This document was originally posted to the OVARIAN PROBLEMS listserv in the summer of 1997.

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As promised, here's a run-down of my experience with radioactive IP phosphorus (P32).

To recap, this is a procedure that Varia et al (_Cancer_ 61:919-927, 1988) reported can significantly reduce the rate of recurrence in women with no evidence of disease at 2nd look. Two notes - NED means NO EVIDENCE of disease or microscopic disease only...NO NODULES! If you have nodules, you're not a candidate. Also, you can't have this therapy if you have adhesions. The adhesions would cause pooling of the P32 and that could cause bowel complications. The impression I got was that my gyn/onc would be unwilling to do this procedure on anyone who has NOT had second look.

So, I had this therapy performed by Dr. Savage on June 6, 1997 at United Hospital and the Ritchie Medical Center in St. Paul, MN. I arrived early in the morning after only a light breakfast. The procedure was performed in the X-ray department. I changed into gowns and emptied my bladder before getting onto the table. My stomach was swabbed with disinfectant and I was given a shot in the stomach (owie!) of Lidocaine (sp?). Then the doc made a small incision in the lower right quadrant of my abdomen (not so bad) and thrust a needle the size of a piece of straw or uncooked piece of spaghetti into my abdomen (again, not so bad...imagine being able to feel something WITHOUT any pain, just the sensation). He then injected about 350 cc of saline solution. THAT I felt. That's probably the most painful part of the whole thing...dealing with an abdomen full of fluid. Felt just like the day I woke up with cancer last summer (tumor popped, filling my abdomen with fluid, I suppose). Once my organs were swimming, so to speak, he injected the technisium 99 and put an x-ray device over my abdomen and called in a radiologist. We all watched a screen where a big black spot (the technisium) began to spread throughout my abdomen. It looked like a black pool of ink on a white kleenex where someone was dripping more and more dabs of ink around the rest of the kleenex until more and more of it was solid black. The radiologist confirmed that this meant I had good spreadage (no adhesions) and he then injected the P32. More saline solution was pumped in (up to 750 cc, I believe...owie!). Then my doc took a single stitch and they rolled me over to the chemo center for rotation.

For the next four hours I was rotated. Every fifteen minutes I switched lying positions, from stomach to back to left side to right side. In addition, each time I switched, they'd change the elevation of the bed, so that either my head or my feet were elevated. After 4 hours, they let me go.

My grandmother drove me home (3 hour trip). Halfway home we stopped to eat and I had a good appetite, though I could only eat about half the meal because there just wasn't room in my abdomen for my stomach to expand.

For the rest of the day I pretty much had to just relax. Saturday I was up and functioning but not happy. But Sunday, though some pain still lingered, I felt cheerful again. On a misery-and-suffering scale of 1 to 10, where 10 is a round of Taxol/Carbol and 5 is an all-body allergic reaction rash (and a CT scan is a 3), I'd give P32 a 4. Ibuprofen was very helpful...and for some reason (doggone me for forgetting to ask why), this procedure causes sharp pain in the shoulders.

Feel free to write if you have any questions. (webbrl@morris.umn.edu)

Incidentally, Dr. Savage has done a LOT of these, he says, and has considered writing it up, but says he's just too busy to do so. Perhaps other warriors or their docs should contact him and apply a little...encouragement.

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