WARNING: If you can't handle a mild description of mucus & operations, don't read!!!
This is a very RARE cancer & I had the pleasure of learning all about over the last couple weeks. PMP is a very peculiar type of cancer. It is a type of cancer that is usually associated with cancers of the appendix and sometimes ovarian cancers. It often presents like ovarian cancers with people having abdominal pain and distention. The STRANGIST thing about this cancer is that it creates mucus type tumors in the abdominal cavity. And I got to see this first hand. VERY WEIRD. This past Tuesday I scrubbed in on & assisted in an 11 hour surgery for a PMP patient. When we opened up the patient, and forgive my crude description, but it looked like a jelly fish EXPLODED inside of her belly. Sometimes they refer to this as "Jelly Belly." There was this mucus-like tumor ALL OVER her intestines, liver, & abdominal wall. Very intimidating at first glance. But this is why MDA surgeons are so amazing....and that's why the surgery took 11 hours....and I was there for all of it. The surgery began with me and the fellow physician (the attending let us start without him while he finished up another case), so I got to first assist for a big part of the operation. We slowly worked at getting as much of the tumor out as possible, which is known as debulking, & cytoreduction which involves surgical removal of the peritoneum and any adjacent organs which appear to have tumor seeding. It takes a long time and a lot care and a lot of patience. I also got to help with partial bowel resection & spleen removal, etc. One other part of this surgery that is very unique is known as perfusion, this where heated chemotherapy is perfused intraoperatively into the patient's abdominal cavity & we then push on the belly (it is temporarily sutured during this part of the operation) for 90 minutes during the perfusion to make sure it is mixing around. (Affectionately refered to as "Shake & Bake.") The point of this is to hopefully kill all of the microscopic tumor cells that were left over after the debulking. Here is more info on this type of operation: Sugarbaker technique
I am getting some AMAZING experiences with some of the greatest surgical oncologists in the world. Some of the surgeries that I have seen and helped with are not experiences that most students get. I feel very blessed and honored to be allowed to have such experiences and training with the best of the best. Most students don't experience this.
It's been awesome!
4 comments:
Wow! And yeow! I hope there is a big survival rate with PMP! That poor lady. . . .
Shake & Bake just reminds me of "Talladega Nights: The Ballad of Ricky Bobby", which was hilarious, but not so much in this instant.
That's great you love this rotation too! Loads to choose from with graduation on it's way!
How awesome is that!!! I think it's so wonderful that you're getting to do these things. I love your descriptions. It creates a very good visual in my grape! Which is a good thing! Thanks!
But, how awful for that poor woman! Is this something that she could possibly live longer now that it's been operated on? Or will it just buy her a bit of time? Or is that one of those " we'll have to wait and see" things.
Is MD Anderson mainly a teaching Hospital? Gosh, I'm glad you're there!
Tell us more stories!!!
She will most likely live longer with this, but I am not exactly sure what her prognosis is. PMP is so rare and not well understood, so I am not sure if there is a good estimate on the prognosis. I'll look it up. The interesting thing about cancer patients that get treated at MDA is that their prognosis many of the time is better than those that get treated at lesser known/lesser specialised hospitals. It is always better to get treated at a place like MDA where the docs are SOOOO specialized in their fields and therefore have more experience in what they do. MD Anderson is part of the University of Texas system (as is my school UTMB which is University of Texas Medical Branch), and so it is a great teaching hospital. Unfortunately, I only have 2 days left. bummer.... but there will be more training there if I get a job there.
Hi Alli,
I am a PMP survivor who just stumbled across your blog ... I had the big "shake & bake" in Austalia in 2001 and ... so far ... am still all clear ... my surgeon is hopeful it will never return!!
Just thought you would like some first hand information from a patient. Keep up the great work ... you sound very passionate it is that passion that makes a great surgeon!!
Cheers, Kay
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