Bile Duct Ca w/Metastasis to lymph Nodes. Are we on the right track?

Hi Eileen,
Sorry for calling you Sara! Eileen, I got a second opinion from the Mayo Clinic but it was for a chronic bile duct issue that goes back to resection – not for cancer. However, I was able to send the records and talk to the doctor on the phone. I think bigger hopsitals are giving second opinions that way now. I think its a good hopsital to start with because they were one of the first hospitals to do liver transplants for CC patients – something the Clinic has never done.

Its so disheartening when a doctor doesnt recognize you. Here you are going through this major crisis and your case and life is all in a days work for the doctor. On the other hand, the doctors are swamped with cases and only allowed small amount of time to meet with patients. Its like a factory. I honestly don’t know how more mistakes are not made. But I did ask around the Clinic about Dr. Pelley and was told you either love him or hate him.

Betsy

Hi Sara,
I live in the Cleveland area and I’ve been a patient at the Clinic for 3 years. The surgeon who diagnosed me and did my liver resection is Dr. John Fung (love him!). I also met with Dr. Pelley but never had chemo/radiation treatments. I can’t say I care for Dr. Pelley’s “bedside manner” but my doctors respect his opinion and highly recommend him. I’ve been thankful to have the Clinic so close to home. I’ve undergone many procedures there that a smaller hospital could not do.

If Dr. Pelley isn’t sure it is CC, does he want to get more biopsies?

Betsy

Eileen,

I apologize if I missed this above, but have you sent off the tumor slides to another facility for a second/third opinion? The diagnosis is critical to be sure the “virgin” cancer cells are treated with the best chemo possible on the first pass. I would pick one of the major cancer centers that routinely sees high numbers of cholangiocarcinoma, pancreatic, and lung cancer patients. I’m not sure about lung cancer, but Fox Chase, the Mayo Clinic, Memorial Sloan Kettering, and Johns Hopkins are all hospitals relatively close to you that are highly involved with pancreatic and bile duct cancers. I know that some of the institutions may tell you that they require you come in and see a doctor to get a second opinion, but historically patients have been able to push for a second opinion on diagnosis through just sending the medical records to other cancer centers. I think it may help if your husband’s oncologist makes the request.

All our best to you and your husband.

– Sara

Eileen….Your husband may very well not experience any vomiting and nausea as preparatory drugs will be given beforehand. I would think that you will be able to drive for 2

Hi,
I presume the doctor you will consult tomorrow is an oncologist;
Gemzar/cisplatin ;Gemzar/oxaliplatin gemzar/xeloda is the first-line systemic therapy they may offer to your husband. In your case,you can ask the oncologist whether it is beneficial to add a molecularly targeted agent such as erlotinib,sorafenib or bevacizumab.
When you have lymph nodes involvement, it may due to other disease such as infection but most of time,if they confirmed metastasis they will not do surgery but give chemo first to shrink the tumor and the lymph nodes and then perform surgery later if they can in hoping for a better surgical outcome.
Columbus ,Ohio University Clinics and Hospitals may be another place for you to consider since they also provide clinical trail at this moment for unresectable bile duct cancer using Gemzar/xeloda and bevacizumab and their team is familiar with CC.
God bless.