mparsons

Hi LadyLinden,

Yep. The bump is there to stay. I’m pretty thin these days, so mine really sticks out. When I get accessed, nurses often ask, “Where’s your port?” I just unbotton the top of my shirt, and then there’s often a little giggle, as if to say, “Well, never mind, no one could miss that!”

From the parts of the procedure I recall, there’s a bit of pushing around to get things positioned the way they want. I could see that causing some initial swelling and bruising in some cases. Anyway, I assume the improvement with yours means all is well, and the area of the procedure is just settling down.

Mark

Hi Beardme,

I’m sorry to hear about your husband’s diagnosis. I too had a Klatskin tumor, and was first evaluated under the transplant protocol at UCLA. Because of lymph node involvement, I was also dropped from the protocol, which is not atypical. More surprising to us, they were unwilling to do a resection because of the lymph node, and elected to put me on palliative care. Before agreeing, we sought a second opinion at USC with Dr. Robert “Rick” Selby. He did two resections on me, including a lymphadenectomy.

So, if the lymph node involvement is the only reason they refuse to do a resection, I think you are exactly right – you need a second opinion from a more aggressive surgeon. I can only recommend two surgeons, one in Los Angeles (Selby) and one in Pittsburgh (Dr. Wallis Marsh, UPMC), with whom we had consultations and they agreed to surgery. Hopefully, others will chime in with recommendations closer to you.

Best wishes to you and your young family. You will be in our thoughts and prayers.

Mark

Hi,

I live out in your area, and the hepatologist who diagnosed me two years ago is a USC doctor in Riverside, Zeid Kayali. I am glad that your husband was diagnosed early stage. Resection should be a real option for you, and surgery is the best possible treatment for this disease. I’m also glad you are hooked up with a surgeon experienced with cc. We will hope for a good report in November.

If UCI says no to surgery, get a second opinion! I’d recommend Dr. Selby, Chief of Hepatobiliary and Pancreatic Surgery, Abdominal Transplantation, at USC, if you can work out insurance. He did two resections on me with more advanced stage disease when others, including UCLA, had said no.

Best wishes to you and your husband. Mark

Hi Lisa:

I am so sorry to hear about your diagnosis, but am pleased that your team of physicians seem to be moving so quickly with your case. I spent too much time with my community doctors at the beginning, which slowed my diagnosis. Once I got to an academic medical center with knowledge of the disease things moved very quickly. It sounds like you’re in a good place.

The itching was my first symptom and, for me, the worst. They may do an ERCP on you and place a stent, which should give you good relief. For various reasons, that was only partially successful for me, and I’ve had somewhat elevated bilirubin during the entire two years I’ve been fighting this cancer. Two different physicians tried the usual treatments of cholestyramine and antihistamines with no real benefit. My hepatologist at USC put me on Rifampin. It is considered a second-line treatment for pruritis in these cases, but even so few physicians seem to know about it. He has a number of end-stage liver disease patients on it successfully, and it has been 100% effective for me. No itching! Anyway, if itching continues to be a problem, it’s something you could ask about.

Best wishes to you as you proceed toward treatment. You will find great wisdom and support here.

Mark

Hi Patti:

I’m sorry to hear about the bad side-effects of Xeloda for you. I did well on it for several months last year, but I know it has been hard for others. I am currently on Folfox. The Folfox protocol includes oxaliplatin and folinic acid infused, and then 5-fu on a pump for 46 hours. I have advanced-stage metastatic disease, and have done seven rounds of Folfox since mid-June. Happily, where I’ve had no response to other chemo agents like Gemzar, we have seen shrinkage and stabilization with Folfox.

That said, I have had side effects, including bilateral neuropathy (fingers) from the Oxaliplatin, and lately more fatigue and nausea from the cumulative effects of the chemo. I am currently skipping a round to recuperate (and get my platelets out of the basement).

That has been my experience, and from others I’ve talked to it’s not atypical. The good news is that for some of us this cocktail seems to be effective where other agents have not, which has made some of the negative effects seem more tolerable. Of course, everyone is different, so we will hope you have very limited side effects.

Wishing you the best, Mark

Hi Stan,

A year ago, I went through 25 radiation treatments of the liver with Xeloda. I tolerated it remarkably well for the first few weeks. I had severe fatigue the last week or so, and for a couple weeks after treatment. Other than fatigue, I had no other significant issues. I hope you do well. Keep us posted.

Mark

Hi Cathy:

I am having the usual sensitivity to cold from the oxaliplatin. I had no problem on the first round, but have experienced it with the four rounds since then. For me, that begins immediately during the infusion of the ox (don’t accept that cold drink the volunteer brings around), but only lasts a few days and has been quite manageable. I know others can have more severe neuropathy, but that has not been my experience.

The 5-fu pump does not perhaps rise to the level of being a pain, but merely a bit of a nuisance. I am always glad when I get to disconnect. That said, I spent months last year with a PTC (percutaneous transhepatic catheter) and its attendant bag strapped to me. By comparison the pump is easy. Plus, at night the gentle whirring sound can be soothing!

Mark

Hi Cathy,

As you said in another thread, it doesn’t seem like there are that many with bone Mets from cc, but I’ve been told it’s common. Given how quickly my bone Mets developed, we took lack of growth on Folfox as a very positive result. Most positive of all, I had considerable bone pain in the spine and sternum, and that was greatly reduced after just two rounds of Folfox. I hope it works well for you. As far as toleration, one reason I am on Folfox is my liver numbers have been elevated for a year now following Gemzar and radiation. Folfox is cleared by the kidneys, and my liver functions have remained stable. Like you, my platelets are very low, but my platelets have also been stable in five rounds of Folfox. I’ve had mild neuropathy, some fatigue and nausea, but all quite tolerable.

That’s been my experience…I hope that helps and that you do well.

Best wishes, Mark