pcl1029
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Hi, everyone,
This link is about cancer vaccine.
God bless.
Hi,
You are always welcome.
since your son is the manager of the radiology dept. of the hospital; If I were you, I will ask him to ask his radiologists friends in his department to reread your previous PET and CT scans and the future ones to get a better idea and comparison. As you know, it depends on the experiences and knowledge of the doctors to read the scans and differences of reading are not uncommon.God bless.
Hi,everyone,
this is the abstract Gavin posted above if you cannot open it.Abstract
Background and Aim Cholangiocarcinoma patients usually have poor treatment outcome and a high mortality rate. The role of adjuvant chemotherapy (AC) is controversial. Our study aimed to evaluate benefits of AC in resectable cholangiocarcinoma patients.
Methods A retrospective study included 263 patients who underwent curative resection in Srinakarind University Hospital. These patients had pathological reports showing a clear margin (R0) or microscopic margin (R1) of lesion-free tissue.
Results There were 138 patients who received AC. This group had a significantly lower mean age than patients not receiving adjuvant chemotherapy (NAC) group (57.7 ± 8.5 vs 60.4 ± 9.0 years, P = 0.01). The level of serum albumin above 3 g/dL was more common in AC group than the NAC one (87.7% vs 79.2%, P = 0.04). Patients who received AC had significantly longer overall median survival time (21.6 vs 13.4 months, P = 0.01). Patients with a combination of gemcitabine and capecitabine regimen had the longest survival time (median overall survival time of gemcitabine and capecitabine 31.5, 5-fluorouracil and mitomycin 17.3, 5-fluorouracil alone 22.2, capecitabine alone 21.6, and gemcitabine alone 7.9 months, P = 0.02). Benefits of AC were likely to be found in patients who had high-risk features, that is, high level of carbohydrate antigen 19–9, advanced stage, T4 stage, lymph node involvement, and R1 margin.
Conclusions AC significantly prolongs survival time in resectable cholangiocarcinoma patients, particularly in the high risk group.
Hi, Lainy,
sorry, I did not notice your question till today;here is the answer.
1. NANOKNIFE
“IRE, or irreversible electroporation, is a new minimally invasive surgical technique that selectively kills tumor cells by using electrical fields to make holes in cell membranes. Our utilization of the newly developed IRE technology to treat patients with unresectable pancreatic cancer constitutes the first use of IRE tumor ablation to treat the typically fast-growing and fatal cancer that occurs in the pancreas.
IRE kills tumor cells without causing collateral damage to adjacent tissue.
IRE kills tumor cells without causing collateral damage to adjacent tissue.
Courtesy of Angiodynamics.”The combination of minimally invasive surgery and IRE allows for faster recovery with less tissue injury and, it is hoped, a better long-term outcome. At a minimum, patient quality of life should improve in the near term.
2. CYBERKNIFE
Stereotactic body radiation therapy: Stereotactic body radiation therapy (SBRT) delivers radiation therapy in fewer sessions, using smaller radiation fields and higher doses than 3D-CRT in most cases. By definition, SBRT treats tumors that lie outside the brain and spinal cord. Because these tumors are more likely to move with the normal motion of the body, and therefore cannot be targeted as accurately as tumors within the brain or spine, SBRT is usually given in more than one dose (
. SBRT can be used to treat only small, isolated tumors, including cancers in the lung and liver (.Many doctors refer to SBRT systems by their brand names, such as the CyberKnife®.
God bless.
Hi,
it is difficult to say;I have not been on that GEM/CIS regimen. but if he can work full time ,I don’t think it will be a problem. the key is how he will feel after the first cycle(21days) GEM/CIS treatment. I think that will be a good indicator for your answer.
God bless.
Hi,Nancy,
Congratulation.
I am a patient of this disease for more than 4 and half years; all I can say is thank God for the chance to live as long as He has given to me and I always start to prepare for the next hurdle that may comes up on the horizon;hopefully I can finish the 110 meter hurdle race in time for the word “cholangiocarcinoma” to be disappeared from the dictionary.
God bless.
Hi, everyone,
Please check the link below about immunology research, I hope good news like this will come more often, if so, our hope for prolonging our lives as CCA patients will be much faster when big Pharm join hands together with famous cancer research centers.
I consider this is a big step going forward for us and the giant step will come sooner.
Hi,
AsCites in liver patient, esp. On cirrhosis liver patient, account for the majority of patient who develop ascites. The rest is caused by malignancy .
Portal vein hypertension is one of the major reason for develop ascites in liver patient.
GI OR internist specialist can have a better ideas to care about ascites with regard to use diuretics to get rid of the swelling and edema,but also should provide and address the hydration issue thru monitor of electrolytes ,BUN/CREATININE; plasma and total protein etc.God bless.
