Search Results for '5fu'

Hi, Marion,
Yes, the linked study is for 5 patients, but the side effect of 5FU are listed long time ago , this article got my attention because of they specifically mention the word “capecitabine induced”.
Below is another link about 5FU cardiotoxicity.

http://7thspace.com/headlines/428372/5_fu_induced_cardiac_toxicity___an_underestimated_problem_in_radiooncology.html

I do not think most of the CCA patient will see a cardiologist until their GP or oncologist suggesting the patients to do so. I think getting a EKG reading for 24 hours( using holter monitor device ) every year is a good starting point.but it needs an order from your GP or cardiologist. Standard EKG at the doctor or at the hospital may not pick up the EKG change at the time of testing.
God bless.

Hi,
Cardio toxicity of 5FU include angina,arrhythmias including,Ventricular tachycardia,cardiogenic shock,chest pain(unspecified),coronary vassos plasm,myocardial infarction,palpitations,electrocardiographic changes and sudden death.
Patient who have cardiac problems should mention it to the doctor before starting 5FU or capecitabine. And adequate hydration is helpful.

Beta-blockers such as Lopressor; calcium channel blockers such as Diltiazem and nitrates such as nitroglycerin tablet or the patch will help to relieve the chest pain.
Upon such findings, as a patient on Xeloda for almost a year, once again, I will tap into my resources to see what they can suggest to me.
God bless.

We spent another day in hospital did nothing. Many doc came but the surgeon doc didn’t come. His residence doc came and said per the CT, the tumor is very close to hepatic artery that the surgeon thinks too dangerous to do surgery. I asked recommendation, residence doc doesn’t seem to have idea. said need to talk to family–us with doc. I said so where is the doc that never shows up??? I am not happy about the response at all. We still don’t have much detail on what’s going on. I got the CT report, and CT in CD. Will take to Sloan once my dad is discharge.

Today they said will talk to the surgeon and discover next step. oh yeah, that’s the same answer I heard 2 days ago. We are here for 2 days nothing happened.

The big question I have is they put him in hospital because bilirubin is high. 3 blood tests, 15, 30, and when we were in the hospital the 1st day, it’s 23. So from 30 to 23, dropped. I wounder if the stent wasn’t working but now works a little? If we still need to drain bile outside of the body. I am mad that the surgeon said we need to take care of the high bilirubin; it’s so high and dangerous…. ok, so we are in the hospital 3 days, this has not been taken care of or even talked about. I don’t see they believe this is urgent any more?? I have a strange feeling… maybe the surgeon wants to know if my dad is operable, but found he can’t do it, so he lost interested in us.

one oncologist came yesterday. said if we like to go to Sloan, it’s great idea. he doesn’t see confident about any helpful chemo suggestions. Said in general, it’s Gem… and the 5FU? The 2 medicine I see often in this board. he said could help extend a few months live. very depressing. I asked if he can give us different treatment options to compare pros/cons/side effects…. like a menu that we can consider in restaurant? Maybe I asked too much, he said no. just Gem something and the 5FU…the standard ones. I am not comfortable with his answers that doesn’t seem to work with my dad per his situation.

The radiation doctor also came yesterday. Dr. James Wong, chairman of radiation. He seems very optimistic and said the tumor is small. He has treated a lot of patients and many of them well under control, sounds very confident and promising. He said if we like to start, can do 5 days 15 min each day for while/maybe a month I forgot. I ask side effect… he said if my dad can’t stand it, maybe start 2 weeks, wait 1 week. something like that. And he said his department is very high ranking, aim very well on the tumor…. Dad felt very comfortable and hopeful after heard from Dr. Wong. I hope it is so “easily” under control. I heard radiation accumulates. Some people start well, and later very weak. Not sure my dad already very weak…. can he afford to do that. But leave untreated is no good either. so tough.

Dr. Fong won’t see us until my dad been discharged from current hospital. It’s so waste of time staying here. I feel lost again about the next step.

Thanks Eli for the info that the foundation’s link on staging is out of date. I found that I could download all of the previous AJCC Cancer Staging Manuals from the AJCC website for free. I downloaded the 6th version (2003-2009) and found that it matches the foundation’s info on staging for ICC (pp131-138 of the manual.) I also finally looked at the NCCN Guidelines for ICC (7th ed., 2010) which you mentioned and found the staging that Percy previously stated. It’s interesting that they dropped the MX classification (which the Ochsner pathologist used) so I assume, since they didn’t find any distant metastasis, M0 must apply. If that’s the case, my wife’s stage is Stage IVA.

