Introduction for my Dad~
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Hi slittle1127-
My Dad previously took gemzar+cisplatin and his scans did not show shrinkage right away either, but I don’t think that that is uncommon. Give it more time! It definitely worked for my Dad over time! Also, I know the numbers/prognosis can be daunting, but nothing is set in stone and everyone responds differently. Remember that timelines are based on averages and your husband could be an outlier!! Easier said than done, I know all too well. Anyway, I hope he can get insurance coverage – soon. Best wishes.
I wish I had good information to offer, but I am not knowledgeable enough to do that. However, my husband has been on Gemzar and after 3 cycles, there has been no noticeable shrinkage of tumors, but he has not been sick at all. Did not lose any hair. He has been off the chemo for a few weeks and we are waiting for health insurance and then he may get treatment again. Since he stopped chemo, we have seen ascites. Of course, he is weak and was anyway. The ascites may have come with or without the chemo. He is on the cusp of the 90 days prognosis he was originally given. We were told that chemo might extend his life by 90-180 days.
Thank you for your kindness and support! I truly appreciate it! The info from “Uptodate” was helpful…thanks PCL1029. Do you happen to remember what year the study was published re:Gemzar+Xeloda (must be fairly recent)? The results for sorafenib are encouraging as well…even if it was rats. I wish it was covered by insurance – it’s so darn expensive.
Thanks again gang!
Base on current edition of “Uptodate.com”, a website used by medical professionals in the US.
The combination of Gemzar+Xyloda is active for advanced billiary tumors.- in one study ,there were 22 objective responses(3 complete) out of 75 patients.
Favorable results have also been seen using Erlotinib,(an oral tyrosine kinase inhibitor)
with partial response and 7 additional pt. remained progression-free at 6 months.PS : Sorafenib is a multikinase inhibitor ;in a study done by Z.Guan in mice;published at 2009 GI Cancers Symposium,they found”complete tumor regression was achieved in 22.2% VS 0% in the untreated rats.” but please remember this was done in rats not HUMAN for cholangiocarcinoma.Sorafenib is FDA approved for hepatocellular carcinoma only,However ,it is not uncommon for “off label use” by MDs.
Hello Marcie and welcome to our wonderful family. Your post is very nformative and sounds like you are a Doctor/Nurse. That is a compliment. Mu husband, Teddy, at 73 went through a double Whipple, 1st one was aborted after 4 hours, however, the real deal was very successful. 5 top notch doctors said no Chemo because of location (contained in bile duct valve) and all clear margins. 2 years ago it returned where his duodenum used to be and he had Cyber Knife. Last year it returned and we were advised in June that they could do no more. With that said, rest assured that you are in one of the BEST places you can be for treatment. If I was in this position again and Teddy was 73 again I would do just as we did. You do the best you can, listen to your gut and don’t look back, it serves no purpose. The only thing I would suggest is to ask the ONC what is different between the 2 choices and how much will each help him. Best of luck and please keep us posted.
Hi Marcie,
Welcome to the site. Sorry that you had to join us all but I am glad that you have. And yes you are right on both counts, there is a wealth of knowledge and experience here and also that the people are indeed wonderful. Hopefully you will come back again and I look forward to reading more of your posts.
I can’t help you with your specific question regarding further chemo options for your dad as my dad never had chemo. But I am sure that others will be along soon that can help you and will share their experiences of the chemo’s that you mention with you. In the meantime, there is a search function on the site that may help you with this issue, and I am sure that using this will throw up past discussions that will be of interest to you.
I’m glad that you have posted here and joined us as you will get a load of support and help from us all, and if you have any other questions then please ask away and we will all help if we can.
Best wishes to you and your dad,
Gavin
Hello! I’ve been reading your posts now for about 2 years and have found much comfort and wisdom in them. Thank you! There is a wealth of information on this site….and wonderful people that I wish didn’t need to fight this battle.
The reason I’m posting now is because I have a question regarding treatment options for my father. I have done a search on both treatment options, but I am curious as to whether anyone has tried both and what their experiences were. Likewise, if anyone has any information on either of these alternatives, I would appreciate hearing from you!
Brief medical history:
My Dad is now 70 years old. In Feb/Mar of 2008, my Dad was diagnosed with cholangiocarcinoma of the common bile duct at Mayo Rochester. He underwent the whipple on 3/10/08 (Invasive grade 3 to 4 and node negative). He had no follow-up chemo/rad.In June 2009, the cancer was thought to have recurred in 2 peripancreatic lymph nodes. Dr. Nagorney agreed to go back in and resect these, however, biopsy showed hematomas and no neoplasm. Biopsy of the pancreas showed invasive adenocarcinoma. No resection completed.
Subsequently, my Dad did 6 weeks of radiation and 5-FU followed by ~8 months of Gem/Cis. He tolerated it well for the first several months, but then was hospitalized 3-4x for a gram-negative infection. His blood counts were very low which forced him off of chemo in April 2010.
This summer he had 3 days of intense IRT which destroyed several small liver nodules.
Today, he has a 3 cm mass in the peripancreatic region which is occluding the SMV and splenic vein; ~1 cm lesion on his liver, small growing lesion on his lung, and a non-occlusive thrombus in the portal vein.
Going forward, the two options are: Gemzar + xeloda vs. Nexavar (sorafenib).
Does anyone have words of wisdom or personal experience to share?
Thanks so much in advance for your help!
Marcie
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