Chemo and radiation before bile duct surgery

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    Thank you Margaret, Mario, Lainy, Betsy, and members for your help. It means a lot that you would take the time to assist and encourage me.

    Concerning your mention of difficulty with stint placement: During the ERCP, when the stint placement was under consideration, a complication occurred which involved danger of liquid invading the lungs. It was necessary to discontinue further ERCP action. The hospital involved was Riverside.

    Tuesday, during my discussion with the surgeon, I learned that the tumor is located lower in the bile duct than previously believed. (Before, they thought that half of the liver and the left bile duct could be cleanly removed, and that I might be left free of cancer.) The surgeon said that the tumor is low, near the “Y”, and that there is a possibility that both bile ducts as well as the common bile duct might be involved. He mentioned the need to possibly down-stage the tumor. He felt that if I had radiation and chemotherapy (Gemzar), perhaps the tumor would be reduced. He also felt that by having radiation and chemotherapy before surgery, less would be required. (He wasn’t suggesting the Gemzar as a cure.) He felt that if the tumor could be reduced enough, perhaps he wouldn’t have to take out the right bile duct and the common duct.

    While this seems encouraging, I read in Margaret’s note that they felt that chemo and radiation may have destroyed her husband’s common bile duct. If the purpose is to save the common bile duct, isn’t chemo and radiation a little contradictory?

    The surgeon says that surgery is the only hope. He was very patient and answered all of the questions we asked him. I must admit, however, that we were a little “floored” at the time. Since Tuesday, I’ve thought of a few more questions. We are to meet with the oncologist on Thursday. (They got the appointment ASAP.) I was told that action shouldn’t be postponed for more than two weeks. Perhaps you can help me with questions.

    One question that I have is that if it’s extra hepatic, not spread to the liver, and slow growing, what’s the rush?

    Another doctor (neither from Riverside, nor from that medical group), after looking at my medical paper work (including the ERCP), stated that I might not want to take the time for another opinion. He felt that Riverside had a good team.

    Oh, another thing, enlargement of lymph glands was indicated!

    Again, I would like to say that any help is appreciated.


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