I got the results back from my recent CT scan and since you’re reading this, I figured I might as well just copy the report right in here for your total edification. It’s down at the bottom of this post. As you’ll see, the goo continues to grow in my peritoneum, most specifically on my liver and in a few spots on what remains of my omentum. This is not unexpected. Systemic chemotherapy isn’t effective with pseudomyxoma peritonei because the goo isn’t really connected to any blood supply. I’m getting the chemo as sort of a precautionary measure, but it doesn’t really appear to be doing anything for me besides making me feel sick most of the time. My tumor marker results continue to rise at an alarming rate. The goo continues to grow. With any luck, I’m done — or very close to being done — with chemo. My oncologist is talking about switching me to some other drugs, but honestly I can’t see where that would make much difference. I await the word of my surgeon, Dr. Esquivel, as he is a true expert with this disease.
Anyway, so… the bad (though unsurprising) news with the CT scan is that the goo is still there and is growing. The good news is that it’s all still confined to my peritoneum and shows no signs at all of acting like a regular metastatic colon cancer. This is very VERY good news.
On my reports like this, they keep referring to my diagnosis as “colon cancer metastatic to peritoneum”, but that’s really not entirely accurate. The cells that escaped into my peritoneum and began multiplying as pseudomyxoma peritonei were not malignant. They were from a benign villous adenoma. Granted, villous adenomas are especially prone to go bad (“Bad polyp! Bad!!”), but mine was not malignant when it was removed. So… I’m guessing the various doctors, most of whom are likely unfamiliar with PMP, are just trying to come up with a description that seems reasonably accurate.
Anyway, here it is. I hope to be hearing from Dr. E. some time in the next few days and I’ll report back then.
INDICATION: Followup cancer metastatic to peritoneum.
STUDY: CT OF THE CHEST, ABDOMEN AND PELVIS W/ORALAND INTRAVENOUS
TECHNIQUE: Axial multidetector CT of the chest, abdomen and pelvis
was performed during intravenous administration of non-ionic
contrast. Oral contrast was also administered. Delayed images were
obtained through the kidneys, ureters and bladder.
FINDINGS: Comparison is made with abdominal CT’S performed 5/31/2011 and 3/3/2011.
CHEST: There is a chemotherapy injection port implanted in the
right anterior chest wall with catheter extending into the upper
aspect of the right atrium. There are no significantly enlarged
hilar or mediastinal lymph nodes. The lungs are clear. No axillary
adenopathy is seen. A right thyroid nodule seen on the March study
is not as conspicuous on today’s exam but certainly does not appear
to have increased in size. No pleural effusions are seen.
ABDOMEN AND PELVIS: The previously noted subcapsular collection
surrounding the right lobe of the liver has continued to increase in
size, now measuring up to 1 cm in width compared to about 0.8 cm
before. This extends into the subhepatic space where it has a
nodular configuration that measures approximately 2.6 x 1.6 cm
compared to 2.1 x 1.2 cm previously. Findings are consistent with
serosal metastases.Again noted are a number of ill-defined soft
tissue densities involving the omentum with some interval progression
since 5/31/2011. Image 2.191 on the current scan shows two nodular
soft tissue densities just medial to the ascending colon that were
not clearly visualized previously. These measure 1.2 and 1.3 cm in
maximum diameter. An increased amount of ascites is seen in the
right aspect of the pelvis, which, in the absence of intraperitoneal
chemotherapy, would be suspicious for progression of disease as well.
As noted before, the patient has had a hysterectomy. A number of
clips surgical clips are seen in the omentum.
As noted previously, the patient has had cholecystectomy. There is
a small amount of pneumobilia. No focal liver parenchymal lesions
are seen. The spleen, pancreas and kidneys are unremarkable. Bone
windows are unremarkable.
IMPRESSION: Findings are consistent with progression of disease.