Using Radiation Therapy in Resected Biliary Tract Cancer
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Hi Li,
Welcome to the site. Sorry that you had to find us all here and I am sorry also to hear about your dad. But I’m glad that you joined in with us all here as you will get a ton of support from everyone here. From what you say about your dad and his treatment, it sounds like he has been through a lot of treatment and it is great to hear that he was able to have the surgery as unfortunately many people are not candidates for that.
I know that you are confused about things, that is common and something that we all go through at times. No wonder I guess as none of us are doctors or anything are we! I wish that I could help in answer your question for you but I am not a doctor and can not give specific medical advice. I do have some links for you though and hopefully they will be of interest and use to you.
We have a list of major treatment centres in the USA and it can be found here –
https://cholangiocarcinoma.org/for-patients/major-cancer-centers/
We also have a list of treatment centres that was created by the members here on the site where either they or their loved ones have been treated and hopefully you will find some info there about facilities in Chicago. It can be found here –
And, the search forum function at the site of the page will help throw up any discussions and links here on the site as Mary has suggested to you. Just type in what you want to look for and it should throw up what is on the site. I did a quick search and it came up with this –
https://cholangiocarcinoma.org/db/search/chemoradiation+after+adjuvant/
But you can have a more detailed look if you want to. Off the top of my head, I think that a few people have went through these treatments and hopefully the search forum will throw up their experiences for you.
I hope that you will keep coming back here and please let us know how things go for your dad. We are here for you.
My best wishes to you and your dad,
Gavin
Hi Li,
Welcome to the Discussion Board. From what you describe, your dad has been through a lot of treatment, with good result. It is great that he has your support in investigating treatment options.
I had radiation after adjuvant chemo, for intrahepatic CCA. In my case, it was five weeks of IMRT radiation with concurrent capecitabine. I was advised to have this because I had very close resection margins and my lymph node status was unknown. Proton radiotherapy was not mentioned.
Decisions about how to proceed with radiation and the specific type of radiotherapy are very individual as they depend on the tumor location relative to other anatomy. Some types of radiotherapy are more focused and can avoid damage to adjacent organs. Such therapies are often needed for gastrointestinal cancers given how many vital organs share the abdominal space. In my case, for example, my doctor had to defend use of IMRT with my insurer, using planning models that showed that the more usual radiation could damage other organs but the IMRT would not. My radiation also involved management of my breathing during the therapy to limit exposure. Sometimes spacers can be used to protect nearby organs.
Your radiologist will perform careful planning and modeling to be sure that the treatment is not harmful. But you should still ask all the questions you have in order to feel confident the proposed treatment is appropriate for your father.
If you search “proton” using the Board engine, you will find a few other patients reporting on their experiences plus additional medical journal articles Gavin has posted.
Best wishes that the next stage of your father’s treatment brings positive results.
Regards, Mary
Hi Gavin,
Thank you so much for the article. I was wondering if anyone went through chemoradiation after adjuvant 6 month chemo?
My dad was diagnosed with stage 3b perihilar cholangiocarcinoma in 5/2017 – locally advanced with 2 lymph nodes positive and lymph vascular invasion. He went through curative surgery in may 2017 with removal of left and right infected hepatic bile duct, common bile duct and gall bladder. Afterwards he had aspirational pneumonia and stayed in hospital till end of July. After rehab he started in August adjuvant chemo with Capecitabine for 8 cycles. Now we are done with chemo. CT shows abdominal area still clear. There is a nodule in lung continuously reducing from 10mm (August) to 7mm (November) and smaller (Feb 2018). Doctor recommended monitoring lung and chemoradiation with proton for abdominal area where tumor was removed.
The article indicates they don’t Recommend proton because of the proximity of stomach/intestines. Would proton cause more damage than the regular X-ray radiation? But my Dad’s radiation oncologist says proton is actually better in terms of causing damage to adjacent organs because of its better control. Any idea? I’m confused.
Any help or suggestions are greatly appreciated. We are in Chicago area seeing radiation doctor in Chicago Proton center.
LI
Using Radiation Therapy in Resected Biliary Tract Cancer
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