Discussion Board Forums General Discussion CA19-9 is rising after 4-week break from Gem/Cis chemo

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    Hi Ping,

    Welcome to our community.  It is positive news that your husband has done well with treatment and is feeling well during his break from chemo therapy.

    It can be tough to decide when the doctor gives patients several different treatment choices.  CA 19-9 is an indicator that can help track what is going on with our cancer, but it is not a perfect one so doctors usually look at other factors as well.  Quality of life factors are important to patients, so how your husband is feeling may be a consideration as well.  If you feel very unsure about which option to pursue, it may be beneficial to have a second conversation with the doctor or even to seek a second opinion from another doctor with experience with cholangiocarcinoma.

    Gemzar alone for many patients is an easier chemo to tolerate.  There are usually fewer side effects than with the Gem-Cis combo.  If you are choosing between Gem alone or more Gem-Cis, the doctor should be able to tell you for your husband’s case if there are any trade-offs or differences between the two that should be considered in making that decision.

    I hope the next rounds of treatment are also successful in keeping your husband’s cancer under control.  Please stay in touch.

    Regards, Mary



    Hello all,

    Thanks for letting me to join this discussion board.  This is my first time posting.

    Here is some of the background info about my husband.

    ·        January 2019 onset PSC symptoms.

    ·        5 ECRPs done between February and June 2019 with one septic episode in March.

    ·        In July 2019, he was diagnosed with CCA stage 4, inoperable, metastasized to his Omentum.

    ·        In July two metal stents were placed in his bile ducts before starting the chemo treatment.

    ·        In January 2020 completed 8 cycles of Gem/Cis chemo treatment.

    ·        Post-chemo CT scan shows unchanged in all areas with a few areas show slight improvement.

    ·        Post-chemo lab results show his CMP and CBC are all decent with Alk Pho slightly elevated (190).  His CA19-9 went down to 498 from the highest 33,000 prior to treatment.

    ·        We took a 4-week break from chemo in February 2020 so that his body can recover.

    ·        Post-break lab results still show his CMP/CBC are all decent.  But his CA19-9 jumps from 498 to 2107.

    ·        The Oncologist gave us two options:

    • Resume chemo in two weeks but this time would be just Gemzar only.
    • Continue to take break for another 4 weeks and see if CA19-9 continues to incline.  If yes, then CT scan and start chemo again.

    My husband is doing well through the break.  His appetite has returned and he gains some weight back.  We would really appreciate if any of you could share experiences or advises to help us to make the decision.  It is hard to get back on the chemo, especially seeing him regaining strength and joy for life during the break.  But we know the cancer is still there.

    Thanks a lot.


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