pcl1029
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Hi,
First I am just a patient of this cancer for 39 month and I am no doctor.Based on the last 2 messages that you wrote. the first thought that go thru my head is to let your doctor telling you about the condition of your husband at time of your next appointment; listening to what he said about the prognosis and you should ask specific questions to get the best pictures of your husband’s current disease situation.Below is a web site about asking questions ;please pay special attention to the staging,treatment,clinical trials and support sections. Ask questions about your husband’s PROGNOSIS is very helpful for you to prepare the future for you and your husband of this cancer.
http://www.cancer.net/all-about-cancer/newly-diagnosed/questions-ask-doctorSince I understand your deep concern and want to know before the appointment;here I will provide some of my thoughts which may be completely wrong and different than your doctor. so just regard this info. as part of the educational process for this cancer.
1. the gallbladder has no bile in it ,that means it is not functioning normally;the sludge is like the precurser of the formation of gallstone but now this is not an important issue as compare to the cancer.
2.”Pancreas: There is a regular mass seen in the body and tail of the pancreas. The mass causing occlusion of the splenic vein and encasement of the splenic artery. Significant splenorenal collaterals is noted.” this is the part I will pay more attention to it. It indicated that in the lower part of the right side of the common bile duct( the total length is about 6-8CM long) that closed to the intestine, there is a mass or lesion or tumor (6x3cm) in size, growing in the body and tail part of the pancreas.In short, this mass is located near the bottom of the common bile duct; and that mass pressured the splenic vein(the blood vessel carries blood back to to liver and to the heart and lungs for re-oxygenation )and thus affecting the returning of the blood to the heart.
The other part ‘” encasement of the splenic artery.” is of more concern (the blood vessel supplies the oxygen rich blood back to pancreas,liver and stomach). This artery is encased or surrounded or invaded or blocked by the same mass or lesion or tumor and that may take away the option for surgery.3.”Also, there is a 11mm length area of a severe narrowing or constriction of the distal common hepatic duct just proximal to the insertion of the cystic duct. Proximal to this area of severe near-complete stenosis the common hepatic duct measures about 5 mm. The common bile duct distal to the area of the stenosis measures about 2 mm.” from this message, it described
another area of lesion or tumor (the 11mm long narrowing lesion) just the near to the entry of the cystic duct(the duct where the gallbladder connected to the common bile duct) . this narrowing of the duct is mostly likely blocking the flow of the bile(the digestive juice) from the liver to the intestine
and therefore cause jaundice and itching. BTW, the diameter of the common bile duct is about 5-6mm, and the left and right hepatic ducts are around 3mm wide. therefore from your message description, the report emphasizes ,quoted”this area of severe near-complete stenosis”– this almost means a complete blockage.If you consider the left and right hepatic duct and the common bile duct together is an oak tree( shape like a letter Y); that means there is a tumor(11mm narrowing lesion) on the upper middle part of the trunk and there is a 6x3cm mass at the bottom right of the trunk. see below link for physiology and anatomy if you are interested.
http://en.wikipedia.org/wiki/Common_hepatic_duct
As a patient, I sincerely hope everything will go as smoothly as possible in your way.And I hope the Grace of our Lord, will extend His hand, as He had done to me ,to your husband.
Keep in touch and
God bless.Hi,
I am a patient of this disease for 39 months, so I think my suggestion may be of interest to you.1. Go to the social security office near you and apply disability benefit for your girlfriend. You will get disability financial help since your girl friend had worked 22 years . But the most important benefit of all is that, your girl friend will get the Medicare benefit in 18 month from the date of CC diagnosis rather than at the age of 65.
2. If I were you, I will go to USC now , get the second opinions on surgery, radiation and oncology there and start the treatment there rather than The City of Hope ,especially your financial means is limited. see a liver specialist ( surgeon) first , then follow his suggestion to see the next specialist, radiation or oncology.
Surgery provides the ONLY possible cure for this disease. Don’t waste money on other healthcare institutions if money is of concern. Remember, not all the healthcare institutions are equal of quality esp. for this cancer. And Please forgive me if My wordings above is too strong because I am only a simple man and not good at fine expression. But I care about your situation.
God bless.Hi,
If I may, look up the recommended doctors in different field under our experience forum about UC SAN FRAN medical center.
You need first to see a Liver specialist ( liver transplant or surgeon ) to assess the possibility of liver surgery or resection, for it is the ONLY possible cure for this disease at least for now.
Second, consult a medical oncologist for chemo treatment if needed and third, consult with the interventional radiologist for possibility of treatment.
Do them all down there in San Francisco ; schedule them within the same day or the next day. Bring all your reports and most important, THE CT scan disc copy and blood report.
Keep in touch and
God bless.Hi, Marion,
I don’ know the answer , but I will start to watch this side effect while I will be on the OFF week and compare to the ON week, and of course I will report to your guys about this little experiment .
So far the amount of deposit is not that much, may be twice the amount when people wake up in the morning and look into the mirror in the morning.
God bless.HI,
That is at least a true but minor side effect for me ( corneal deposits developed during chemotherapy with capecitabine.)
