pcl1029

Hi,
May I ask what are the names of ” all anti-nausea meds;” your mom had taken.
If I know the names, I may be of help to you in finding something for her nausea/ vomiting issue.
God bless.

Hi,
No body wants to wait 4 months or so for treatment. Cancer cells divide and multiply at a rate of doubling its size every 3-4 month in general ; Most CCA are of the slow growing kind, some are faster and some are slower.
My personal experience was ICCA grew from nothing to a size of 2.5x3x3.5cm in about 10-12 months on my second resection of the liver. But I saw other member on the board that his/her ICCA grew about 2cm each in two dimensional description(ie: from 11x12cm to 13x14cm ) in just 2-3months time. ECCA are in general smaller in size, more lymphatic and perineural involvement as compare to ICCA.
Ca19-9>129 is indicative of cholangiocarcinoma (CCA) if not definite.
Oral capecitabine may be of value if Gemzar don’t work.

I am only a patient and by no means have the expertise of a medical doctor.And of course the health system is different from the States and your country,therefore it may have difficulty to get capecitabine approval for such use by your oncologist in Australia without tumor appearance.
In the mean time, you can try Oncozac, an immunomoderator without prescription ( get info. from the internet )to boost the immunity of your father’s immune system.
I hope the above info helps.
God bless.

Hi,
As long as the size of the tumor are In general, the size of the tumor double in size every 3-4months,not counting the growth of the tumor density because the lack of data.
RFA is a very easy procedure to take, patient can go home the next day and not much pain or suffering afterwards.That is at least holds true for my experience. But of course, if the sizes become bigger,then surgery is much preferred.
God bless.

Hi,
The medical term for radiation treatment hypersensitative skin reaction is called ” radiation recall dermatitis ” RRD in short.
If the radiation involved an IV chemotherapy,ie: 5 FU then the RRD will appear early ( minutes to 14 days) and usually last for a couple of weeks. But if the chemo sensitized agent is by mouth ie: capecitabine , then will have a longer lag period( a few days to two months) and may last for months—uptodate.com
BTW RRD may also related to the radiation dose patient received enough to trigger the RRD to occur.
Another reaction is called ” radiation enhancement” by which the hypersensitity SIDE EFFECTS resembles RRD. It can be localized or extend beyond the irradiated field.
God bless.

Hi, Kris,
You are a happy warrior , your positive attitude shines through in your message yesterday even the result was not what you expected. It takes a lot of courage to report those unexpected occurrence.
This disease is unpredictable ,difficult to diagnosis and prognosis is uncertain. But there are more research being done for this disease and hopefully some good treatments will pop up in the future for all of us. However a magical bullet is still far beyond reach .That is why I pray each nite and thank Him for the good fortune God give me all these extra days since my diagnosis in May,2009. Only He knows when the time is come for each of us. your joyful spirit and courage will lift up a lot of others on this board. Thanks and
God bless.

Hi,
Where is your mother currently receive the diagnosis and treatment suggestion? and who are the doctors?,It will be useful for other patients if they are in the same situation and areas looking for help.
Since your are in the Chicago area and I am too. I will recommend Northwestern Univ. interventional radiology consult if you are ready to go for radioembolization. they are the leader in this field internationally.
However, the patients over the age of 65 on this board who had received radioembolization with Y90 did not have the best outcome that we hope for,especially with other health issues involved. This will my only concern for your mother. Quality of life over quantity;providing the best supportive care are also viable ideas, But most of the medical literature will tell you age is not a risk factor in deciding treatment plans but comorbidity does. If your mother’s tumor s do not metastasized to other parts of the body, without treatment, there is a good chance that she can see her 79th or even 80th birthday apart from counting in the other health issues. CCA is a relatively slow growing cancer, In my case, my most recent resection in 2010 indicated it ,the tumor grew from nothing to a size of 2.5x3x3.5cm in roughly one year.
I am a patient of this disease for 46 months now but make sure you understand I am not a doctor but just a patient having the same disease as your mother. so my observation is purely on my own without medical research to back me up. therefore medical oncology and radiology consult are needed if you want to make a sound medical decision.
God bless.

Hi,
It is fine to use anticoagulant like Coumadin, Arixtra or enoxaparin sodium (Lovenox) oand a newer type of anticoagulant like rivaroxaban (Xarelto) as prophylaxis in DVT (deep vein thrombosis) and the formation of blood clots in the portal vein.
It is common that cancer patients have coagulant problems and thus warrant to use of blooding thinning agents on a long or short term basis. It is that often used sentence in the medical fields that ” the benefit out weight the risk” is the suggestion or reason to use medications, and this is one of the example. Management of the side effects by your oncologist is the key.
God bless.

Hi,
I am a ICCA patient like your MIL and I am not a doctor. I am 63.

If my guess is correct , since your MIL has lymph node involvement, she is in stage IVA rather than stage I, therefore it doesn’t matter how many lymph nodes were found positive. The PNI just mean that the tumor had spread to the nearby nerves and it is not involved in the classification of the stages.

I had 15 mm of clear margin after the removal of the entire left lobe ,14 month of adjuvant chemotherapy after resection and it still came back.
So the 50-70% recurrence is real.

Lainy and Randi ‘s suggestion of 2nd opinions is highly useful. I went to Mayo Clinic by just calling them up, told them what is my diagnosis, what I want to consult with.( for me, after my second resection, I ask for liver specialist Dr. Gores and a medical oncology consult on site there.)

With regard to clinical trial at this point,I do not think you MIL will need that at this time. I will persuit it only when current available treatment regimens failed.
Besides ,for ICCA, there are interventional radiation treatments available.

God bless.