jscott

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Viewing 15 posts - 61 through 75 (of 124 total)
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  • in reply to: Proof of concept — Experience sharing wiki #78377
    jscott
    Member

    Percy,

    You ask a very good question:

    “The key question I think is do you want the wiki to be more medically related or experiences related? and what will be the difference or relationship between this discussion board and the wiki if any?”

    Frankly, I am not sure the answer. It could be both, or it could be one or the other. As I hear experiences from other CC warriors, and as I do my own research, I just have a strong need to record that information somewhere so it hopefully can be helpful to others.

    During those times when I feel like I need to work on it, the wiki gives me a way to (at least feel like) I am making a contribution.

    How it ultimately evolves, is anybody’s guess. I am open to any and all suggestions though :)

    Jason

    PS — Just as an example, I updated the clinical trials page to include the information Marion posted on financial assistance from lazarex. I also added the “cryoablation” link you posted to the “other procedures” page. It only took a couple of minutes, and maybe it will be found by someone down the line.

    jscott
    Member

    Hi Caroline,

    Those trials look interesting. I did some quick research on Cabozantinib, and it does look effective in other cancers.

    My understanding of conventional wisdom is that cholangiocarcinoma behaves somewhat similar to pancreatic cancer (I do not know if this is well supported or not although our first oncologist believed it). In any event, here was an interesting study looking at cabozantinibs impact on pancreatic cancer cells:

    http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3674365/

    What I thought was noteworthy was
    -The strong response of the cells to cabozantinib
    -The long-term viability of treatment (cancer only slowly created resistence)
    -Cabozantinib seems to re-invigorate Gemcitabine effectiveness

    Of course there is a big gap between lab and clinic, but it did look promising.

    If your mom does choose a clinical trial, please keep us up to date. Any information that could help dispel the great unknown of a possibile clinical trial would be very helpful.

    Best wishes,

    Jason

    in reply to: Question for folks who have done Gem/Cis #78460
    jscott
    Member

    Hi Mary,

    I agree with the others that there is a wide range of possible reactions. I wrote up the experience my wife had, and I also included a few other gem/cis experiences here:

    http://cholangiocarcinoma.wikia.com/wiki/GemCis

    My wife’s experience was that it was very tolerable, and we were able to do lots of travel etc (especially on the off week). I think this is on the positive side of possibilities though.

    Jason

    in reply to: Proof of concept — Experience sharing wiki #78373
    jscott
    Member

    Hey Gavin,

    Just to clarify, I was trying to get some of Percy’s great information into the wiki, but I don’t think Percy has had a chance to look at the wiki yet. Hopefully, Percy can take a look at the info and add / edit anything that needs fixing.

    Best,

    Jason

    in reply to: Proof of concept — Experience sharing wiki #78370
    jscott
    Member

    Thanks for the comments and suggestions.

    Marion:
    Editing the wiki is pretty similar to making a post on these forums.

    When on an existing wiki page:

    You can either choose to edit the whole page by pressing the blue “edit” button at the top of the page, or you can edit a specific section by clicking on the small “edit” link by that section.

    When editing a page, a message box will appear that contains the current content of the page or section. Make your changes in this box. I like Wikia because they use an editor that makes editing similar to using MS Word.

    Once done adding your edit, you can either “preview” your changes or “publish” your changes. NOTE: nothing changes until and unless you publish your edits.

    Creating a new wiki page:

    When you are on a new wiki page (say by clicking a “red link”) you are asked if you want to start with a blank page or use a template. I usually start with a blank page. It is probably easiest to first go to an existing page and copy the content (press edit, select all, copy with crl-c). Now you can go to your new page and paste (ctrl-v) the old page content and use that as a template.

    It might sound complex, but it is really very easy. Again, no worries if you make a mistake. Rolling back changes or updating pages is easy for me to do.

    Willow:
    The main advantage I see is that the wiki is organized into more specific categories, and the wiki pages themselves are further organized into research vs experience areas. For example, figuring out where in the “chemotherapy” forum one would go to find out how gemox is affecting patients could be daunting. With the wiki, you select the “chemotherapy” page which then provides a link to a specific “gemox” page.

    Randi:
    You make a great point. I was a little bit hesitant to try and add research and science to the wiki mainly because I don’t feel expert enough. I also am concerned that the forum members may not feel comfortable contributing to that type of wiki. Organizing patient experiences seems both very helpful to future patients, but also something everyone can contribute to if they want.

    I take the point though that experiences could become unwieldy, and patients may be more interested in information that is backed up by experiences.

    Perhaps I should organize each treatment page into three sections:

    Section 1 — Treatment summary (with external links to summary information) and available Research (with links as well)

    Section 2 — Experience summary. This is where I or whoever is working on the particular page tries to summarize all of the available experiences into helpful information.

    Section 3 — Patient experience details. This is more of the patient experience free-form that I have illustrated so far.

    What do you think of that type of organization?

    Gavin:
    Have you really seen wikia links?? You are the google whisperer! I had thought it was under the radar :)

    Jason

    in reply to: im speechless #78415
    jscott
    Member

    Wow! That is so awesome.

