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-Tata Memorial Hospital, Mumbai – They probably see the most number of CC cases in India(200-250 annually) and perform the highest number of surgeries.
-Global Hospital, Chennai – Dr. Mohammad Rela is world renowned Liver surgeon. His team had performed ~50 surgeries by 2015. His team is one of the few which goes for aggressive surgeries for advanced tumors, in some cases even early type IV hilar CC. There is not enough data on the success of such aggressive surgeries.
I am sorry to hear about the diagnosis. However, looking on the bright side, a type II tumor is very much resectable (I am assuming this is The Bismuth-Corlette classification – type II).
Here is my advice for your next steps (and you should act quickly)
-Confirm the diagnosis: You need a second opinion to confirm the diagnosis. The best place to get confidence on diagnosis for Hilar CC is Tata Memorial Hospital, Mumbai. But a word of caution, TMH is very very crowded and it will be hard work for you and your Mom to get through the process. Along with diagnosis they will also tell the course of treatment and you can be sure it will be in your best interest. If it really is a type II tumor – they will recommend surgery. And believe me that is your best option – if this tumor is resectable you should get it removed as soon as possible.
-Go for the surgery with an experienced doctor asap : For the surgery, again one option is TMH, Mumbai – Dr. Srikhande and Dr Goel are both good. But same issues with it being very crowded and not comfortable for the patient and family. But you will be sure of good surgery. Lilavati is an option but my personal experience was not very good with Dr. Jaganaath, although he is very experienced surgeon. They seem to be very money minded and not caring towards the patient. You can try Dr. Jaganaath at Lilavati too, it may have been one off bad experience. But definitely act swiftly and go for surgery.
Feel free to reach out to me if you need any other help.
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.
Thanks a lot marions for the information.
My father is currently being treated at Tata Memorial Center, Mumbai, India. From what I have got from the doctors, they receive around 200-250 cases of cholangiocarcinoma every year. This may not be a very accurate figure. From our research so far, this is the best center available in India for cholangiocarcinoma.
I will provide more details and specifics when I have more time.
Aniket.September 12, 2015 at 5:29 pm in reply to: Neoadjuvant Chemotherapy as a bridge to Surgical Resection #89704
Thank you so much Julie for the response and congratulations on your 1.5 years NED!
My father is an Indian resident and is being treated at Tata Memorial Center, Mumbai, India. This is the largest and best cancer center in India and they are definitely handling the most number of cases of cholangiocarcinoma in India. The decision has been taken after discussion by the multidisciplinary team here. I have already initiated a remote second opinion process with Johns Hopkins Medicine and am also pursuing a local second opinion with one of the best surgeons in India for liver resections.
As you mentioned, in my father’s case the call for surgery is not as straightforward as your case. The surgeon wont know if he can get clean margins until he has started the surgery. Also elevated levels of CA-19 9 are not a good indication for him. However as per research I have done so far, chemo is unlikely to reduce the size of the tumor, especially considering only 2 cycles are planned before surgical reassessment. I am worried we are losing time and whatever window we have for resection may close anytime. Also many research papers indicate that even positive margin resections offer better prognosis than no resection at all in hilar cholangiocarcinoma.
Aniket.August 15, 2015 at 2:09 pm in reply to: Info on Best Surgeons around the world particularly in India. #89365
Thanks Marion for the link and search function tip. Will try to mine out some information.