October 20, 2013 at 3:36 am #76520
Kris…this is a good question to pose to Dr. Kato at his upcoming web presentation. I have been told that the risk of Portal Vein Trombosis (PVT) is very high although, some have been successfully operated. (Very few that I know of.)
MarionOctober 20, 2013 at 2:49 am #76519kvollandParticipant
My husband’s tumor was into the edge of the portal vein but had not wrapped around it. They were able to resect a small potion of the vein out.
I wondered but I never asked our surgeon because it wasn’t an issue but I don’t understand why they can’t resect on a regular basis….with the vein or the artery. They put teflon grafts in all the time and they can do bypasses with harvested veins…..I think of aortic aneurysms and the telfon then use to repair that so I don’t see why they can’t just cut out the bad section and replace it.
I know on my son’t thyroid surgery they took out 5 cm of his internal jugular vein because a lymph node had grown into it and they just stitched the two pieces together.
I guess I should have asked. If anyone knows the answer, let me know. I would love to know.
KrisVOctober 20, 2013 at 2:25 am #76518
Lj…..portal vein encasement is not unusual. I recall very few instances in where the surgeon was able to literally “peel of the tumor” however; as said, this is very rare. My fingers are crossed that the upcoming scan will reveal shrinkage. Please keep us posted. We care.
MarionOctober 19, 2013 at 5:09 pm #76517pcl1029Member
I do not have the tumor wrap around the portal vein, so I cannot tell you about the experience, but welcome to this corner of the web.
In most CCA cases, if surgery cannot be done, then systemic chemotherapy and or with targeted agents such as Avastin ,Nexavar will be part of the treatment plan along with stents to relieve symptoms.
God bless.October 18, 2013 at 11:38 pm #76516lutherParticipant
Hi I am new to this site. My husband was diagnosed with extra hepatic cc in July 2012. It started with jaundice. He had 4 stints pit in & they kept stopping up so the drs put in a medal stint. We went to md Anderson in houston . They confirmed the diagnosis. Non resectable. We went through chemo. Gemzar- cisplatin. They hoped it would shrink enough to br resected. PTScan showed no shrinkage at all. We found a dr. at columbia hospital in New York who has done miracles with resections where other drs. would not touch. His name is Dr. kato. We went there. He said he could not do it was too risky. We have just finished chemo of taxol – carboplatin. We have another pet scan in 3 weeks. Hoping and praying its shrunk. The drs. Here don’t know what to do after that. The cancer is wrapped around his portal vein. Has anyone else had this similar situation. If so please let me know what we might except. I wish u all the best of luck & I am praying for all of you.
Thanks for any information you may want to share
Beverly in louisianaOctober 18, 2013 at 7:55 pm #76515
Surger…sounds like a good plan and I wish for a super clean scan heading your way.
MarionOctober 18, 2013 at 6:40 pm #76514surfer1Participant
Our plan is to see how the scan goes in November and the follow up meeting with Dr. Imagawa. If surgery is recommended, I’m not sure we need a second opinion since he seems to be knowledgeable/experienced in CC. If he doesn’t recommend surgery we will definitely get a second opinion. I guess I better start working with our insurance to see if we can be seen at USC(currently they don’t contract with them). If not it will be out of pocket or go to UCLA.
Thanks for all the input.October 18, 2013 at 6:36 am #76513gavinModerator
A belated welcome to the site from me as well. Sorry that you had to find us all but glad that you have joined in with us here as you’re so in the right place for support and help and tons of each will be coming your way from everyone here. So glad to hear that your husbands local doctor was so on the ball in ordering an early test and that the CC was caught at stage I. That might not sound like good news to most people but in this case it is.
I hope that the chemo goes well for your husband and does indeed lead to further options being explored with regards to surgery etc. Have you thought about seeking further opinions from those very experienced in treating CC patients?
Please keep coming back here and share with us how everything goes for your husband, we are here for you. I look forward to hearing more from you.
