Downers Grove woman has new lease on life after innovative procedure

October 03, 2017 | by Edward-Elmhurst Health

An appendectomy is usually a pretty common surgery, but for 57-year-old real estate broker, Patricia Michels, her appendectomy turned into something more.

It all started in late 2014 when Michels went to the emergency room at a local hospital complaining of severe pain in her lower abdomen. Because scans showed a ruptured tumor on her appendix, she underwent an appendectomy.

Her pathology report showed the growth on her appendix was a mucinous adenoma — a slow-growing tumor that produces mucin, a key component of mucous. The tumor’s rupture led to a condition called pseudomyxoma peritoniei (PMP), which involves widespread release of adenoma cells and mucous into the abdomen. When these cells grow, they can cause life-threatening obstruction, even when the adenomas are precancerous, or even benign.

As soon as Michels found out her tumor was precancerous, she went into high gear and researched her options.

"I learned there were a limited number of physicians with expertise in cancers and related problems of the appendix,” she says. “I was willing to go anywhere. Then I read about Dr. Salti and felt fortunate that there was someone in this area."

George Salti, MD, is co-medical director of the Edward Cancer Center and medical director of the Edward Hospital Surgical Oncology program. He's also one of the few surgeons at a community hospital to offer HIPEC (hyperthermic intraoperative peritoneal chemotherapy), a treatment for certain tumors that originate in or spread to the abdominal cavity. HIPEC is unique in that it combines surgery with chemotherapy.

"There are only about 1,500 of these procedures performed each year. And PMP patients are among the best candidates for it," Dr. Salti says.

Dr. Salti recommended that Michels go ahead with the surgery, but told her she also had a "wait and see" option — monitoring the disease progression with regular scans.

That wasn’t okay for Michels, who wanted to be proactive and take control of the situation.

"I wasn't comfortable with waiting. I wanted to fight it before it turned ugly,” she says.

A few months later, Dr. Salti performed laparoscopic surgery on Michels to remove any visible tumors. He then made an additional incision — a few inches larger than the tiny incisions needed for the laparoscopic part of the procedure. Through this opening, he inserted his gloved hand to feel for any abnormalities that the laparoscopic tools couldn't access. He then removed some additional mucin and the omentum, a fat-storing pouch that sometimes traps tumor cells.

Next, a chemotherapy solution was delivered via catheter to the abdominal cavity where it was circulated for about 90 minutes to destroy any undetected tumor cells. This approach allows for chemotherapy to be delivered in a single, higher dose and with fewer side effects.

After the procedure, Michels was only in the hospital for five days. She was fed intravenously and lost 12 pounds, but she was out showing a home to a prospective buyer several hours after she got home. Michels says it took her about two and a half months to fully recover.

Fast forward two and a half years. Michels is still healthy, living and loving life. She recently had a follow-up appointment with Dr. Salti where she underwent an MRI and a blood test to check for any signs of cancer.

“All of it came back normal,” she says. “Dr. Salti was thrilled, since two years is a nice milestone.”

Michels will continue to see Dr. Salti every 6 months. Looking back, her experience has taught her several life lessons.

“I have a new 2-month-old grandbaby — my first one,” she says. “I am so grateful, thankful and confident in Dr. Salti’s abilities. I try very hard not to take anything for granted.”

Learn more about HIPEC.

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