This is something I have learned and would like to pass on.
In our experience, we had to rely on case reports and physician experience rather than rigorous scientific studies to determine the seemingly best therapy.
Although we found the medical literature helpful in describing the natural history of cholangiocarcinoma, we were disappointed that no studies with sufficient sample sizes have been done in patients with this disease. And, even if such studies were done, the clinical heterogeneity of the disease would make it difficult to determine which particular therapy would work for everyone.
As such, we gathered as much obervational data as we could in determining a case -based treatment regiment consisting of combination of different therapies, some evidence-based from other cancer studies, some anecdotal.
Everyone is different, so the treatment regimen in my opinion, is really based on a case-by-case basis, taking into account the disease severity and location of the cancer.
This board is an invaluable tool in the search of the treatment process. I am so glad to have found it.
Marion