered young and healthy enough to withstand such a difficult procedure. And if the procedure was considered successful, it could keep the cancer at bay. It was considered successful if he had lived 5 years past the date of diagnosis.

Being that we were parents of a 10-year-old and a 15-year-old, the 5-year prognosis was devastating. Our family was at the center of our lives. Ron completed that family and this diagnosis was nothing short of devastating to me as his best friend and his wife.

The next few days were very much a blur as I tried to encourage Ron to focus on recuperating from his surgery and try not to worry about the diagnosis and especially not to consider it a death sentence. Our family came to the hospital to pray with us and as I stated previously, there had been several family members who had had similar diagnoses and lived many, many years cancer-free. We had hope that, based on his age and relative good health, he would make a full recovery as well.