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Hi,Chris,
may I ask how old is your wife and when she got diagnosis?
Did they (James OSU) ask you to be in one of their clinical trial involved one of the molecularly targeted agents( drug in pill form to take at home)? Is that why you have to wait for 4 weeks at least. Did your wife do any chemo prior to go to James? and If I may, can you tell me the drugs they used.Your info will help a lot of people here. Thanks in advance.
God blessHi,eli
this is for you, the biomarkers are much more specific for CCA than the general one testing I used yesterday for testing purposes.Remember,eli, I am old and I am not a software computer genius like you.it takes more time for me to upload or download one page of something than to read a research study. SEE, you can help out in so many ways to benefit all of us and this is a good example ;It means I can copy info. of charts and tables and post on this board for all the patients and caregivers to help to explain things better.
In deed we need help in so many ways if other professionals willing to do so when they visit our wed sites and contribute whatever special skills they have. I know some of the nurses and a lot caring individuals are helping out a lot already on this web site. and besides we have you , a poet,a researcher in UK and a patient advocate in US too.what a great bunch of people to work with .Thanks again.Eli and good luck and give me feedback after you talk to your oncologist about biomarkers for your wife. it will be of benefits to me and other patients.
God bless.https://docs.google.com/open?id=0B9UTQLyQ5e2PMWU1Y2YyYTYtNjc2Zi00MDJlLTgzOTAtMGZkYWEwZDVhZDk0
Hi,eli,
it works, all I need is click the download button,and then I can adjust the size of the copy.
Thanks,it will help all of us in the future.
BTW yes, this is a general info copy ,I will share the rest later.
God bless.Hi, eli,
Let see how it looks,I hope it works.
Thanks
God blesshttps://docs.google.com/open?id=0B9UTQLyQ5e2PNDg3YTg1NWQtYTRmMi00OTFiLWE4ZmYtMGE5NjYwZjBlMDA3
Hi,Eli,
Your understanding is correct about the “Target Report Now”.
And that is what it is as you said they listed the drug that are EXPECTED to work.and that report cost about 8,000 insurance money.
I did it because I want to know exactly what a patient can be expected from the report just in case patient on the web ask me questions about it;and partly also because the vision ofASCO they put out recently.
Unless the patient is very rich and can pay the lab to do the fresh tissue report,I personally think it will be done very often.
BTW,my report is on image format and need to convert to PDF format in order it can be share on the web.
God bless.Hi,Eli,
The top message that I posted is the first page of my chemo sensitivity report .I cannot convert the image file to the PDF format for the copied report .that is why I type it out.Any suggestions so I can share the rest of the report on this web site.
Thanks again.
The chemo sensitivity report is called “Target Now” report by the company.
Depends on where you order the report, you may not need fresh tissue sample for the new machine that some lab use to test your sample.
God bless.Hi,
Actually what I forgot to suggest to you is that , I think radioembo or chemoembo is an option you should pursuit further.;go back to talk to Dr.Sella if you think my suggestion make sense to you.
What the radioembo will do is to kill the localized tumor, the 8cm one and if your husband has another small one they can either do both with the radioembo or do RFA on the small one if the location of the tumor is allowed.
and this is actually the reason I want to know about your husband’s cat scan report result.
God bless.Hi,
Liver transplant will be most successful if it is the extrahepatic kind(ie: the tumor is located in the common bile duct. I presumed your husband has the other kind called intrahepatic CCA which I have too. If so, liver transplant will be out of the question unless some other places or surgeon like Dr. Keto may go for it.can you quoted the ORIGINAL Cat scan so I know more about your situation and give you suggestion.
Remember,I am only a patient ,the same as your husband,a patient and not a doctor.
God bless.Hi,eli,
YES, it is not a common lab test performed by the hospitals and clinical labs the physicians offices used. But I think you can try to ask the doctor to order it for your wife and see what will the oncologist will say about the test at least.
God bless.Hi,eli,
I use CRP(C- reactive protein) ,which your doctor can order from any lab or hospital to monitor the inflammation process.
I asked my oncology before to order IL-6 for me and he said hospitals don’t performed IL-6 testing and he seems not that of interest to him since he has already got my “chemo sensitivity report.
But I saw you can order it thru the internet;http://www.lef.org/Vitamins…/Interleukin-6-IL6-Blood-Test.html .
I don’t know whether this kind of place will provide the same standard as the hospital or clinical lab do.
God blessHi,
I will hold off giving cetuximab until after the CAT scan or MRI result after finishing the 2nd cycle of the regimen. You may have google and saw the following information;but just in case, I copy it here again for you.[See BOXED WARNING and DOSAGE AND ADMINISTRATION.]
Cardiopulmonary Arrest
Cardiopulmonary arrest and/or sudden death occurred in 4 (2%) of 208 patients treated with radiation therapy and Erbitux as compared to none of 212 patients treated with radiation therapy alone in a randomized, controlled trial in patients with SCCHN. Three patients with prior history of coronary artery disease died at home, with myocardial infarction as the presumed cause of death. One of these patients had arrhythmia and one had congestive heart failure. Death occurred 27, 32, and 43 days after the last dose of Erbitux. One patient with no prior history of coronary artery disease died one day after the last dose of Erbitux. Carefully consider use of Erbitux in combination with radiation therapy in head and neck cancer patients with a history of coronary artery disease, congestive heart failure, or arrhythmias in light of these risks. Closely monitor serum electrolytes, including serum magnesium, potassium, and calcium, during and after Erbitux.
And for cadiovascular : peripheral edema=10% for Erbitux; 20% for Gemcitabline and 5% for oxaliplatin.
EGFR expression testing should be done prior to Eribtux treatment as recommended.
BTW,your oncologist is right,this GEMOX+cetuximab ,even in USA,is still under clinical trials.The final long term outcome is still uncertain.God bless.
Hi,Janet,
I actually tried to answer your message, but I think ,as it had happened before,it disappeared while I was answering;may be because I went in and out of the message board to confirm what I had in my mind.
So this time around I will make it short.
The esophageal varices(bleeding) is common among liver cirrhosis patients; beta blockers like nadolol and Inderal can help to lower the portal vein pressure and keep the hemodynamic situation stable for your husband.
As long as you keep an eye on his symptoms (ie: vomiting blood or dark black color stools) and keep the hemoglobin>8;then he will be fine.
If you can, next time when his MRI results comes back, try to copy the report or quote the reports.; so it will help me to understand more about your husband’s condition.Have you talked to or had a radiation oncology consultation?
If there are no other metastasis and your husband only had the 9cm mass,
radiation therapy such as radioembo with Y90,chemoembo such as TACE with adriamycin ,mitomycin and/or cisplatin; SBRT and 3D- CRT are reasonable options too.The system chemotherapy your husband taking is relatively new; and I am sure your oncologist had tell you the pros and cons, so I will not repeated here. It seems to me that recently in addition to the traditional chemo like GEM/CIS or GEMOX; I see oncologists using Afinitor(everolimus)-a mTOR inhibitor, MK2206- a AKt inhibitor,AZD6244-a MEK inhibitor etc .alone or in combination with other agents .These proteins work on the P13K-AKt and RAF/MEK/ERk pathways which represent two of the most frequently activated growth factor signaling pathways in human cancer cell biology.Inhibition of both pathways could yield greater benefits than inhibiting either pathway alone. There are still a lot for me to digest,but I think this is the current thinking to treat solid tumors like CCA.
God bless.