Hi, Jason,
You are right, since it takes so much time to answer the questions from this discussion board (ie:I spend average at least 1-2 hour for each member in order to provide some answers ,especial to those new members with medical questions.) I did not visit the wiki until tonight. I did take a quick look on your wiki and it looks good. I will talk to you next week for more details .
The key question I think is do you want the wiki to be more medically related or experiences related? and what will be the difference or relationship between this discussion board and the wiki if any?
God bless.Hi,
If I may, try to get a 2nd opinion on BOTH medical oncology and immunology.
If I were you, I will look for clinical trials and MASS GENERAL(MGH) is among those research hospitals (and Sloan-Kettering) that can provide a better chance for finding clinical trials.(sometimes they has the trial set up but not always be known right away);that is why you may need to talk to both departments to know what are available.
I find some clinical trials under this web site,but I did not go into the details of each one,so please forgive me if not suitable for you. Those are #2 (XL184);#4 (PDT);#21 Pazopanib;#33 (Adoptive Immunotherapy);#36 CPI-613
#50 LY-280-1653 AND #60 cd8+young TIL.God bless.
Hi, Adjuster,
1.I hope you had read the follow link, the part of the road map ; if so I presumed that liver surgery was being rule out,right?
http://www.cholangiocarcinoma.org/punbb/viewtopic.php?id=7843
2. what is the exact date you started the Gem/cis, Is it started around 9/27/2013? Base on that and the CT scan report from 11/11-12/26/2013,
I assume that your situation are STABLE after 3 cycles of Gem/Cis. (the 8/30/13 report did not mentioned any size and numbers of the tumors.)3. You have both lobes of the liver involved;also the lymph nodes are involved(base on the 8/30 report); therefore systemic chemotherapy or targeted therapy are the best choices; you should also consider clinical trials since under NCCN guidelines ,for advanced unresectable CCA , clinical trial is recommended. Below are some of the clinical trials I find under this web site.
I find some clinical trials under this web site,but I did not go into the details of each one,so please forgive me if not suitable for you. Those are #2 (XL184);#4 (PDT);#21 Pazopanib;#33 (Adoptive Immunotherapy);#36 CPI-613 ;#50 LY-280-1653 AND #60 cd8+young TIL.4. I presumed your tumor marker is referred to CA19-9(ie:3/27/13 – 356; 10/22/13 – 333; 12/13/13 – 450 -); It is raising but just slowly; At this point I will not pay much attention to them , it may relate to the effects of the chemotherapy or the inflammation caused by the ICCA is still there. And I think you mean 8/27/13 instead of 3/27/13, right? However, I will pay more attention on the next tumor marker result on early February.; If it is still raising and there is no change in the Ct scan in February ; then I will question the oncologist what s/he will do next? may be a switch of chemotherapy will be of benefit? Of course; if the next scan shown disease progress, and the tumor marker is raising again ,then you know the GEM/CIS is not working and you need to discuss the result with your oncologist, in the mean time . If I were you ,I will get 2nd opinion from another medical oncologist ASAP (ie:Dr. Jalve in MD Anderson)to look for options now and be prepared just in case.
5. Since you have lymph node involvement,I do not think Y-90 can take care of them alone; so If I were you, I will not consider that option at this point.But down the road you may have to do chemoembo or segmental radioembolization as NW suggested;and make sure they can take care of the lymph nodes too by cryoablation or IRE.
I do think the time is short if you do not start ASAP to pursuit other systemic treatment or clinical trials (ie:they take a lot of time from you to check out whether you are suitable for the trial;or from your oncologist, if they change your chemotherapy, it will at least take another 8 weeks for the next CT scan to check the result of the new chemotherapy to see it works or not.)
The reason is simple because of your tumor load is not decreasing ,sooner or later the liver function will be affected and therefore will also affected your treatment options.6. Please remember, I am only a patient like you, I am not a doctor, if my medical history can be of any help please check the link below and just start reading on 3rd recurrence and you may get some ideas.
http://www.cholangiocarcinoma.org/punbb/viewtopic.php?id=10240
God bless.
Hi,
Yes, university of Maryland and most teaching hospitals.
in fact clinical trial #32 listed on this web site have the info. you need .
check the link below.http://www.cholangiocarcinoma.org/clinicaltrials.htm
God bless.
Hi, Gavin,
thanks Gavin,
BTW, Chicago is cold and under 10 inches of snow.
However, We are a very rich town in the sense that we can spend 70 millions dollars for a QB like you know who. What a waste of money. I guess that is why the windchill factor will be -10 to -25 F tonight and tomorrow.
Please say hi to your mum for me.
God bless.
