pcl1029
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Hi,Kathy,
On Dec.2010,FDA approved for a SINGLE day administration of fosaprepitant 150mg(IV form)+Zofran and decadron; In a phase 3 study of 2247 patients who were receiving cisplatin(>70mg/m2) based chemotherapy.BTW, the average of cisplatin for CC is between 25-75mg/M2.
The control group received the standard aprepitant administration in the standard three-day schedule with Zofran and decadron.
Preliminary result indicated complete antiemetic response were nearly IDENTICAL between the two groups.(72.3 vs 71.9%)-from literature review rervsion.19.1 :Jan 2011-Prevention and treatment of chemo-induced N/V .
So you can ask your doctor to see whether this SINGLE DAY SCHEDULE is good for you.Hi,
Take care and thanks for caring your friends.
BTW, if I may suggest,especially to the spouses of the patients;or caretakers over 50 and live with the patients . It will not be a bad idea for you to have an ultrasound of the liver or abdomen(the cheapest way) or a CT scan with CONTRAST of the abdomen and pelvis. In this way it will eliminate the possibility of environmental factor such as diet(seafood especially),water or air contamination.
God bless.Hi,
If your need hepatobiliary surgical consultation in the Chicago area,
You can try my surgeon,Dr.John Brems 224-783-5500;or his personal nurse Holly at 630-715-7253.
He is a professor in surgery at Loyola;He performed over 700 liver transplants and over 1000 liver and pancreatic resections;soft spoken and above all respected by his GI peers.
God bless.Hi,Lainy,
Thanks for your cheerful welcome.
I am a little bit tire,but beyond that I am as good as new.
They find no cancerous growth base on the pathology report;may be the RFA and chemoembo did a good job.
It took only three hours for the surgery and Dr.John Brems did honor my request to have 10 additional unstained slides prepared for my future needs.
On the other hand I don’t know how many of you will do the same request I did,
I finally meet my enemy face to face,I ask Dr.Brems to take 3 pictures to show me where my cc is( I saw my own liver finally); the cc after they cut it out and
another picture just after the removal of the CC; it is very interesting and valuable to me because I like biology,chemistry and I like to take pictures too.
Thanks for your cheerful welcome once again.
God bless.
becaHi,
I STRONGLY second to Lainy’s suggestion.
get all the surgical,pathology reports,CT scan and MRI and labs and get a second opinion for Barnes Jewish Hospital as soon as possible.
they are better equip to due with CC.
God bless.Hi,
Thanks to everybody’s prayer fingergcrossing everything and kind thoughts,I have just been released from the hospital.
Everything were fine;surgery only took 3hr.same Dr.John Brems and his team;Just very tired;they put me on liquid diet the whole time.
God bles.Hi,
Gavin lives in Scotland,I Think his help is valuable .you can connect with him.
What stage the ICC ? Besides chemotherapy,radiation,chemoembolization are other choices.2nd line chemotherapy like 5FU alone or in combination with other chemotherapy agents in the platinum group or with molecularly targeted agents like Tarceva are other choices.
As always,consult doctors for 2nd or 3rd opinions are highly recommended.
God bless.Hi,
Please read my e mail reply to you ASAP.
I will be out for a few days from this board if you need information From me after today.
God bless.Hi,
Hilar cc is a subgroup of ductal cc under extra hepatic cc.
Did he has fluid in the abdomen instead of stomach?
Is he constipated?Did he pass gas? 5 liters of fluids from the stomach instead of abdomen? Did his doctor give him lasix and or Aldactone(diuretics)to relieve the swelling of the legs and abdomen ?
Again consult doctor first before making any change .
God blessHi,
BTW, Levaquin will be available as GENERIC in the States on July ,2011.
one of the generic drug companies which will manufacture levofloxacin is Hospira .
And it would be much cheaper than the Brand-name Levaquin.
God bless.Hi,
It is a very good summarization and uptodate of the current CC treatment plans.
If your mom has the combination type of CC and HCC; Can you ask the doctor why or why not using sorafenib also.
The use of cetuximab and Gemox that you quoted to have a 63% response rate for the 30 patients;you also mentioned about the Malka study of the same regimen for 50 patients but only has a 11% response rate .I think it has a lot to do with the patient’s population in each study. You may ask the doctor is this a good choice of regimen for your mom. But remember,targeted therapy like cetuximab or erlotinib or sorafenib do come with toxicity and drug resistance and these are important things that needed to be consider before the use of them.
“Nine patients of the Gruenberger study had sufficient shrinkage to permit a later potentially curative resection,but long-term outcomes were not reported.further study of this combination is warranted”–from”systemic therapy for advanced cholangiocarcinoma” Jan 2011 uptodate.com .
Again, thanks for this concise info. for CC.
God bless.Hi,
If you can ask the doctor what is the result of the” swallow evaluation”; then you may have some idea why she cannot swallow.Most of the doctor will order that swallow evaluation when patient cannot eat or drink or swallow while they were in the hospital in U.S.
Zofran comes as ODT oral dosage form and you can just put it over your daughter’s tongue and it will dissolve itself into the blood stream without swallowing;it is for nausea and vomiting.Other medications like dexamethasone and reglan do come in liquid oral dosage form.
As a patient,I can say no matter how mild the side effects are; chemo is absolutely not a pleasant experience no matter what drugs are used.
God bless.Hi,
Surgery provides the only possibility of a cure;radiation treatments are options for LOCALLY advanced CC; systemic chemo are options as adjuvant or neoadjuvant treatments for patients with or without metastatic tumors.Liver transplant is another option but I do not think your brother will be qualified based on his current condition.
The only other option is to join a clinical trial at the university hospitals or clinics locally.
Again,the above is for information purpose only;consult your physican before any change is a must.
Sometimes the patient’s gut feeling or instinct may serve him well;only your brother can decide what the next step will be. As a Patient MYSELF,I,with God’s grace, always try to compare my” quality of life” against of “the length of time I wish for.”
CC is a long and winding journey that required courage ,knowledge and wisdom to navigate and the outcome is always in God’s hands.
God bless.Hi,
As always,this is for information purpose only,consult doctor before any change of treatment plans is a must.
Gemzar or gem/cis do not seem to offer an advantage for ductal cancer
(eg hilar CC) patients as for intrahepatic CC patients; 5FU is another alternative of chemo treatment commonly used. So it is ok to use 5FU instead of Gemzar. It is not stronger than Gemzar;it just works differently. 5FU can be combined with other chemo agents like cisplatin and it also comes as an oral dosage form called capecitabine (xeloda).
Again, systemic chemo is only one of the ways to due with CC;other option for ductal CC included radiation treatments like PDT,EBRT,SBRT and clinical trial.
If you can, get a 2nd opinion on using radiation as treatment opinion may not be a bad idea because your mom is only 47 years young.
CC is a long and winding road that requires patient , courage and knowledge to navigate .If you look at CC as a CHRONIC disease,then you will feel more positive about the situation and have more energy to help your mother in the long run.
God bless.
