Chemotherapy aiming to improve surgery outcomes(Fr. MD Anderson)
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Hi,everyone,
This is the current philosophy and practice of using CHEMOTHERAPY in general for treating.CCA that I believe in which is the less,the better.. I think his assessment is reasonable too.The following is quoted from the link at the end of this message under the experts review section if you want to read it through the whole thing even though it is for colon metastasis.
“As we take stock of what is now available, we need to clarify how these agents will be used to maximize outcomes. This might include optimizing RRs with at least three agents when curative resection is the goal, or maintaining quality of life with sequential therapy if exposure to all agents is a reasonable expectation. Sequential monotherapy starting with capecitabine or 5-FU/LV with or without bevacizumab and then proceeding to either oxaliplatin- or irinotecan-based chemotherapy as second-line therapy may be considered in patients who are asymptomatic, in those with relatively slow-growing disease and/or in those with multiple sites of disease that are deemed to be unresectable. This is in line with National Comprehensive Cancer Network guidelines. Additionally, monotherapy may be more appropriate in elderly patients and in those with significant comorbidities. In contrast, initiation with combination therapy is more appropriate in patients who have excellent performance status and clinically aggressive disease, in those with significant symptoms and/or in those who may be considered for salvage via surgical resection.”
God bless.
Hi,
It is difficult for the general public to look at a study and determine it is a good or not so good a study.
It is also true that a study appeared on the NewEngland journal of medicine or The Lancet may seem to be of more significance than appeared on other journals. But whether it’s real value is benefiting to those who seek them remain to be seen in real terms when other unrelated research party can reproduce the same result.; when other party can confirm the same findings .this is how we know it is a good study.
As whether the study is valuable or not to the patients or solely for the purpose of just producing papers to sustain grants allocation, that is a more difficult subject to learn and answer. And Marion is right on that.
As a patient, I really like to use this term to represent myself because It reminds me I am part of all of you who unfortunate to know each other through this web site. The point is, as a patient, I read the info on the link before I put them up on the web and I try to explain a little more of the content in a simpler English that other patient can understand it better or easier.( this idea is from one of the e mail I received and I thank her for that; because if the info is very useful but only a few can understand the medical jargons and others don’t, what good is it to put them up here.) I think the info from that link is worth for our consideration even it is not directly indicated for cholangiocarcinoma but liver metastasis. CCA is a rare disease that I think we have to look beyond our disease for answers.
God blessI agree Percy, in that information should be brought forth on this site however, we have to remember that even though we are linking to a specific study – it does not mean that it presents itself to be is a “good” study. Furthermore, at times we see bad studies followed by subsequent bad studies. In fact, experts disagree on what is considered to be a valuable study. What I am trying to convey is that yes, it is important to make available “everything” relevant to “our cancer” we should look for those studies coming from reputable sources. This is the information we would like to present to the treating physicians. I say physicians because; in many instances a radiologist, oncologist, gastroenterologist, surgeon all, may be part of our medical team. We want to make sure that all are on the “same page” and that information regarding our illness is readily available to all.
Hugs and love,
MarionHi,
This study offer hopes,in evidence-based research ,that unrectable can become resectable.( the Italian research)For those who are young and fit patient, the 5FU,leucovorin,oxaliplaitn and iriontecan combo ,even though it is very toxic,may offer hope for resection.The French study is also encouraging too.
Try to read it carefully to get the correct idea before render your judgement.talk to the doctor about the points your are interested in the study,make sure you ask why or why not for each of his/ or her answer.The doctor may not like you to ask this kind of specific questions but deep down the know they have to look into your question and do more research.and in that respect,you,as a patient,will be benefit in your treatment as well as earning your respect from the doctors because of your knowledgable questions.
That is all the reasons we, Gavin ,me and others try to put up related studies on this board ,yes, they are boring to read, even like this one is relatively easy one ,but you never know, if you don’try to know more and bring them up to the doctors,you may rely on just the average knowledge of the doctors had without the upto date ideas apply to the specific patient,you. Then you may miss the opportunity.
this is also the reason for 2nd opinions,bringing up different treatment plans you know ,ask the consulting doctors for possible better different outcome in addition to what they think they will recommend beforehand.
God blessHi,
here is the link if you are interest in the subject matter.http://www.imt.ie/clinical/2012/01/chemotherapy-aiming-to-improve-surgery-outcomes.html
God bless
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