Eli
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Hi Percy,
Thanks for the words of caution about hypoglycemic symptoms. My wife is not diabetic or even pre-diabetic, so I agree it’s probably not a good idea to put her on Metformin.
Speaking of hypoglycemia, my wife takes maitake mushroom extract on a regular basis. As you know, maitake mushroom lowers blood glucose in many patients. It definitely seems to have that effect on my wife. She had to stop maitake during chemo, because our oncologist was worried about low blood glucose. She restarted maitake after she was done with chemo. If hypoglycemic effect reduces the risk of relapse, and that’s a big IF, I hope she can get it from maitake.
Best wishes,
EliLainy, you are welcome. Note it’s not just ICC. They also found that it reduces the risk of hepatocellular carcinoma (HCC).
I agree with Percy and Kris:
Continue Gem/Xeloda as long as it keeps working. Meaning, the tumors are shrinking or stable. If and when it stops working, switch to a different regimen.
Gem/Cis is the standard of care because it’s the only chemo combination that has been tested in a Phase III clinical trial. All other combinations have been tested in Phase II trials. Phase III trials are superior to Phase II trials.
However, and this is very important…
Phase III trial of Gem/Cis proved only one thing: Gem/Cis combination improved survival compared to Gemcitabine alone. That’s it. The trial did not prove that Gem/Cis is better than Gem/Xeloda, or any other regimen.
If you don’t mind seeing the survival stats, take a look at this paper:
Targeted Therapy for Biliary Tract Cancer
http://www.mdpi.com/2072-6694/3/2/2243/pdfScroll to Page 3 of the PDF and find this table:
Table 1. Phase II studies of gemcitabine-based regimen for unresectable biliary tract cancer
The table shows the stats from three Gem/Cis trials and four Gem/Capecitabine trials (Xeloda is commercial name of Capecitabine). Keep in mind, these are Phase II trials. Sample sizes are quite small. Also keep in mind, patient characteristics can differ quite significantly between these studies. So it’s not necessarily an apples to apples comparison.
One thing is sure: it’s a very tough choice. You have my sympathy.
Susie, she’s doing great but that’s all I’m going to say for now. Don’t want to jinx her by going into details. Our next scan is coming up in two weeks.
It’s normal to be worried when a close blood relative is diagnosed. The good news is, the vast majority of CC cases are not hereditary. Hereditary CC is extremely rare. It’s also hard to prove and test for.
We discussed this topic before, many times. You can use Search function of the forum to find previous discussions. Click Search link in the green outline near the top of the page. Type ‘hereditary’ and click Search button. I found 42 posts.
Formydad,
I’m sorry if I confused you, but I did *not* say it was Intrahepatic CC.
What I wrote in my last post is just one possible option. There are a few others. For example, see Percy’s post where he explained how hilar CC at the “Y” junction can grow into the liver.
It’s hard to tell what it is without knowing all the details. You have to find out more information to fully understand what your dad has.
Formydad,
You wrote:
Quote:I don’t know which my father has. Originally cancer supposedly started in liver but after further tests it is said that it started in bile duct and had moved to liver.There is another way to explain what you wrote. The tumor was completely inside the liver, but the doctors didn’t know if it was hepatocellular carcinoma or intrahepatic CC.
Hepatocellular carcinoma is cancer of the liver. It starts in the liver cells. As it grows, it can penetrate the bile ducts.
Intrahepatic CC is the opposite. It starts in the ducts and penetrates the liver as it grows.
These two cancers can look very similar on the images. The doctors need to biopsy the tumor to figure out what it is.
Here’s a good picture of the bile ducts (green color):
Both intrahepatic and extrahepatic CC start in the bile ducts.
Intrahepatic CC starts in the thin ducts that are spread throughout the liver.
Extrahepatic CC starts in the thick portion of the bile duct that sits outside the liver.
If CC starts at the point where the ducts exit the liver, it’s called different names. Perihilar CC, or hilar CC, or Klatskin tumor.
Marion, you can link to the threads directly. What you can’t do is link to the search results page that links to the threads. So if you search returns just a few hits, you can simply copy and paste those.
Hi Kandre,
The article you linked in your first post refers to the treatment called Selective Internal Radiation Therapy (SIRT). The same treatment goes under a different name: TransArterial RadioEmbolization (TARE), or simply radioembolization.
The treatment uses radioactive chemical element called Yttrium. Yttrium exists in different variants: Y90, Y99, and many others. Y90 is the most common variant used in radioembolization. I’ve never seen Y99 mentioned before, so I think it must be less common than Y90.
I recommend that you try to search the forum for these terms:
radioembolization
Y90You will get tons of pointers to the older discussions.
Here’s the direct link to the forum search page:
http://www.cholangiocarcinoma.org/punbb/search.php
ADDED:
Take a look at this discussion… lots of useful information in there.
http://www.cholangiocarcinoma.org/punbb/viewtopic.php?id=7931Hi Gavin,
Your link to the search results doesn’t work too. When you do a search, the forum software generates a web page with the search hits. This web page is temporary. You can’t use the page URL to link the search results in a post. That’s why both your link and Marion’s link don’t show anything.
As far as I know, there is no good work-around. You either have to copy the search results in your posts, or explain to the forum member how they can do the search themselves.
Hope this helps,
EliRandi, congratulations!!! I am so happy for you and thank you so much for sharing your wonderful news. Don’t feel guilty for one moment… you do give hope to others.
Hi Jilly49,
Would you mind posting more details about your experience with DCA.
1. What dose did you take? (in mg per kg of body weight)
2. What schedule did you follow? I’ve seen different schedules used. Five days on, two days off; One week on, one week off; etc.
3. Did you take your daily DCA dose in one shot? Or did you split it into smaller doses two-three times a day?
4. Did you use DCA powder or capsules?
5. Did you take any supplements with DCA, such as Vitamin B1 (thiamine) or coffeine?
6. How long did it take for the side effects to develop?
7. Have you experimented with lower doses to try and reduce the side effects?
Thank you very much in advance for taking time to answer these questions. Your answers will be of great help to other patients looking into DCA.
Eli
