Eli
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Here’s what our medical oncologist said about Decadron:
Decadron doesn’t control nausea in and by itself. Rather, it enhances the anti-nausea action of Zofran. If Zofran does a good job of keeping nausea under control, Decadron is not needed. If Zofran fails to bring nausea under complete control, Decadron can be added to help Zofran.
Well done, Baron Bosse!
The link to CC.org is a nice touch. It doesn’t exist in the English version.
Good morning Lainy,
I don’t want to start the day by having a debate with the forum matriarch (you!). But… I think we need to get this right for the sake of our new member. So please forgive me for being argumentative.
Your Teddy had CyberKnife treatment *after* Whipple, on a *secondary* tumor. This is very different from using CyberKnife on a primary extrahepatic tumor before Whipple.
Primary extrahepatic tumor sits inside the bile duct. Bile duct is a thin tube 4-7mm in diameter (thinner than a pinky). CyberKnife uses high intensity radiation to burn the tumor. I believe it’s virtually impossible to burn the tumor inside the bile duct and NOT damage the duct itself. Even if it was possible, the dead tumor would still be sitting there, blocking the flow of bile.
So I stand by what I wrote. When we are talking about *primary* tumors, I believe this is true:
Intrahepatic CC: CyberKnife might be an option
Extrahepatic CC: CyberKnife is NOT an optionThe usual disclaimer applies. I’m not a doctor. Please seek professional medical advice from a qualified doctor.
Best wishes to all,
EliA short article by Dr. Servan-Schreiber, the author of AntiCancer book.
He was adamant about the harmful effects of processed sugars. Here he says that sugar in fruit is okay.
Does the sugar in fruit feed cancer?
http://anticancerbook.com/post/Does-the-sugar-in-fruit-feed-cancer.htmlDiana, welcome. My wife is about the same age as your husband. Her symptoms first showed up three days after she turned 44. I know exactly what you are going through.
One piece of advice, if I may. Try your best to manage your stress and frustration. Prolonged, daily stress can be very harmful. It *can* trigger illness (speaking from personal experience here). Seek professional help if you have to. Your husband needs you in the best possible shape.
Wishing you and your husband the best,
EliP.S. Lainy mentioned CyberKnife. It might be an option if the tumor is inside the liver (intrahepatic CC). As far as I know, CK is not an option if the tumor is in the bile duct outside the liver (extrahepatic CC).
Randi, congratulations! So happy for you.
FYI, I emailed your post to my wife. Her first anniversary after surgery is in July. She’s still doing chemo.
Subject line of my email: Inspirational Message
There you go… you are an inspiration!
Wishing you the best.
Byron,
I searched PubMed for these terms:
cholangiocarcinoma radioembolization
bile duct cancer radioembolization
biliary cancer radioembolizationThis is what I found:
Trans-arterial (90)yttrium radioembolization for patients with unresectable tumors originating from the biliary tree
http://www.ncbi.nlm.nih.gov/pubmed/21677339Transarterial hepatic yttrium-90 radioembolization in patients with unresectable intrahepatic cholangiocarcinoma: factors associated with prolonged survival
http://www.ncbi.nlm.nih.gov/pubmed/2143197018F-FDG PET independently predicts survival in patients with cholangiocellular carcinoma treated with 90Y microspheres
http://www.ncbi.nlm.nih.gov/pubmed/21308371Radioembolization in the Treatment of Unresectable Liver Tumors: Experience Across a Range of Primary Cancers
http://www.ncbi.nlm.nih.gov/pubmed/21127414Radioembolization of liver tumors with yttrium-90 microspheres
http://www.ncbi.nlm.nih.gov/pubmed/20113679Yttrium-90 radiotherapy for unresectable intrahepatic cholangiocarcinoma: a preliminary assessment of this novel treatment option
http://www.ncbi.nlm.nih.gov/pubmed/19876691Treatment of unresectable cholangiocarcinoma using yttrium-90 microspheres: results from a pilot study
http://www.ncbi.nlm.nih.gov/pubmed/18759346Regional infusion-radioembolization
http://www.ncbi.nlm.nih.gov/pubmed/18722928All of these articles were published in “peer reviewed medical literature”.
I can’t access the full text of the articles AND I’m not a doctor. So I can’t tell whether any of these articles prove the efficacy of radioembolization for treating CC.
It would be very prudent to show these articles to your radiation oncologist before forwarding them to your insurance company. You don’t want to give your insurance company MORE ammunition to support their position.
