pcl1029

Hi,
that is Ok .
recovery is an individual thing.
but recovery to 137,000 before the next scheduled cycle is always a good sign.
some doctor use 100,000 as a cut off point ;others use 75,000 and 50,000 ;all based on the doctors experiences and their own judgement on each patient’s condition. and that is why need experience oncologists to make the call rather following the books.
God bless.

Hi,
may be this will help.

http://www.cholangiocarcinoma.org/punbb/viewtopic.php?id=2080

http://www.docguide.com/radiofrequency-ablation-treatment-primary-intrahepatic-cholangiocarcinoma?tsid=5

http://www.macmillan.org.uk/Cancerinformation/Cancertreatment/Treatmenttypes/Othertreatments/Radiofrequencyablation.aspx

there are also some discussion under the experience forum of Radiation treatments options on earlier posts.

God bless

Hi,

the answer for your question” My question is at what point I start going to other hospitals that specialize in this particular cancer, consider alternative medicine, check into clinical studies etc. ” is NOW.
The treatment triangle approach to cancer are surgery, chemotherapy and radiation intervention.

John Hopkins will be a good place to start for an overall assessment of your mom’s situation.So you will understand the scope of your mom’s illness.
MASS general Hospital is also good too for a multidisciplinary review of your mom’s case.
But my best bet is MD Anderson in Houston ,# 1 for the best oncology clinics and hospitals in the world for your mom.

I am not a doctor, I am just a patient, but base on what I can understand what you wrote on this message board, it seems to me that systemic treatment ( chemotherapy) may be your mom’s only option at this point in time.
Gem/Cis treatment will affect the kidney function esp. after more than 6 cycles of treatments since the chemotherapy side effect are accumulative.
Gem/Cis will also affect the blood cells including WBC,RBC and platelets and that is why I think your mom needed the blood transfusion.

I am a patient of this cancer for 39 months now. speaking from a patient’s point of view, I will avoid Cisplatin at all cost,I will avoid clinical trials phase one studies to the point that “quality of life” will be my main concern. but that is just my opinion as a patient and not as anything else. I say this because sometimes caregivers will try anything for their love ones but the ultimate control is not in our hands but in the hands of the higher authority.

In short, it is tough as a patient to endure any chemotherapy and quality over quantity of life is acceptable to me even at my age of 63 . I hope my sincere approach to this cancer will not offend you in any way ,but if so, I am truly sorry.
God bless.

Hi,
I don’t know the answer about the cortical retraction since I am not sure what organ or location of the problem,you mentioned.
For the second question, I don’t know whether you had a triphasic CT scan or just the biphasic CT . In general, when you have hypo attenuating focal lesions in the liver these are not a good sign. vague margins will be more clear as time goes by.
Focal lesions are the KEY words to watch. Try to get a triphasic CT next time to get a better assessment of the problem at hand.
God bless.

Hi,
I sincerely don’t know all the answers.
I took Gemzar for 18 month.( bio marker test indicated Gemzar will work in my case); but the cancer returned after 24 month.resection again to remove the 3×2 cm new tumor in a difficult location..RFA to remove the one that was< 3cm in size.chemoembrolization to provide finish touch of the one by RFA.
I never had CA19-9> 37, but I had intrahepatic CCA which is different than extra hepatic CCA that Whipple procedure is one of the procedure that is used .
I never had CEA> 3.5. In fact it was within normal when I had removed the 8×5.6 cm tumor at the first surgery.
Inflammation, infection, acid reflux,GI related issue like colon and rectal problems and stress will all affect the value of both biomarker’s result.
Unless it develop a trend of upward or downward movement in several months. I don’t think it is all that important. However a sudden big jump( ie: from tens to hundreds or thousands in a month) or dive is of value to look deeper at them.
I had no experiences on other issues you mentioned.
God bless.

hI.
1. for surgery or interventional radiologisst purpose. I NEED YOU TO TELL ME WHERE THE EXACT LOCATION OF THE TUMOR.
Usually it is on the CT scan report if you can quote i” word by word”
so I can have more understanding about the location of the tumor.
this is for the RFA,chemoembolization,IMRT or cyberknife or PDT–all of this are performed by the interventional radiologist and not by oncologist.they may even know about theses options.

2. Chemotherapy is order by the oncologist.
6month is not enough,I took gemzar for 18 month and the tumor still came back.
God bless.

Hi, Eli,
Thanks for the article. I think” preventive” in a sense means ” apply the cream as early as possible when the hand foot and skin symptoms(HFS) just developed.(like figure 2 A or B in the article you mentioned) There are different degrees (Grades 1-4) of the HFS. The early signs are reddish color and skin start to peel or crack. at that point moisturized cream such as Eucerin cream may be helpful too as well as the 10% urea cream.
The only topical cream that I know for sure working for burn patients is 1% Silver sulfadiazine Cream and that is a prescription item . I do not know what MEBO is, but if apply the silver sulfadiazine cream and covered with a moisted towel or gauze pad ,it will work too.
The article you mentioned is from China, they may compound their own MEBO from the Chinese herbal medicine formulas and therefore I cannot find the medical name for MEBO.
AT the convention on ASCO 2011 last year, there were a poster for treating the HFS by soaking in a Chinese herbal mixture twice daily or daily in it for a short period of time for several weeks and the picture show the same improvement of the HFS as figure 4 in the article you mentioned above .

http://www.asco.org/ASCOv2/Meetings/Abstracts?&vmview=abst_detail_view&confID=102&abstractID=80328

God bless.

Hi,

From ASCO 2012 notes.

2. For hand foot and skin side effect,apply 10% urea cream at the beginning of the therapy,but not when symptoms occur,will delay the occurrence and severity of the problem.
God bless.