Hollings Horizons 2023 Combined for flipbook - Flipbook - Page 14
Intraperitoneal chemotherapy
Carol’s surgery went well, but surgery is only the beginning of treatment for people
with stage 3 ovarian cancer. Next up was chemotherapy.
I P C H E M OT H E R A PY
The abdominal cavity is flooded
with the chemotherapy drug so that
it coats the surfaces of all organs.
Carol was interested in a less-used option called intraperitoneal chemotherapy, or
IP chemotherapy. In IP chemotherapy, the abdominal cavity is flooded with the
chemotherapy drug so that it coats the surfaces of all organs.
Orr explained that ovarian cancer is a surface cancer that “exfoliates.” Tiny slivers of
the cancer can spread about the abdominal cavity like snowflakes in a snow globe.
Chemotherapy that is given intravenously goes into the bloodstream to reach tumors
through their blood supply — but those little bits of exfoliated ovarian cancer aren’t
well connected to the blood supply.
“Some of these little tumors in the abdomen — they're just sort of sitting there.
You could flick them off. So how is the IV chemo going to actually
access some of those tumors or the microscopic cells in the
abdomen we can’t see?” Orr said.
Studies have shown that IP chemotherapy can improve survival for
women with ovarian cancer. The downside? It’s extremely toxic. So
much so that each round of infusions requires an in-patient stay in
the hospital.
Carol weighed her options carefully, even going so far as to travel
to the Sidney Kimmel Comprehensive Cancer Center in Baltimore
to talk to a leading expert on IP chemotherapy for ovarian cancer.
Orr supported her explorations — indeed, he supports any of his
patients seeking out second opinions.
“We're not dealing with some sort of nuisance. We're dealing
with life-threatening diagnoses. So yes, we all welcome second
opinions,” he said.
Although the treatment isn’t commonly offered at Hollings, Orr
has experience with it and is happy to offer it to patients who fit
the profile that’s most likely to benefit. In Carol’s case, a mutation
in her cancer’s DNA indicated that she could be one of those
people who would benefit. Orr said he was ready to proceed if
Carol wanted to, and she decided to go for it.
Sully and some of the nursing staff
“One of the scary things was that half the people that start IP chemotherapy don't
normally finish because it's too difficult,” she said. “But I'm like, ‘I just have to try it to
give myself the best chance I can.’”
For six rounds, she had three-day hospital stays followed by outpatient chemotherapy
the next week.
“It wasn't a cakewalk,” she said. "But I actually was able to get through it without major
adverse side effects, and that I attribute a lot to the care that I had. The support
system is so important, not only from the nurses here but Joan was there by my side,
and my community was amazing.”
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HOLLINGS HORIZONS Fall 2023
