Peritoneal Metastasis After R0 Resection Surgery
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Hello!!
Here is my dad’s story:
My dad had stage 4 BDC with peritoneal metastasis.His oncologist at the time wanted to treat him with gem Cis. We were extremely reluctant to go down that route. Classic chemo has no effect on peritoneal metastasis.
I had looked into a new treatment called PIPAC which is pulverised chemo into the abdomen.The oncologist said it would not work. We followed our instinct. IT WORKED on my dad’s metastasis. It is estimated that it prolonged his life by at least 3 months.
Now, I have just been told ( by the inventor of the PIPAC, professor Raymond) that this treatment will be available in the same hospital that said it would not work!!
Do Seriously look into this .
( if you search for PIPAC on this site, you will find our story )
Hi,
Just wanted to update that the oncologist has decided to go for USG guided ascitic fluid cytology to have a confirmed diagnosis. He wants to repeat this for upto 3 times incase results are negative.
There is somewhat of a relief that the first of the series has come back to be negative for malignancy.
Although I am not sure what is the sensitivity of this test in diagnosing peritoneal metastases.Aniket.
Aniket…..the new approach to cancer treatment is focused on molecularly targeted therapies. This includes immunotherapy. None have been approved for cholangiocarcinoma however; several ongoing clinical trials are underway.
http://www.cancer.gov/about-cancer/treatment/types/targeted-therapies/targeted-therapies-fact-sheet
Cholangiocarcinoma does not have a second line of treatment, hence molecular clinical trials may prove to be the next best alternative.
One such option is the 16 week TAPUR study:
http://www.cholangiocarcinoma.org/punbb/viewtopic.php?pid=103723#p103723Given that your Dad has hilar cholangiocarcinoma, he won’t carry the PD-1 gene alteration, prominent in approximately 40% of the intrahepatic population.
Having said that, your may want to discuss genetic testing with the physician in order to identify a molecular alteration for which a targeted drug is under investigation. Tumors undergo changes, hence the institutionally preserved biopsy may not be adequate and your Dad may need to undergo an additional biopsy.
Hugs,
MarionHi All,
My father was diagnosed with Hilar Cholangiocarcinoma in July 2015, the tumor was locally advance type IV. He underwent ptdb stenting, internal radiation, followed by chemotherapy. He was deemed eligible for a potentially curative surgery and was operated on in November, 2015. The histopathology report was excellent, R0 resection, clean margins and a lot of the tumor had fibrosed due to pre-operative chemoradiation.
He was undergoing adjuvant chemotherapy as a prophalytic measure to prevent recurrence. However
4 cycles into chemo, 5 months after surgery, CT Scan now has fairly conclusive evidence of peritoneal nodularities and tumor markers are rising as well. It all points to peritoneal metastasis.
Any help on what are our options for further treatment will be great. Conventional treatments or any new treatments which have worked like immunotherapy?Thanks,
Aniket.
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