New member seeking your collective advice

Hi,
May I ask where you and your family immigrant from,some I have an idea of other possible risk factor to help to answer your question in the future?
What age is your father at time of diagnosis?and what stage was diagnosis?
It is normal not to prescribed adjuvant chemotherapy after resection if had clean margin. the size of liver tumor 5cm is relatively small and that may be the reason not to have adjuvant chemotherapy afterwards.
I do not think you oncologist is specialized in treating cholangiocarcinoma and may not understand the prognosis of the disease well enough . but he is not wrong not to have your father put on adjuvant therapy either since the guideline of treating this disease is murky at best.

In my own experience about the growth rate of intrahepatic tumors which have chronic hepatitis B as a risk factor; It took about 10 month after stopping the adjuvant Gemzar chemotherapy to develop the two tumors before the second resection . It grown to about 2.5x3cm and 2.1×2.5cm in the final diameter; so it is relatively slow in grow rate for my case.. RFA can take care of both of them; but my one tumor was located in section8 ,at the top end of live dome and at the back side of the liver and have contacted,but not grown into with the right hepatic vein . the tumor had made contact with the diaphragm. therefore they had to performed a 2nd resection to take it out.That is why location is more important when using RFA treatment than the size of the tumor itself.( if in doubt, and resection is possible, go with resection).
With regard to your father’s case; the growth rate of your father’s tumor may be slower than me; if no other risk factor or other health issues involved (just my guess, I am a patient and not a doctor);”moderately differentiated cholangiocarcinoma” is much better than poorly differentiated CCA).
Here is my suggestion to which you have to consult with an interventional radiologist to see whether my suggestions make sense. will wait for a couple more month to see whether there are other little tumor/s will pop up and if so,you can take care of those in one RFA treatment whether than do it again twice. The key here is the location of your tumors; if it is located near the important parts of other organs such as blood vessels and nerve systems and diaphragm ; then let your radiologist determine the course of action.
good luck and
God bless.

Hi Julie,
I had two liver resections followed by chemo both times. I still had 5 recurrences. I have had steriotactic radiation three different times. The first treatment cycle destroyed two small tumors. The second time it destroyed two more. I recently had radiation and will have a scan on March 19 to see if it worked on one small tumor. Please call me with any questions 330-903-6868.
Lisa

Hi Julie,

Welcome to the family!! I am sorry to hear about your Dad. My daughter has CC and is going to be having surgery soon. So I don’t personally know about recurrence and hope we never do!!! There are many people that have had resections and recurrence. One person that comes to mind right away is Lisa. She has had 2 resections and about 5 recurrences. So she is an expert. Hopefully, she will see this and comment. She is a good friend of ours and loves to help. You say your Dad is stubborn and tough. That is a good way to describe my daughter as well. I wish your Dad all the best as he continues his fight.

Love,
-Pam

Julie…welcome to our site. This cancer is known to have a high recurrence rate hence we like to compare it that of to a chronic disease. Consequent treatment options are limited to the area of occurrence (near major vessels, etc.) You would want to consult with a variety of physicians i.e. radiation oncologist, oncologist, and the surgeon for possible treatment options. Additionally you would want to peruse our site. It is loaded with useful information from those searching for answers and those sharing their experiences with us. When entering key words such as “recurrence, surgery, chemotherapy, etc. many previous discussions will show up.
Additionally, don’t hold back from asking questions; our members are the best friends anyone could ask for and always are here to help.
So glad that you have found us. With your strong family support, experienced physicians, and all of us on this site, your Dad is bound to benefit the best possible available to him.
Surely others surely will chime in real soon.
Hugs,
Marion