pcl1029
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Hi,
I can only say this, the chance are very remote, that you should worry about the liver worms for your sons. It is a local eating habit in that area that takes decades of eating raw fish to develop CCA. The CCA disease is more prevalence in the north of that country than the south part of that country .
Try to avoid inexpensive frozen fish from unknown place,skip raw fish preparations like sushi. Japan is also high on the list as well as all the south east Asia nation like Taiwan ,Hongkong, Thailand, Vietnam ,and China coast cities.
Here in the States, PSC is one of the risk factor that CCA is associated with.
In short, don’t worry.
God bless.Hi,
if you are interestedConclusions by the author: This dosing schedule of FDR gemcitabine plus capecitabine is active in patients with advanced pancreatobiliary cancers. Given its favorable toxicity profile and convenience, this regimen represents an appropriate front-line option for this patient population and may serve as the foundation on which new investigational agents are added in future trial design.
http://www.oncologystat.com/journals/journal_scans/Role_of_Gemcitabine_Based_Combination_Therapy_in_the_Management_of_Advanced_Pancreatic_Cancer_A_Meta_analysis_of_Randomised_Trials.html
“Interpretation by the author.”
The combination chemotherapy as compared to gemcitabine alone significantly improves OS in advanced pancreatic cancer (APC). However, this advantage is marginal whereas the treatment-related toxicity is increased, suggesting the use of gemcitabine-based combination regimens only in selected patient populations. New prospective trials, based on translational approaches and innovative validated biomarkers, are eagerly awaited on this topic.P.S. Even it is not for CCA,but as you all know , most of the regimens,if not all,for CCA are coming from pancreatic cancer protocols with variations.
God bless.
Hi,Gavin,
If you don’t mention the above link , I will never know. thanks.
Say hi for your mum for me.
God bless.Hi, everyone,
and for those who are new here; I finally finished the revision of “Systemic treatment in general for cholangiocarcinoma patient.”
I have added “side effects” and “drug-drug interactions” to cetuximab, Avastin, Gemzar and irinotecan among others.
Please remember,it is just used for references ,therefore you may or may not get any side effects for the chemotherapy agent you take.It is an individual thing for each patient. with regard to the regimens and protocol,remember oncologist can change it to fit the need of the patient, and this is why we ,as patients, need to see the doctors .
God bless all of you.Hi, Gavin,
Very interesting article about IAC or CCA ;Confused and new to me about IAC:
However,there is a very comprehensive discussion about CA19-9 which I found useful.
As always,please say hi t your mum for me.
God bless.Hi,
I think, when in doubt like in your case,go for a 2nd opinion by another GI or liver specialist may be needed. Major hospitals like John Hopkins or Mass General hosp. or New York Pres. hospital etc.
I do not think I can provide any good answers for you.
God bless.Hi,
Below, separately, it may helps a bit.
http://www.ncbi.nlm.nih.gov/pubmed/20164661
http://www.ncbi.nlm.nih.gov/pubmed/17551313
http://www.springerlink.com/content/b201535t2700r972/
God bless
Hi,
May be he is too tired or the ammonia level is high in his brain due to the disease advance. Since I am a patient, and if I am in the same situation, I will call the doctor to see what hIS/her suggestion will be ; insist to talk to the doctor right away, then you will at least get the office staff moving a bit quicker for you to page him sooner. If he still sleepy or confused , call the doctor again to see to bring him to ER is needed if he still very sleepy and confused.
BTW, if he is just too tired, he will respond to your questions and his answer will make sense; in that case you may not need to worry too much. But if he looks confused and the answers do not make some sense, then I will call the doctor.
Hope the above suggestion helps a bit.
God bless.Hi, Lainy and Gavin,
I know for sure fish oil can help lowering of my high triglyceride level; my Gp ask me to take fish oil and it does lower the level as the lab results indicated.
But I eat fish once or twice a week instead when I am on Xeloda now; I do not want to have any drug-drug interactions between fish oil, Xeloda and Oncozac.
BTW, the link below may help unswer Lainy’s question better than me.http://www.nlm.nih.gov/medlineplus/druginfo/natural/993.html
God bless.
Hi,
I am a patient too, hilar CCA if not mets to other part of the body, will stand a chance of surgery which is the only possible cure for CCA.
However, this cancer is relatively rare and experience counts a lot in treating this cancer. So if I were you, I will seek the MOST experienced specialist first for help, where a medical professional trained from may not be as important as how many cases of hilar CCA they had treated before. So ask all of the doctors the same question above and if you satisfy the numbers of the patients of CCA they saw, then stick with them. If not, here is my suggestion. For everything in one place, go to John Hopkins for a 2nd opinion for liver surgical consult,then interventional radiologist and finally medical oncology consult in that order.Finding this web site is a first step, finding the best way to handle this cancer is the final solution.
Keep in touch and
God bless.Hi, Lainy,
Thanks for your counseling , I really need such encouragement, I think that is the result of ” the more you know, the more you know what the limit of human intervention can be.”
My wife helps me in letting me do what I want to do and try to keep all other house work done so I need not be worry about other thing except myself. So it is a partnership and I always appreciate. Thanks for asking , I am sure without her help, I will not be the same now.
Again, thanks for your support .
God bless.Hi,
From a medical professional to another.
I think the order of the speciality you mentioned which to see first is not that important in your case. For the type of cancer your husband and I had, the CCA,
I think ,if I were you, I will go to Dr. Kato to get his opinion about surgical opinion first . If the answer is no, then I will concentrate on finding interventional radiologist for the latest radiation treatments available in your area( since the advancement in radiation treatment is much faster than chemotherapy.). If the answer is still no, then medical oncologist . I am ,as you know, a patient of CCA,I truly understand your husband’s ” go fishing” feeling especially he has seen them all what had happened in ICU over the years.Sometimes ,as your husband may agree,”, too much may not be a good thing ” after all.
Good luck and
God bless.Hi,
In general, a complete response rate is 100% tumor shrinkage occur;
Partial response is >30% in tumor shrinkage after chemotherapy or radiation treatment.
But as a patient, I do not think that much about the overall response rates due to cholangiocarcinoma is a tough cancer and the recurrence rate is between 50-75% even after resection.(surgery), not to mention if it is unresectable .So for ME, it is meaningless to look at the response rate but rather how the patient feels at a particular point during treatment. If the patient feels good that day;that means “the quality of life” for that day is good even it is on the chemotherapy the same day.
I may sound a bit depressed to most of you who read my messages , if so,I am sorry; but even I am now is clean and taking only “maintenance chemotherapy”. I never say I am cancer free for the reason I know I have to always guard against this difficult cancer due to its high recurrence rate. Of course every patient is different in his/her overall health status,eating habits and other risk factors; So what I said may not apply to all of you.
Thanks and
God bless.
