pcl1029
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Hi, Marchoo
may i ask How old your are?
are you on any chemo after resection?
Do you know the date your were diagnosis.?
do you have a stent to put in?
Your answers will help us to understand this disease more
thanks.
God bless?Hi,
CK7. Etc. are antibodies used for tissues staining purposes in the biopsy tissue slides in pathology lab.“The staining profile is non-specific. The differential diagnosis includes a primary intrahepatic cholangiocarcinoma or
metastasis from a pancreaticobiliary tree among others.” this quote simply indicated that based on the slide samples and the additional subsequent test for mucincarcine,another staining test ,they still cannot rule out whether the Dx is intrahepatic CCA or metastasis from the Extrahepatic sources such as the cystic duct,distal common bile duct or the pancreatic duct.
Is this a biopsy sample from the ERCP procedure performed by the GI Specialist?
Since the pathology lab report is not certain what is the final diagnosis,please talk to the GI specialist to see what he will do next.
Did you have a CAT or MRI done to confirm or rule it out?
God bless.Hi, Janet,
Since your husband have started chemo already,and the MRI will be coming up within a week or two;it is better to wait for the results of the scan to see what will be the best thing to do next.and make sure the oncologist and Dr.Sella have a”pow wow” section again to determine the best treatment plans for your husband after the MRI scan.
Base on the summary you quoted(yes ,”impression” on the scan report is exactly what I want to see, thanks); I can understand Dr. Sella’s interest on your husband’s case. Your husband’s tumor is located at the backside of liver,my guess is on the right side of the sternum just underneath the rib cage,2-3 inches away from the sternum. He may experience dull pain now and then;if so ,it may help to lie down and rest for a while.
Make sure the doctor take care of the ascites as well as the portal vein thrombus for your husband.
God blessHi,
When was the last CAT scan or MRI done? In the States, the only way to tell about the progress of the tumor or the absence of it is scan every3-4 months.
If I am correct,your husband has the extrahepatic bile duct cancer(ECCA);as long as he can tolerate the chemo and the tumor is under control(stable or shrinkage);he will be fine. Here in the States ,most patients change the stents every 2-3 months if it is plastic to keep the bile flow smoothly.
Please remember,I am only a patient like your husband and not a doctor;
Chills and fever are the two most common medical problems related to ECCA.and they should immediately call for help from doctors or best to go to ER. Once after your husband finished the ENTIRE course of antibiotics treatment and checked out by the attending GP or oncologist; chemotherapy can be resumed base on the judgement of the oncologist.some likes to wait for a couple weeks more,;order labs to confirm the situation;others like to resume the chemo as soon as the patient is able to do so.
Keep in touch and ask questions;
God bless.Hi, Kandre,
Oxaliplatin is the third generation of the platium family which included cisplatin,carboplatin. In general that means there will be less side effects for oxaliplatin as compare to the first and second generation.(less anemia (RBC);less thrombocytopenia (platelets); neutropenia (WBC);and producing less nausea and vomiting symptoms.
Gemox(Gemzar/oxaliplatin) and GEM/Cis(gemzar/cisplatin) are 2 commonly used regimen for advanced cholangiocarcinoma. There are good objective responses (20-40%) for both of them;but there were NO randomized trial to compare the 2 regimens to show which is better than the others yet.
God bless.
Hi,
According to manufactures of Xeloda and Gemzar,two of the widely use chemo agents for CCA, THE OFFICIAL wording for both are ” until disease progress or side effects intolerable”
For me that means for a lifetime if quality of life is of no concern. Well, a difficult choice in deed.
God bless.Hi,eli
Take “Excedrin migraine” as directed on the label for headache.(aspirin/acetaminophen/caffeine combination)
Take Advil 400mg-600mg and diphenhydramine 25-50mg(Benadryl) x1 dose if your wife also need help for sleep.
BTW ,most if not all the 5-HT3 receptor antagonists like Zofran will make you feel like your head is swollen and heavy;It happened to me and what I did was as soon as I was home,I took motrin 600mg and Benadryl 50mg x1dose and go to bed right away;I woke up a few hours later and felt better.(I only took Gemzar.)