Thanks, Marion.God bless.
Hi,
First, don’t panic. the age factor is on your husband’s side,that means,with proper care and follow through;he can fight the battle better and can tolerate the drugs effects better and longer and a lot of the new drugs will be coming out in the next 5 years and hopefully will end this cancer discussion.
You did not mention how your husband discovered the cancer without symptoms; discovered by accidents: or unrelated problems with this relatively rare cancer-Cholangiocarcinoma. it makes a difference in future discussion. Can he have surgery to remove the tumor?;where the tumors are located? any metastasis to other parts of the body?any pre-existed conditions prior to discover this cancer? where your husband be treated now?
If you are living in California,the best place for this cancer is U.C. at San Francisco.
Other caring people will continue to show their support and will talk to you shortly.
but just give you some ideas about me ; I am a patient of this disease for the last 39 months.
My attitude is to treat my cancer as a chronic disease like diabetis or hypertension and read a lot to prepare for my future.
God bless.Hi,
the easier way is to try mineral oil over the counter,ash the pharmacist on duty how much your should take.(IE: 30 ml first and if not work ,repeat it one more time?) orDulcolax 2 tablets first and repeat in 2-3 hours?(maxium 4 tablet in one course of attempt in general) and may be follow with an suppository too, ask the pharmacist in the drug store and they should know.
As Lisa suggested, Miralax 1 packet daily take it for a few days should work better than Metamucil and relatively safe.
Senakot-S is stronger than Senakot.
Peri-colace is the same as Senakot-s; Colace is the same as Senakot. I am talking here about substitution strength; not generic substitution.
Last but not least,l the Go-lytely solution but you need a Rx for it ;that is why if the OTC drug don’t work within 3 or 4 days or trying ,consultation with a doctor (GP) is a good ideas;but make sure you tell them what OTC medication you had tried and not been to your satisfaction. Otherwise the doc just prescribe the same old thing for you and you will waste time and money.
God bless.Hi,
If the Carafate suspension is too expensive;you can do the same by dissolving one Carafate 1gm tablet into 15ml ( 1 tablespoon) in warm water . Depends on what insurance co you have ;this is another option if we run out of suspension in the hospital and the doc need a stat dose.
God bless.Hi, Liliana,
Sorry for your loss; sometimes live is only given permission by the higher authority up to when He thinks that is the time. The same will apply to me with no exception.
Thanks in advance for your promise of continuing help and communication in the future for this message board, even in this difficult times.
Take care and
God bless.Hi,
Cancer patients receiving chemotherapy have an increased risk of developing cardiovascular complications, and the risk is even higher if there is a known history of heart diseases.–from uptodate.com.5fu,cisplatin both have cardiotoxicity, so does gemcitabine.
God bless.Hi,
please check out the link below too:According http://chemoregimen.com/Biliary-Tract-Cancer-c-27-37.html
And According to clinical pharmacology web site: 2 regimens are being used .
1. Oxaliplatin 100mg/M2 IV on day 1 and 15 in combination with gemcitabine (1000mg/M2 IV on day 1,8, and 15),repeated every 28 days.
2. Oxaliplatin on day 2 in combination with gemcitabine at a fixed dose rate on day 1, repeat every 14 days.God bless.
Hi,
It is good to hear that your mother is responding to the systemic chemotherapy.
Six cycles of the Gem/CIS by all means Is not the end of the chemotherapy.
I think the oncologist will make the appropreiate treatment plans to follow after the chemotherapy base on the CT scan results after the 6 cycles .
Normally, as a patient myself of this disease for 39 months, I am 63 years old by the way,and I have learned that if the tumors contained in the liver and not spread to other parts of the body,TACE or Radioembo can be of choices to delay the progression of the disease,buying time and quality of life. But if it had metastized to other parts of the body, as just one lymph node and one in the pancrease. It may not qualified for such interventional radiological palliative treatment. Get a 2 nd opinion on the radiology treatment to see what they will say.
Keep in touch and
God bless.Hi,
Your husband are among the few of the chosen ones that God’s Grace is upon him in the time of needs. It is a gift that forever shows God’s Grace is His own choice and nothing is related to the character or behavior of the person he chose. But He is always watching.
Congratulation to such a good and uplifting experience for our members.
God bless.Hi,
Sorry to hear the news; the blood clot ,if chronic in nature,can be taken care by long term treatment of Coumadin, In one study,about 39% of the patients took a median of 234days to resolve the problem and restore the patency of the portal vein and therefore may be provide some control of the portal hypertension and varices.With regard to the tumors situation, I think systemic chemotherapy like Gemzar and cisplatin or Gemzar+ xeloda will be the logical choices for the distal bile duct tumor along with the tumors in the liver.
CA 19-9=25 is within normal range of cholangiocarcinoma; but I am a bit surprised by the low Ca19-9 number if the distal bile duct tumor is really originated there and caused his jaundice ; so as the tumor in his pancreas. Normally,except for intrahepatic tumor, if they are malignant; the CA 19-9 number will be much,much higher than 25 (ie: in the >129 level or in the thousands.)
God bless.