My best wishes to you and your husband,
GavinOctober 18, 2013 at 3:47 am #76512kvollandParticipant
Belated welcome to the group. Glad to hear that it was caught so early. We looked back through my husband’s labs and his liver function had been slightly elevated for about 5 years and he had an ultrasound around three years ago and no one saw the mass in his bile ducts. So I say you are VERY lucky to have such an on the ball doctor…..not saying that ours wasn’t on the ball because I agreed that they were elevated because of a couple of his diabetic meds. It wasn’t until the jaundice that we really knew anything was wrong.
It’s great you are hooked up with a good team and as everyone says, get multiple opinions especially with this type of cancer.
Here’s hoping to a successful resection. My husband’s was extrahepatic – Klatskin’s tumor and even though it was into the vein they were still able to do a resection and took about 60% of his liver…..and Yippee, it grows back and according to the surgeon only takes about 6 weeks.
Look forward to hearing how things go!
KrisVOctober 18, 2013 at 2:34 am #76511surfer1Participant
Thank you all for the replies and well wishes. The support means a lot, especially since no one other than those here seem to know about this terrible disease. We are taking it one day at a time and thought all was going well since he hasn’t had any major side effects. However this week his blood counts are down so he couldn’t have his chemo treatment which seems like such a setback. I’m sure it is typical though. We will try again next week.
Thanks again for the support. I check the site often and it has been a tremendous source of information.October 15, 2013 at 9:33 pm #76510jzMember
My Dad was diagnosed with intrahepatic cholangiocarcinoma after his resection at UCLA. The scans couldn’t discern what type of tumor it was before the surgery, but the surgeon at UCLA decided it was best to remove the tumor regardless given the size of ~6cm. Since your insurance has contracted with UCLA, it could be another place for you to get a second opinion. The Pfleger Liver institute is the place you will want to contact. The surgeon my Dad had was Dr. Busuttil, and his oncologist right now is Dr. Finn. They are experienced with CC patients, but UCLA does tend to be more conservative and I do agree with Mark that USC’s Dr. Selby is the person you’d want to talk to, especially if others say no.
Best of luck.
JulieOctober 15, 2013 at 1:02 am #76509
surfer….I would like to follow the others in welcoming you to our site. Next to “zero” disease presentation, Stage I is about as good as it gets. Hence, I would make sure to consult with numerous specialists: surgeons, interventional radiologists and oncologists. I believe that USC treats the highest volume of CC patients in Southern California.
Please keep us posted.
MarionOctober 15, 2013 at 12:42 am #76508lisacraineParticipant
Good for your doctor catching it at such an early stage. I will be praying for shrinkage and surgery.
LisaOctober 14, 2013 at 6:04 pm #76507pattimeltParticipant
Surfer1, I was referred to see Dr. Imagawa at UCI but he said my cc is inoperable & I then saw Dr. Kuo the radiation oncologist & had 2 SIRT radiation treatments. I then had 2 rounds of Gem/Cis chemotherapy & then 2 rounds of Oxilaplatin/xeloda chemo rounds. Seems like I am on 2 of everything. Unfortunately none of then have shrunk my tumor. Now I will be having another MRI to see if the last chemo did anythings. I also saw Dr. Serry at UCI who tried to get me into a trial but I did not qualify for that. I have great respect for all the doctors I have seen at UCI but so far not much good news for me. I feel good right now. I have had no symptoms of cc so far! No jaundice, itching or grey bowels!
I hope you will be able to have surgery which is the best way to go.October 14, 2013 at 4:02 pm #76506mparsonsParticipant
I live out in your area, and the hepatologist who diagnosed me two years ago is a USC doctor in Riverside, Zeid Kayali. I am glad that your husband was diagnosed early stage. Resection should be a real option for you, and surgery is the best possible treatment for this disease. I’m also glad you are hooked up with a surgeon experienced with cc. We will hope for a good report in November.
If UCI says no to surgery, get a second opinion! I’d recommend Dr. Selby, Chief of Hepatobiliary and Pancreatic Surgery, Abdominal Transplantation, at USC, if you can work out insurance. He did two resections on me with more advanced stage disease when others, including UCLA, had said no.
Best wishes to you and your husband. Mark
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