Eli
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Lainy, may I answer that?
Vitamin D is a group of vitamins: D1, D2, D3, D4, D5.
Humans can digest only two of them: D2 and D3.
When you buy a Vitamin D, check the fine print on the bottle. Is it D2 or D3? Most scientific studies say that D3 is easier to digest than D2 (though even that is subject to dispute).
D3 also happens to be the form of Vitamin D that we naturally produce when our skin is exposed to ultraviolet in sunlight.
Searched Tivantinib and Papadopoulos. Must be this study:
Drug-drug Interaction Study of Tivantinib (ARQ 197) With Omeprazole, S-warfarin, Caffein, Midazolam, and Digoxin in Cancer Subjects
http://clinicaltrials.gov/ct2/show/NCT01517399
Lainy, it’s a study out of Taiwan, about Taiwan. They say that CC incidence is increasing in Taiwan. That doesn’t automatically mean that it’s increasing everywhere. Each country is a bit different.
I can’t access the full text of the study, so I can’t see what they have to say about the reasons. Maybe Taiwanese increased their consumption of raw sushi? Or alcohol? Who knows.
Here’s a short article about this study, written in plain English:
Researchers discover biomarker for advanced bile duct fibrosis and bile duct cancer
http://medicalxpress.com/news/2012-05-biomarker-advanced-bile-duct-fibrosis.htmlWe discussed IL-6 testing before; here’s the link
http://www.cholangiocarcinoma.org/punbb/viewtopic.php?id=7336P.S. Marion, I will try to get back to your question when I have a bit more time.
Dear Julia,
I am so sorry about your loss. Your updates in the last few days have been absolutely heartbreaking. Susan is definitely in a better place now, free of pain and distress. May she rest in peace.
My thoughts are with you and your family.
Hugs,
EliMrsD, welcome to the forum.
My wife had positive margins after her Whipple surgery. Same story as your grandma: the surgeon thought that he had been able to achieve negative margins. Final pathology report proved him wrong. The pathologist found invasive cancer cells right at the surgical margin (but no gross tumor).
We opted to do chemo-radiation after studying the statistics. Most medical studies we saw seemed to point in the same direction: chemo-radiation improves survival in the patients with positive margins. If I recall correctly, one or two studies went as far as to say that 5 year survival rate was comparable in the two groups of patients:
(1) patients with negative margins who had surgery alone,
and
(2) patients with microscopically positive margins who had surgery followed by chemo-radiationKeep in mind, the quality of available evidence is not the best. All studies done so far have been small, non-randomized and retrospective in nature.
That said, your grandma’s age is the biggest question mark here. Side effects of chemo-radiation can be very harsh. My wife was a very fit 44 year old at the time of diagnosis. Despite her young age and great shape, she had a very rough time with chemo-radiation. Especially towards the end of the 6 week course. The last week of radiation was probably the lowest of the lows in our entire CC journey.
I agree with what Percy (PCL1029) wrote in the previous post. Given your grandma’s advanced age, think long and hard about balancing “quality of life” vs. “quantity of life”.
Hugs,
EliKris, just in case you haven’t seen it, we discussed DCA here:
http://www.cholangiocarcinoma.org/punbb/viewtopic.php?id=7284
Kris made a very important point. Blood counts can drop like a stone right after the first chemo cycle. Chemo patients can develop infections from their *own* germs, because weakened immune system is no longer able to keep them in check.
My wife took every precaution possible when she started chemo. Yet she quickly developed mouth and throat sores (very uncomfortable). Our oncology nurse said that’s very common and that it could have easily been my wife’s own germs.
So yeah, bird’s poop is not a good idea.
Gavin, thank you so much for posting this link.
I quickly read all abstracts about CC. This one caught my attention:
Gemcitabine and oxaliplatin (GEMOX) alone or in combination with cetuximab as first-line treatment for advanced biliary cancer: Final analysis of a randomized phase II trial (BINGO)
http://abstract.asco.org/AbstView_114_100116.html
Quote:Conclusions:GEMOX-cetuximab regimen was well tolerated and met its primary endpoint (4-month PFS ≥60%). However, median PFS and OS were similar in both arms. Exploratory analyses (e.g., KRAS tumor status) are underway to identify pt subgroups deriving benefit from the addition of cetuximab to CTx.
Bold font is mine.
It’s disappointing to see that GEMOX+cetuximab failed to show advantage over GEMOX alone. Up until now, GEMOX+cetuximab seemed to be the most promising new protocol.
Hi Tiffany,
I looked at the clinical trial in your link. They are testing vitamin D3 (calcitriol) as a supplement to chemo. Vitamin D3 is readily available in any pharmacy. So to answer your question…. yes, you can easily do this at home if you wish. As always, it’s a good idea to check with your oncologist before you add a new supplement.
Keep in mind, our bodies produce TONS of vitamin D3 when exposed to sunshine. As a southerner, you probably get more than enough vitamin D3 when you go outside in the sunshine.
On the other hand, I heard that sunshine exposure is not recommended during chemo. Do you take special precautions to hide from the sun?
Hi Pam,
I am glad to hear that everything went so smoothly. I so much hope that the good news continues for you and Lauren. May those tumors receive the most powerful zapping imaginable!
Hugs,
EliJohn, welcome and thank you for sharing your story. Yes, you are blessed indeed. May your blessings continue for years to come!
Dear SandT mom,
I am so sorry to hear that Ed has passed away. I followed his posts very closely, ever since he introduced himself on this site. He had an amazing fighting attitude, always calm and even-keeled.
My heart goes out to you and your boys. Wishing you peace and strength as you face the difficult times ahead.
Eli
My wife received an IV of octreotide for a few days after her Whipple surgery. Her surgeon prescribed octreotide to prevent a leak in the new pancreatic connection, a fairly common complication after Whipple.
My wife developed a terrible nausea in reaction to octreotide. She was turning inside out trying to throw up. Her stomach was empty after the surgery, so she couldn’t really throw up anything but bile. She was on several medications at the time. It took us a while to figure out that octreotide was to blame. As soon as they stopped octreotide, the nausea was gone.