At least that’s what it looks like until after I digest Percy’s comments. Percy, I just learned today, after reading the 6th edition of the cancer staging manual that there is both clinical staging and pathologic staging. The surgeon never told us the clinical stage. He did say that it was intrahepatic cholangiocarcinoma but because the cancerous lymph node, which was pressing against the common bile duct and causing it to bleed on the inside, I thing he said he was going to perform the surgery more like he would do extrahepatic cholangiocarcinoma surgery. We had conflicting opinions on whether the lymph node had fused to the common bile duct. I believe the surgeon thought it had and the doctor who inserted the stent thought they were separable. The surgeon intially said that he would have to remove all of the right lobe and some of the left lobe, a total of 72%, but after the surgery, he said he didn’t have to remove as much as he initially thought. A couple of weeks after the surgery we met in his office and he gave me a copy of the pathology report and he went throught it with us, emphasizing that it was the best he could have ever expected, specifically addressing the 1 positive node out of 7, and the 2 cm margins. Later the oncologist went through the report with us and the one thing she was concerned with was the “poorly differentiated” histologic grade.

The pathologist report shows the following:

SPECIMEN:
1) Falciform ligament – fibrofatty and vascular tissue. Negative for malignancy
2) Hepatic Artery Lymph Node – One (1) benign lymph node
3) Biliary Stent: Gross Diagnosis only
4) Proximal Bile Duct Margin: Negative for Malignancy
5) Liver Segments 4B, 5, 7, and 8; Partial Hepatectory: See Synoptic Report:

Specimen: Liver
Procedure: partial hepatectomy, major hepatectomy
Tumor size: 6.4 cm
Tumor focality: Solitary
Histologic type: Cholangiocarcinoma
Histologic grade: Poorly differentiated G3 out of 4
Tumor growth pattern: Mass forming
Microscopic tumor extension: Confined to the hepatic parenchyma
Hepatic parenchymal margin: uninvolved, 2 cm from tumor
Bile duct margin uninvolved
No lymphovascular or perineural invasion identified
pT1 N1 MX
One (1) hilar lymph node positive for metastatic carcinoma out of 6
Additionally, hepatic artery lymph node is benign
Background liver is unremarkable

Immunostains performed with appropriate positive and negative controls. Tumor cells are positive for keratin 7 and negative for keratin 20, hepatocyte antigen, and estrogen receptor. Findings are consistent with intrahepatic cholangiocarcinoma. Tumor surrounds and invades a medium sized branch of the biliary tree. There is marked acute inflammation and necrosis in the tumor.

I think I included both info from the surgeon and the pathology report in my previous messages on the discussion boards.

When I said “spread to the liver” I envisioned the cancer starting in a small bile duct contained within the liver and spreading from there to the liver which is in direct contact.

Thanks for the advice on the PET scan. The surgeon said that their policy is a CT scan every 6 months. Maybe this is a Medicare thing. I’ll ask the oncologist about the PET scan.

Right now my wife is scheduled to get GemCis for 4 months on a 21 day cycle, the amounts being the same as used in the Phase III study, and radiation with 5FU for 5 weeks, 5 days a week. So, as you suggest, what I’m trying to do is research what we can do to extend the recurrence time. I’ve read a lot of the published studies and I can’t find the answer there, so I’m trying to research the members of this foundation to document their experience. So, far I’ve got about 50 on the spreadsheet, but unfortunately, only 1 of the 50 comes close to my wife’s condition. I thought you might be a candidate because of the Stage IIB you reported. The report I had said Stage IIB for bile duct cancer indicated the cancer had spread to nearby lymph nodes in addition to other factors.

Percy, thank you for your kind remarks about my contribution to the board. Eli and I are both engineers, and I think it is in our nature to be detailed oriented. I’m 76, retired when I was 57, and most of my career as an electrical engineer was supporting NASA on the Saturn/Apollo “moon” program, the Space Shuttle, and the International Space Station. After the moon landing in 1969, people said, “If we can put men on the moon, then we should be able to _____ (fill in the blank).” Perhaps this should also apply to finding a cure for this horrible disease.

Bruce

Thanks for your responses. I think we’re getting a bit of a handle on it. The oncologist told him to increase dose of Zofran. He had a dose of Oxali/5FU this week and ironically, he’s vomiting less than usual. Could be those IV anti-emetics they give prior to chemo. I figure it must be the disease that’s causing it. It sure is a bad actor

Hi, Eli,
I understand it is for rectal cancer and preoperative; May be I should clarify more . (and it is nothing to do with the above citation since I look at a lot of article today.)
That is I should add “lately I have seen a lot of 5FU infusion pump used (48hr) instead of 5FU infusions for a few hours at the chemotherapy treatment center for colon and other cancers in the place I work;I have also read about Xeloda being used in chemo-radiation instead of 5FU.” But of course I do not know whether it is for CCA or not.

God bless.