Introduction: 55 y/o male with a recurrance.
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marions wrote:prayersforall…welcome to our site. Metastases from unknown primary are not uncommon. Physicians take in account the symptoms and test results and based on that make the diagnoses.
Irinotecan (Camptosar) can be difficult to tolerate however; it appears that your mother seems to be doing fine. Chemotherapy is accumulative therefore; you would want to keep a close eye on possible side effects caused by treatmentsI am hoping for others to chime in also and share their thoughts with us.
In the meantime I wish for your Mom to respond favorably to the present treatment and for the upcoming scans to reveal a reduction in markers and lesions.
Hugs
Marionprayersforall…welcome to our site. Metastases from unknown primary are not uncommon. Physicians take in account the symptoms and test results and based on that make the diagnoses.
Irinotecan (Camptosar) can be difficult to tolerate however; it appears that your mother seems to be doing fine. Chemotherapy is accumulative therefore; you would want to keep a close eye on possible side effects caused by treatmentsI am hoping for others to chime in also and share their thoughts with us.
In the meantime I wish for your Mom to respond favorably to the present treatment and for the upcoming scans to reveal a reduction in markers and lesions.
Hugs
MarionIntroduction -is this cc?
My mother, 65 yrs old was diagnosed with metastatic adenocarcinoma of the liver last June. She had been complaining of apathy for food particularly intolerance to the smell of cooking, itching and bloated feeling in the stomach for 2-3 months and an ultrasound showed the metastatic deposits in the liver.Colonoscopy and endoscopy did not reveal anything. PET/CT results
Right lobe lesion 15 by 8.3 cm
Left lobe lesion 5.7 by 4.8 cm
– multiple, necrotic fdg avid lesions in both lobes of the liver suggest metastatic
Disease
-FDG avid pre vascular nodes suggest metastatic disease
-no other FDG avid lesion is seen elsewhere to suggest a possible primary neoplasmCEA 19.1 CA19.9 -427 AFP 1.73 CA 125 – 256
Our oncologist started her on gemcytabine and xeloda 3 cycles of 21 days. She tolerated the chemo very well. A review was done in Aug 2011
Shrinkage right lobe 9.7 by 5.2 cm left lobe 1.9 by 2.4 cm
CEA 12.2 ( earlier 19.1)
CA 19.9 88.9 ( earlier 427)
CA 125 56.6 ( earlier 256)The same chemo gemcytabine 1600 mg and xeloda 4 tabs daily was continued for 3 more cycles of 21 days and review PET CT done in End of Oct 2011-
Right lobe lesion stayed the same at 9.7 by 5.2 cm
Left lobe lesion reduced to 1.7 by. 1 cm( last scan 1.9 by 2.4 cm)CA 19.9 – 125( earlier 89.9)
CEA 14.2( earlier 12.1)
CA 125 70.8. ( earlier 96.
She was given about 45 days of rest from chemo . Her appetite improved and she felt her symptoms had disappeared.
In December 2011 she was started on gemcytabine and oxitan for 4 cycles each of 15 days. But from15 Dec onwards she felt the same symptoms . so a mid term review was done in Feb 2012. CT scan results
Right lobe lesion increased to 11.1 by 7.8( earlier 9.7 by 5.2 cm)
Left lobe 1.7 by 1 cm same as beforeCEA 53.8( earlier 14.2 cm)
CA 19.9 990 ( earlier 125)
CA 125 -305( earlier 70.No new sites
Doctor feels it could be cc and not pancreatic but says treatment options are the same he advises.
Now she has been started on 48hour IV of 5fu, 750 mg -9 hrs each
Irrinotican 240 mg -2hrs
Calciumleucorin 300mg -2hours1st cycle completed had a neutrophil boosting injection felt very weak had mouth sores, throat infection.
Was treated on antibiotics and improved2nd cycle over. Much better tolerance.
She has no diabetes, hypertension but has been asthmatic for years but no other known illness.
has been tolerating chemo well except the 1st dose of 5 fu which gave her a fever and she felt weak for 2days.
Sorry for all these details. But just wanted to find out if anyone had a similar experience – metastaitic adenocarcinoma of liver with unknown primary and can suggest what options are available for her.
Prayersforall
obgpac…..welcome to our site. In anticipation of a consult with doctors at John Hopkins you would want to gather all medical records including blood test, scan results, physician and surgery reports etc. At times, physicians schedules may not allow for consultations in the order preferred therefore; take whichever comes first (radiology oncologist, or hepatobiliary specialist.) Please, also remember that palliative care encompasses numerous ways of treatment and that there is no time limit set. Many patients are benefit from it for years.
Good luck and please, keep us posted.
Hugs
MarionHi,
Others will join in for more support for you;in the meantime, as you may know the treatment triangle of CCA consists of surgery,radiation and chemotherapy ;all three sides of the triangle are equally important in the treatment of CCA.I am no doctor;I am ,like you, a CCA patient for 34months.the difference between your and mine is you have the Extrahepatic CCA and I have the Intrahepatic type CCA.
However if I may suggest, when you get 2nd opinions as you suggest at John Hopkins(BTW,they are #1 for 25 years as the best overall quality hospital in the States.) So you have already chosen the best place for consultation I will suggest start with your consultation with a hepatologist(liver specialist) first to get an overall assessment of your current situation; then base on his recommendation to have the interventional radiologist consult for the possibility of using RFA to burn off the 2 small tumors in the liver or have the radioembolization or chemoembolization done so to give you a relatively free of serious side effects treatment for your recurrence;then I will see the medical oncologist for his final opinion.
BTW,we had a bit info on the RFA,chemoembo and radioembo under the forum discussion on “Radiation etc”;please spent some time to learn more about each one.good luck and
God bless.In November 2008 I underwent a modified Whipple for Cholangiocarcinoma in the proximal bile duct. My surgeon referred to the operation as a surgical cure, no nodes or other evidence of unresected tumor. I was back to work in 3 months and life was getting back to normal. No adjuvant therapy. Feb, 2010 I was dignosed with a recurrance without biopsy studies. I underwent dual chemotherapy for 6 months. At the conclusion with mounting pain I was advised that the tumor is no longer responding to chemotherapy. Therapy was stopped. I took my CT scans to another radiologist who diagnosed me with diverticulitis. I was better 2 weeks later after completing the Cipro/Flagyl drill. All was well until this past Valentines Day when I was diagnosed with recurrent adenocarcinoma, metastatic cholangiocarcinoma after a 2.0 by 1.4 cm lesion was identified on the edge of my liver by CT scanning. Biiopsy, 4 days later confirmed the diagnosis. I am faced with returning to the treatment/paliative path and have heard use of different radiation therapies being used. I am interested in pursuing an Oncologist at Hopkins to discuss this.
Thank you for your attention.
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