Surgery for stage 4 intrahepatic CC

Thank you all for getting back to me! I really have tried to be assertive at my dad’s appointments; my mom jokes that Dr. Friedman (the oncologist) must dread seeing me sitting there with my notebook! At the appointment on Tuesday, I’ll definitely try to get some straight answers as far as the CT result specifics…I have the feeling it’s now or never as far as the possibility of resection goes.

Pam, I’ve thought about my anger towards the oncologist–I know I am angry in general because cancer just sucks…but I really feel he tap-dances too much. I can’t tell if it’s because he doesn’t know some of the answers or if he can’t be that straight with my parents. Either way, I leave feeling very unheard. If the CT isn’t good, and Pittsburgh won’t operate, I need a new game plan. Either Fox-Chase or CTCA maybe.. they are both in the Philly area. I just hope with all my heart that surgery is now possible.

I’ll let you know how Tuesday goes, and thank you again for all your kindness!

Now that I think of it, I’m not sure what Dr. Pingpank meant by that comment (that they are one of only two places that do this kind of surgery). I took it to mean that they will do resections along with “debulking” of areas where mets are.. but now i don’t know! If it were up to me, I would have gone to Fox-Chase in Philly for the chemo instead of staying in Lehigh Valley (where my parents live)–but my parents are so loyal, so trusting, and wouldn’t dream of going to someone else.

I have struggled from the beginning with the lack of straight forward answers from the oncologist; I understand the need to be positive, but I have gone to all my dad’s appointments, notebook in hand, and I always leave frustrated. My dad had a CT at the end of December ( after 4 rounds of chemo)–the report had no mention of any mets, so I asked if that meant they were gone, shrunk, what? He couldn’t answer the question; he said he would check with the radiologist to see. He never called us back; at the next appointment, I asked if he had found out about the mets–he never followed up on it. I thought the absence of mets seen on a CT in September would have been a big deal….Honestly, I get so angry watching this guy busily type his notes and schedule the chemo instead of talking to us that I could just scream.

Sorry…back to the possibility of surgery. If Dr. Pingpank (or Dr. Marsh) feel it’s worth taking a look (after looking at the new CT)they’ll schedule the laparoscopy. The resection can’t be done that way, but they would just continue and do the major surgery if they feel it’s doable (they said it would be about a 10-12 hour surgery!) They would remove the part of his small bowel that had mets attached; the CT in September showed mets to the small bowel and omentum. When we went to Pittsburgh in Jan, I thought we were going for the resection then; I was shocked when the surgeon said he wanted my dad to have at least 3-4 more rounds of chemo. He basically said that since the chemo was still having a positive effect, he didn’t want to interrupt that treatment before it was totally exhausted.

So–two hurdles to cross. First, the surgeon has to look at this new CT and feel it’s worth taking a look; second, once he looks inside, decide to attempt the resection/debulking. I am so worried I can’t seem to focus on anything else. This disease is freaking awful.

Thank you for your help and concern–I so appreciate your input!

Thanks for getting back to me! The laparoscopy would be just to look around first to see where the mets are–I neglected to say that my dad’s CT in Jan. didn’t show the mets (they were there in Sept). I found this surgeon accidentally–I was looking for someone who might do intraperitoneal chemo since his mets were in the abdominal cavity and no where else. The surgeon called back and actually said he’d consider him for resection.

You’re right–I was thinking the same thing–how often has he done this surgery for CC? But he is a colleague of Dr. Marsh, and I sent his stuff to him also, and he said my dad would be in good hands with Dr. Pingpank….If they take a look via laparoscopy, and he felt the resection/debulking was doable at that point, they would just continue and do the resection. As far as his main tumor, I have no idea exactly where it is—just that it’s intrahepatic, that it’s by the ducts of the left lobe (left lobe severely atrophed and right has taken over function). I also don’t know size–the oncologist is very vague when I ask specific questions!!