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In Memory

Smsunfl David

Patient Information

Age: 33

Sex: Male

Diagnosed: 10/15/93

Location: Cranston, Rhode Island

Diagnosis: Stage IV DSRCT

Hospital Miriam Hospital Providence, RI

Oncologist Dr. William Sikov
Oncology Surgeon: Dr Paul Sugarbaker
Consultant - Dr Brian Kushner

Passed Away: 09/98

Website

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Treatment

Surgery

First Debulking: Inoperable tumors. Found a tumor something between a golf ball and tennis ball in size extending from pancreas to stomach and appearing to infiltrate both organs (this assumption turned out to be incorrect). Found numerous metastases, small nodes seeding intestine, stomach, both omentums, diaphragm, aorta, and peritoneal wall. Disease was unresectable, took numerous biopsies, and closed up after four hours.

Chemotherapy

CAP - Cytoxin-Adriamycin-Cisplatin

Surgery and Intraperitoneal Chemo

Second Surgery - 9 1/2 hour surgery by Dr Paul Sugarbaker and Stevies. Large tumor was between pancreas and stomach, attached to the surface tissues of both organs, but invading neither. They were able to completely resect all the visible disease in abdomen. The resection required taking gall bladder, both omentums, and appendix. One tumor had completely penetrated diaphragm. Following this resection, heated (110 degrees Fahrenheit) cisplatin was introduced into abdomen and incision was closed. The surgeons had placed a catheter and four drains in abdomen, but had difficulty getting cisplatin to drain.
After surgery, had adriamycin (body temp.) once a day for five days.
Hospitalized for 22 days.
Complications with cramping and diarrhea for about 20 months.

Chemotherapy

ICE (Ifosmoside-Carboplatin-Etoposide)

Exploratory Surgery

Dr. Sugarbaker found two small nodes of disease (an pencil eraser in diameter) on pancreas

Chemotherapy

Taxol and Carboplatin, followed by Adriamycin - Four cycles

Surgery

Third Surgery - Dr Sugarbaker finds a tumor wrapped around portal vein, extending to aorta. The tumor is essentially part of the vein and isn't resectable.

Chemotherapy

Dr. Kushner recommends High dose cytoxan (5 grams/m2).

Stem Cell Rescue (bone marrow transplant)

High dose thiotepa with stem cell rescue
three cycles of thiotepa at roughly three week intervals

Time Line

Date Test Treatment Chemicals Result
9/93 CT 0 0 Mass on pancreas
10/15/93 0 Surgery 0 Inoperable. Tumor size of golf ball extend from pancreas to stomach, also small nodes seeding intestine, stomach, both omentums, diaphragm, aorta, and peritoneal wall.
11/93 0 0 0 0
12/93 0 0 0 0
1/94 0 0 0 0
2/22/94 0 Surgery and Intraperitoneal Chemo cisplatin Able to resect all the visible disease in abdomen. Removed gall bladder, both omentums, and appendix. One tumor had completely penetrated diaphragm.
2/24/94 0 Chemotherapy - through cathetar into abdomen Adriamycin - once a day for five days 0
3/94 0 Chemotherapy ICE (Ifosmoside-Carboplatin-Etoposide) 0
4/94 0 Chemotherapy ICE (Ifosmoside-Carboplatin-Etoposide) 0
5/94 0 Chemotherapy ICE (Ifosmoside-Carboplatin-Etoposide) 0
6/94 0 Chemotherapy ICE (Ifosmoside-Carboplatin-Etoposide) 0
7/94 0 Chemotherapy ICE (Ifosmoside-Carboplatin-Etoposide) 0
8/94 0 Chemotherapy ICE (Ifosmoside-Carboplatin-Etoposide) 0
9/94 0 0 0 0
10/94 0 0 0 0
11/94 0 0 0 0
12/94 0 0 0 0
1/95 0 0 0 0
2/95 0 0 0 0
3/95 0 Exploratory surgery - Dr Sugarbaker 0 Found two small nodes of disease (an pencil eraser in diameter) on pancreas
4/95 0 Chemotherapy Taxol and Carboplatin 0
5/95 0 Chemotherapy Taxol and Carboplatin 0
6/95 0 Chemotherapy Taxol and Carboplatin 0
7/95 0 Chemotherapy Taxol and Carboplatin 0
8/95 0 Chemotherapy Adriamycin 0
9/95 0 Chemotherapy Adriamycin 0
10/95 0 0 0 0
11/95 0 0 0 0
12/95 0 0 0 0
1/96 CT 0 0 Indicates something may be going around liver.
2/96 MRI 0 0 Also, indicates something may be going around liver.
3/13/96 0 Surgery - Dr Sugarbaker 0 Found tumor wrapped around portal vein, extending to aorta. The tumor part of the vein and isn't resectable.
4/96 0 Chemotherapy High dose cytoxin 0
5/96 CT Chemotherapy High dose cytoxin - discontinued No change in tumor
6/96 0 0 0 0
7/96 0 0 0 0
8/96 0 Stem Cell Rescue 0 0
9/96 0 Stem Cell Rescue 0 0
10/96 0 Stem Cell Rescue Thiotepa 0
11/96 0 Stem Cell Rescue Thiotepa 0
12/96 0 Stem Cell Rescue Thiotepa 0
1/97 0 0 0 0
2/97 0 0 0 0
3/97 0 0 0 0
4/97 0 0 0 0
5/97 0 0 0 0
6/97 0 0 0 0
7/97 0 0 0 0
8/97 0 0 0 0
9/97 0 0 0 0
10/97 CT 0 0 No tumors seen, but having problems with common bile duct. Tumor suspected to be compressing.
11/97 0 0 0 Discussed surgery
12/10/97 0 0 0 Doctors no longer recommend surgery
1/98 0 0 0 0
2/98 0 0 0 0
3/98 0 0 0 0
4/98 0 0 0 0
5/98 0 0 0 0
6/98 0 0 0 0
7/98 0 0 0 0
8/98 0 0 0 0
9/98 0 0 0 Passed Away

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