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Thanks gavin. The article has a recommendation for when dialysis should follow chemotherapy that I will ask the oncologist about. If John has chemotherapy on Tuesday morning and dialysis is Wednesday night, it seems like it is beyond recommendation.

I am not sure I have a good answer for why this cocktail is being recommended. As background john had partial liver resection in October 2013 without clean margins. He had 5fu for 7 treatments at reduced dosages due to his other medical conditions including renal failure, which he did not.handle well (two hospitalizations during treatment). March 2014 scans were clear. So he was told to follow up with six month scans in September. A few weeks ago he developed a cough and difficulty breathing. I thought it was allergies because he was spending a lot of time doing yard work. Turns out his right lung had half filled with fluid due to cancer now on lung. Ct scan indicates it is also back in liver. Local oncologist consulted with oncologist at sloan Kettering and are in agreement to try gemzar this time. Dosage that john can handle is the concern.