Eli
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Willow, I agree with Lainy, no one but the oncologist can tell you. They may not know it either. If the nodes are positive, it’s automatically stage IVA. If the nodes are negative, the stage depends on the tumor number (T). Not sure if they can determine it accurately without “opening her up”, as you said in another thread.
Percy, thanks for your comments.
This recent paper contains a very detailed, technical discussion of various staging systems:
Clinical diagnosis and staging of cholangiocarcinoma
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3331791/#S6titleI always say that my wife is in remission. I never say “cancer free” or “survived cancer” because I’m afraid to jinx her.
Superstitions aside, I think that “in remission” is the most accurate way to say it from the medical point of view. There are no tests to say for sure that a patient who had resection is completely free of cancer cells.
Dianne,
Ask the oncologist if you can replace Reglan with Compazine. Both have the same purpose: control nausea in between Zofran dozes. If I remember correctly, our oncology nurse told us that some people tolerate Compazine much better than Reglan.
Note though, it’s VERY important not to take Reglan and Compazine together. They interact with each other. The side effects (tardive syskinesia) can be sever and irreversible.
Eli
Just realized something:
The current staging system (AJCC 7th edition) was published in 2010.
Prior to 7th edition, intrahepatic CC didn’t have its own staging system. It was staged the same way as liver cancer (hepatocellular carcinoma = HCC).
2009 diagnosis of ICC must have used HCC staging.
But…
HCC doesn’t have stage IIB either. It has stages I, II, IIIa, IIIb, IIIc, IVa and IVb.
Hi Bruce,
The article that you linked talks about stages of bile duct cancer in general. It doesn’t make the distinction between intrahepatic, perihilar and extrahepatic CC. This is not quite accurate.
Each sub-type of CC has its own staging system. You can find the staging systems in the NCCN Guidelines. Stage IIB is a valid stage for ECC, but not for ICC.
Hope this helps,
EliBruce,
The post that you found could have been in error. Another possibility, Stage IIB referred to an older, outdated staging system. Staging systems went through many updates.
You can find the current staging systems for ICC and ECC in the NCCN Guidelines. ICC system is on slide 27 (labelled ST-3). There is no Stage IIB.
Stage II is T2 N0 M0. Stage III is T3 N0 M0. There is nothing in between.
Alla, you are welcome.
I’m not sure if you saw the Ball in a Jar story. I think it’s very powerful. Trying showing it to your son:
http://www.cholangiocarcinoma.org/punbb/viewtopic.php?id=7667
Here’s the link:
(I removed a dot at the end of the link and that did the trick)
Hi Percy,
Here’s the 1st paragraph:
Quote:I have switched from infusional 5-FU to Xeloda as preoperative therapy for rectal cancer.Bold font mine.
This is not a blank recommendation to choose Xeloda over 5-FU in all types of cancer.
Most top hospitals in the United States offer special services to international patients. The two hospitals that you mentioned are no exception.
http://www.massgeneral.org/international/default.aspx
I’m not sure if you realize this or not, so I’m going to say it like it is. Paying out of pocket for cancer treatments is VERY, VERY, VERY expensive. You need to be well-off to be able to afford it.
This is just a guess and I may be completely wrong:
Radioembolization delivers a very high dose of radiation to a small area. Radiation damages the body tissues. The tissues become “dry” and brittle. It is possible that the damage to the surrounding tissues is bad enough that the surgeon might not be able to make the new surgical connections.
My wife had external beam radiation after her surgery. Compared to radioembolization, external beam radiation delivers a much smaller dose to a much larger area. I don’t recall who told us this – either radiation oncologist or the surgeon – but the message was that any subsequent surgery would be very difficult technically due to radiation damage.