    Jason

    in reply to: Newly Diagnosed #75810
    jscott
    Member

    Judy,

    I think they do y90 for pretty large tumors, but it might depend a bit on where it is situated. At diagnosis, my wife had a number of tumors, the largest of which was 9cm. The plan at the time was to use y90 if chemo did not work. I don’t think size would necessarily prevent the procedure in Ron’s case.

    As far as combining gem and capecitabine (xeloda), there has been some research on the combinations. This chart has references to lots of the chemo trial research:

    http://www.discoverymedicine.com/Daniel-M-Geynisman/files/2012/08/discovery_medicine_no_74_daniel_v_t_catenacci_table_1.png.jhtml?id=2

    GemCape and Gem/5FU are the ones relevant for your question. It looks to me like the combination does have a reasonably good response profile.

    Hope that helps,

    Jason

    in reply to: GEM/CIS, now imrt, then what? #77591
    jscott
    Member

    IMRT and Y-90 are different radiation treatments.

    IMRT is an external beam radiation treatment.

    Y-90 is an internal radiation treatment where beads imbued with yttrium-90 are released in the artery feeding the liver. Since cancer cells are heavy blood “drinkers,” the beads lodge in the tumors and the Y-90 radiation kills them.

    The different radiation therapies are very confusing and use a LOT of acronyms!

    This link is a very good overview of the different radiation options:

    http://www.cancer.gov/cancertopics/factsheet/Therapy/radiation

    Jason

    in reply to: Medical Records #77289
    jscott
    Member

    Very good idea to get a copy of your records. It makes getting additional opinions much easier.

    Some tips to consider:

    -copy the image CDs to a computer. I create a folder with an appropriate date / name (e.g. 2013 11 23 CT scan) on the computer and the copy everything on the CD over to that folder. You can then use that computer to make copies of the CD image files as needed.

    -Scan all the records into .pdf documents if you can. Again, I find a date / name format works well (e.g. 2013 11 23 CBC labs). Naming things by starting with the date will keep all your records in chronological order.

    -I get lab reports through the hospital website. Not sure if this is available at all hospitals. I print them out and then scan them.

    -DROPBOX – this was a great help. I copy all records / image files to a folder on dropbox. That way, I can get any record I need from any device (computer / phone / ipad / whatever) from anywhere.

    It is probably a bit of overkill, but it helps to get quick turnaround for 2nd opinions.

    Jason

    jscott
    Member

    Thanks Lainy!

    I will give those a try.

    Jason

    jscott
    Member

    Dang it!

    Why does it always have to be brocolli and cualiflower that are good for you rather than beer and pizza! :)

    Jason

    in reply to: Is anyone taking cabozantinib (cometriq)? #77572
    jscott
    Member

    Were any of the prior chemotherapies initially active?

    This looks like a relatively safe compound that could potentially make a previously active chemo active again:

    http://www.cancerresearchuk.org/cancer-info/news/archive/cancernews/2013-10-02-Blood-pressure-drug-improves-effect-of-chemotherapy-in-mice?view=n-and-r-homepage

    Here is the research article:

    http://www.nature.com/ncomms/2013/131001/ncomms3516/full/ncomms3516.html

    There is also a trial ongoing with this compound, although I think it is in combo with radiation.

    Hopefully someone from the Cabozantinib trial will post a response to your question. Trial results, even partial results, would be so helpful to hear.

    Take care,

    Jason

    in reply to: Great Results #77586
    jscott
    Member

    Interesting article, although it is from 2006. I wonder how things are going for that group?

    Jason

    in reply to: Finally delurking – husband has nonresectable CC #77384
    jscott
    Member

    Hi Mary,

    My understanding is that Gemcitabine + Cisplatin is the standard first line treatment. I would ask your oncologist the rationale for going 5fu + radiation instead of gem/cis.

    There could be a very good reason, but I would want to be sure I understood the logic.

    Best of luck,

    Jason

    in reply to: chemo question #77305
    jscott
    Member

    My wife is doing 12 cycles of gem/cis.

    The tumors have shrunk and the remaining lesions look inactive on a PT/scan. The plan after 12 cycles is to do IMRT radiation on the main tumor region and switch to xeloda chemo.

    I think different institutions have different theories about what to do next after success with Gem/Cis. Some would say keep on a chemo that is working (we had an oncologist with this philosophy). The advantages I see for switching up the strategy are:

    1 – The radiation can hopefully kill cancer cells that are developing some chemo immunity before they become fully immune.

    2 – My wife gets a break from gem/cis (improves blood counts and hopefully quality of life since Xeloda is milder for many people).

    3 – We have a chemo that is known to be effective in our “back pocket” if things go sideways in the future. (i.e restart gem/cis)

    4 – Some evidence that survival times independently associated with number of different chemo regiments employed (although this is speculative imo).

    I am comfortable with our strategy, but by no means do I think it is necessarily best. After success with gem/cis, I think there is very little in the science that is definitive. We all just have to work with our docs and make a call on what approach we feel most comfortable with.

    Jason

Viewing 15 posts - 61 through 75 (of 124 total)