God bless.Hi,
Acupuncture works but depends highly on the skills and experiences of the person who performs the procedure.
Make sure he/she is certified.
God bless.Hi,Eriq,
Please also have radiation oncology consultation scheduled for you when you call MD Anderson for appointment along with the medical oncology consultation.
It will provide you another option to treat this disease if not contraindicated.If you can not tolerate Gemzar/cisplatin regimen or Xeloda. There is a chance that you will not tolerate Taxol well with regard to the side effects of nausea and vomiting.( 10-30% of patients who take Taxol will have the same % as Gemzar or Xeloda to have the side effects of nausea/vomiting. but much much better than cisplatin(>90%)
BTW, I am just a patient like you and not a doctor. May I ask how old are you? what is the official diagnosis they gave you? Intrahepatic CCA with mets to diaphraghm and abdomen,but where?
God bless.Hi,
I believe your husband has extrahepatic cholangiocarcinoma (ECCA).
but you also mention a few tumors in other places.
I s it possible you can quote a few words from the CAT or MRI reports about the “other few tumors”,where they are? how bid are they? and BTW how old is your husband? <50 yrs old?
I am Just a patient like your husband . and I am not a doctor;but I may be of help if I know what exactly your husband’s situations are?
God bless.Hi,Eli
Sometimes dexamethasone ,a steroid, may be the cause. But if just given as premed for one dose,then the side effects should be gone by now and HR should return to normal. If not, call MD .
Hydration more to increase volume of fluid intake will help to increase the volume of the blood flow,thus the heart will not need to pump faster to maintain normal heart function.
God bless.Hi,
thanks Marion and Eli for your compliment. yes it is a lot of work;but if you love what you are doing like both of you do,it is worthwhile.Here is the breakdown for that stats: for Nov1-Dec 18,2011(patient pop=22)
(# of patient information may not add up to 22 due to lack of data provided)GENDER: Female=14 ; MALE=8
AGE:range=29-80(
with 6 in the 50’s; 2 in the 60’s
in the 70’s ;
1 in the 80’s ; 6 in the<50's; 4 with no data.
DIAGNOSIS : intrahepatic CCA=9
; extrahepatic CCA=9
not sure ICC or ECC.= 4
(18 of the patient DX alone in 2011,with 2 recurrences ;4 passed away)CHEMO/RADIATION:
GEM/CIS = Gemcitabine+ciplatin protocol= 9 patients.
GEMOX = Gemcitabine+oxaliplatin protocol=2 patients.
GEMOX+panitumimab = 1 patient.
GEM/CIS+everolimus = 1 patient.
5FU protocol +? = 1 patient.
Not sure about protocol = 4 patient.
Geographic LOCATION: UK=1 pt. Egypt=1 pt;Canada=3 pts ; rest=USA.The observation::
1.The Male to Female ratio; usually is more in man than women.
2.There are 6 patients in the <50 age group;a LARGE difference from the
reports that I had studied;age between 50-70 is the prevalence group.
3.GEM/CIS is the most used protocol in both ICCA and ECCA. and just one using 5 FU(including capecitabine);that is a bit surprise to me.BTW, this is just a simple data collection in a random selected period with NO STATISTICAL adjustments.
God bless.Hi,Eli,
Your surgeon is right, that is why I did not do it until now.
But I have to know in case the questions comes up on this message board. especially now ASCO view targeted therapy as the priority of future treatment plans in the next 10 years. That means most if not all drug companies will devote more time,money and resources to targeted drug research.Without knowing exactly what the bio markers means and how it may be used, I cannot be of help to those who wants to know more ,like you.
The field of bio marker testing is not standardized yet;for example ,I read that MD ANDERSON bio marker standard is different than the lab I used,mine is more sensitive because they can used up to 20% of cell sample than the 1%MD Anderson used.(I read the data from one of the reports I got.)
But I cannot prove that.
God bless.
