Mom’s update

Hi everyone,

Just thought I would update you on mom’s progress. So she had a liver resection complete left and partial right for a 6 cm chonlagio last July 2010. Since then she has suffered many complications, bile duct leaks, septicemia and required a second surgery but then she recovered. She came home and started gaining weight and doing better, although she went home with the bile bag which caused some problems. She refused the radiation therapy offered to her last year and only did 6 weeks alternating of Gemzar and Xeloda chemotherapy and had to stop due to recurring hepatitis and cholnagitis infections. She was readmitted this Feb to March for a month for treatment of the infections and that point nothing else was done. The surgeon told us he did brush biopsy, but then two weeks later he told he didn’t do the brush biopsy! So they were unsure of what to do, they sent her home with a pip-tazo antibiotic pump for almost 12 weeks and she did end up developing resistance and had to be switched over.
Then she ended up back in hospital in May for 3 weeks due to an upper GI bleed and needed 11 pints of blood transfused. She then came out and felt better once they sourced the bleed, which they say they biopsied and it was negative, but we’re not sure what that means anymore. This whole process has been frustrating nonetheless, especially since we are a medical family and understand when mistakes are being made!

Now she has had a 2 by 2 cm recurrence at the cholejejunal junction this past July 5th and has been in hospital ever since. She has had multiple infections, turned jaundiced, and they took lymph nodes biopsies of her paraortic nodes (in her abdominal cavity near the tumour) and they were negative! But the recurrence is very near to the hepatic artery and so the surgeon said he couldn’t take it out. They first offered brachytherapy but then said they couldn’t get to the tumour to place the brachytherapy bead. And now she is on TPN and jejunostomy feeding and they say she needs to gain weight before they are going to irradiate her entire liver 10 by 10 cm field! And that’s the only option they have offered. They have not offered focussed radiation options. We feel this is possibly too aggressive given that she only has a local recurrence, however they keep saying she isn’t “strong enough” to get the radiation therapy. To top it all off, my poor sweet mom is having blood infections and is on pip-tazo antibiotics and has hepatic ischemia (which means the tumour is now compressing part of the hepatic artery) which is causing her jaundice and discomfort..She has been in hospital for 2 months now, where all she has had is infection after infection and I am here to ask if anyone out there has ever had radiation therapy such as IMRT or stereotactic radiation or even gamma knife radiation applied to themselves or their loved ones while they were on antibiotics for infections while in the hospital? The reason I ask is we have already asked for a second opinion in Seattle as well as Slaon Kettering Memorial and they are willing to try anything whereas the people here in Canada are using a very conservative approach (which is do nothing at this point because she is too sick)….but I wonder what some of you have experienced in terms of criteria to receive focussed radiation therapy?

We are looking for help for my mom for prolongation of life as long as possible as we are aware there is no cure yet….

Thanks for your time..
Kavita