EDIT:
Found two more articles via Goodle Scholar:
Yttrium-90 Radioembolization(SIR-Spheres) for Cholangiocarcinoma: Preliminary Study
http://www.jvir.org/article/S1051-0443%2808%2901410-3/fulltextRadioembolization (Yttrium-90 Microspheres) for Primary and Metastatic Hepatic Malignancies
http://journals.lww.com/journalppo/Abstract/2010/03000/Radioembolization__Yttrium_90_Microspheres__for.12.aspxYou are right to be concerned. I think your sister’s nutritionist is misguided.
Cancer cells consume glucose from the blood supply. It’s true they do it at a higher rate than normal cells. Unfortunately, it’s not possible to “starve” cancer cells by eliminating sugars from the diet.
I read an article, written by an MD, that explained it this way:
Our bodies are very good at keeping blood sugar levels at a fairly constant levels (except for diabetics). A person can go on a hunger strike, yet his blood sugar level will stay in the normal range until he is fairly close to dying from starvation.
Please tell your sister to listen to her oncologist and eat a varied, healthy diet.
Derin,
Watch out for dropping neutrophil counts (ANC 1.6). Stay on top of your oncologist if ANC drops further. You run the risk of catching infections if neutrophils drop too low.
FYI, our oncologist prescribed Neupogen shots when my wife’s ANC dropped to 1.4. Neupogen worked very well. The last ANC reading was 5.8.
Hi Lisa,
Thanks for your post. My wife also has incisional hernia. We don’t know when exactly she developed it. It really became prominent about a month after she finished radiation treatments. Given your post, I think we too will blame it on radiation.
Our surgeon said the same thing. No rush to repair hernia, as long as it doesn’t cause any pain. My wife wears an abdominal binder to keep hernia in check. Basic model around the house, on top of her regular clothes. When she goes out, she wears this one under the clothes:
http://www.bellefit.com/corset.php
If you want to get one, note that their size table runs too small. My wife had to go one size up. Buy one from Amazon if they have your size. They don’t charge restocking fee if you return.
Our surgeon wrote a letter for the insurance company. Still waiting for our claim to be processed.
Stacy, *all* surgeons do the frozen sections biopsy. It’s the only kind of biopsy that can be done quickly in the middle of a surgery. My point was, you want an experienced, skilled pathologist doing it. Let’s hope your FIL gets a good one on Monday!
Best wishes,
EliHi Derin,
You asked:
Quote:I’m also told radiation with oral Xeloda after the chemo, but what are they going to be shooting it at? Everything was removed and the liver didn’t have involvement so I’m a bit curious about that as well.Please see my post in your thread, “What Chemo should be used for me?”.
http://www.cholangiocarcinoma.org/punbb/viewtopic.php?pid=54501#p54501
If my explanation is not clear – please let me know!
Welcome to the site. I certainly understand your anger and frustration. I experienced the same emotions at many points through my wife’s CC journey (she got ill in April 2011).
If I can give you one piece of advice, it would be this:
Try your best to manage your stress and frustration. Relaxation techniques, yoga, long walks in the park, whatever works for you. Your father needs you in the best possible shape. Daily stress can be very harmful. We all know it but tend not to take it seriously. Just so you understand where I’m coming from, I will mention this. I had a cardiogram in May 2011, one month after my wife got sick. It was perfectly normal. I had another one in November. It showed some abnormalities in the heart. Not something one would expect at age of 44. Looking back, I did a very poor job of keeping my daily stress and frustration under control. Hopefully you don’t fall in the same trap.
My best wishes to you and your father,
EliMarion,
The classic Whipple resection removes all the organs you mentioned, plus it also removes pylorus (the bottom part of the stomach).
Some surgeons perform a newer version of Whipple that preserves the pylorus. The jury is still out which version is better.
My wife had the classic Whipple, i.e. her pylorus was removed. Our surgeon said that clinical trials of the pylorus-preserving Whipple failed to demonstrate any tangible benefits in terms of recovery, quality of life, etc. He thinks the classic Whipple is better from oncology point of view… less chance that cancer cells are left behind in the pylorus.
Eli
Stacy,
There are lots of important questions you can ask your surgeon. But… if you are going to see him the morning of the surgery, I say leave the poor guy alone.
Let him focus on the task at hand.About your FIL. Fully agree with Marion and Lainy. There’s only so much you can do.
Good luck on Monday and please keep us posted.
Best wishes,
Eli
