pcl1029
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Hi,
“So would Cisplatin/Gem not work because it is too similar to Oxali???”
Carboplatin and oxaliplatin are sometimes called a “second generation” platinum drug. The first generation consisted of the drug cisplatin, which came to prominence in the 1970s. Carboplatin was designed and planned as an improvement – a drug that worked in largely the same way with the same chemical mechanism, but with better biochemical properties that would not produce such nasty side effects. The idea was that with a lesser side effect profile, higher dosages could be given .
So the answer is no.“Have you read of any cases where they have switched from Oxali to Cisplatin after one had worked and vice versa? “
Sorry the answer is no again.“I also read in your previous post that Gem/Xeloda/Avastin would be a possibility. I know its different for everyone, but what would you say is the most logical choice if/when the Oxali were to stop working???”
The answer is yes;but as you know I am only a patient like you and not a doctor;therefore you need to talk to the oncologist ,and please remember,
newer regimens may come up anytime ,so only ask the doctor at the time of need and not when your current treatment is still working.In that way ,you will not miss the boat of better treatment plans.
God bless.Hi, Trevor,
This was the reply to you not long ago from me if your former ID is ” tnyjax34 “.
Hi,
If GEMOX(the regimen which you are having now) works like you say, I will continue the course of treatment until otherwise. You want to reserve more options for the future just in case. For me(as a patient),CC is a long war and not just a battle. You need to think far ahead of the game if God is willing to give His Grace to you and me to have that long the time frame to fight and learn about CC.
Gemox+ Cetuximab(a MoAb like bevacizumab-Avastin) have good results in objective response(63%) but long -term outcome were not reported.So when I read this article ,I ( as a patient)will think about what is next if this regimen don’t work again after initial success and/or if the CC recur again for the 2nd time . The other clinical protocol is Gemzar+Xeloda+Avastin which also provided good results but side effects like colon perforation from Avastin has been reported.
In general “IF IT WORKS,DON’T FIX”
God bless.The following is my response to your current questions.
If currently your CCA is “stable” that means your CCA is currently responsible to the GEMOX treatment . Carpoplatin and cisplatin(which you had before changing to oxaliplatin because of nausea/vomiting side effects) are more or less the same because they are all belonging to the platium family .
Gemzar+ carboplatin is mainly a regimen for bladder cancer. GEM/CIS and GEM/CAP are for biliary and pancreatic cancer.If you have peritoneal metastasis GEMOX+ Avastin may be of value since I knew it has good objective response( partial response>30% for my sister-in law’s peritoneal carcinomatosis in her omentum.) She had to discontinue the Avastin due to colon perforation caused by Avastin. But every patient is different and the incidence rate for GI perforation of Avastin is <1%-4%.
Folfox is 5FU+oxaliplatin but CAPOX–CAPecitabine(a prodrug of 5FU)+ OXaliplatin may be easier for patient since Xeloda is taken by mouth. If you had extrahepatic CCA before you had the liver transplant,a phase II study of CAPOX trial of 65 patients with advance biliary cancer shown more favorable results to extra than intrahepatic CCA patients.
Of course molecularly targeted agents like Tarceva and others are among other choices if you will need them in the future.Again, please always keep in mind that ,the addition of other drugs ,in theory, will add toxicity too. so you have to weight the benefits against the adverse effects as well. good luck and
God bless.Hi,
“Tumor (<7mm in diameter )may not be detected by PET because the amount of FDG uptake by the lesions cannot be resolved reliably.
PET has a greater sensitivity in detecting recurrence in a previously irradiated part of the body than CAT or MRI. The increased uptake of FDG beyond eight weeks after the completion of radiation therapy represents probable recurrent or persistent tumor,rather than an effect of radiation.”
-PET literature review version.17.3 uptodate .com
Therefore PET/CT will be a good choice next time than CAT to solve the unanswered problem.
God blessHi, Lainy,
I wait for the whole day,finally I see what I wanted.
Congratulation, you are now belonging to the 5,000 posts elite member club.
A lot of poems for those who seek comfort and encouragement.
Job well done,Lainy.
God bless.Hi,
Base on the info. you provided,the age factor 55 is on your dad’s side. However, I do not think liver transplant is an option anymore (based on Mayo’s criteria). Resection or surgery may not be choices either because of the lymph node involvement,but you can ask the doctors during 2nd opinions on surgical consult.Liver cirrhosis will not exclude or prevent your dad to have chemotherapy like GEM/CIS;but GEMOX is a better choice due to less side effects on the kidney and hepatic toxicity.. Molecularly targeted drugs like sorafenib is another choices.But the preexisted health condition of your father will complicate the treatment (ie: cirrhosis patient makes it more difficult to clear drugs like sorafenib and other drugs like Xeloda due to hepatic metabolism..)
In addition, liver decompansation do occur in in chronic cirrhosis patients who have the disease for a long time and ascites is a problem as well as portal hypertension due to the back up of fluids in the lymphatic system.
Therefore acsites should be treated as well.
God bless.Hi,
Please if,you can ,tell me when your dad was diagnosis?and where is the tumor located? And how many spots? Did he got the RFA done or still in question?
Did you dad also has cirrhosis in addition to cholangiocarcinoma?
How old is your dad and his current health condition ?I will check back in tonite and will answer your question .BTW, where you dad got treatment?
I am only a patient like your dad and not a doctor.
God bless.Hi,
I suggest John Hopkins for your husband for PET SCAN,medical oncology , radiation oncology consultation and overall care.
John Hopkins is the #1 hospital care provider for the past 25 years.according to US News & World Reports.
If there are no metastasis in other parts of the body from the PET/CT scan, and if your husband has extrahepatic bile duct cholangiocarcinoma as I think it may be, be sure to ask if liver transplant is an option . Mayo Clinic or Dr. Keto in New York or Dr. Chapman in St. Louise are your next places for liver surgery opinion. However if the PET/CT scan is positive for metastasis, patient will not be able to qualify for either liver transplant or liver resection in general.
God bless.Hi,mcf,
After reading 3 reports about ascites, there are only a few studies suggested aimed at reducing ascites formation.In patients in whom the cause of ascites CANNOT be found,some suggest a high protein and low fat diet with medium-chain triglycerides (MCT). Patient who do not respond to the above measures ofter need to be treated with PARACENTESIS as marion suggested- literature review version 18.3 Sept,2010. uptodate.com.
Skeletal and/or neuromuscular weakness side effect of Taxotere is 53-66%.
God bless.Hi,Eli,
From my personal experience, it took about four months to grow from zero to 1.5cm and took another 12months to grow to a 2.1×2.5x3cm tumor at resection time.
God bless.Hi,Eli,
The other 684 patients must not have the specific gene mutation in the tumor that the researchers are looking for.
God bless.Hi, Pam,
I do understand exactly what you mean about talking the “mumbo jumbo”.This report is for the public . so I hope you will understand the ASCO mumbo jumbo too. What the content may not be that important to us especially ; but the VISION and TREND of the cancer therapy is what it is all about ,for me at least.
I sincerely believe that if we,the patients,can hang around for 5 more years or so;more effective regimens with less or no side effects will be found for us. it will be more or less like taking a blood pressure pill daily for high blood pressure.
Say hi to your daughter for me and keep up the spirit.
God bless.Hi,Gavin,
IL-6 and inflammation relationship is one of the subject I am looking for lately.
I down load it but have not read it yet,
A big thanks for saving my time.
again, make sure to say hi to your mum;the BEAR are in hibernation,may be next year.
God bless.Hi,Gavin.
I am very sorry for the loss of your dad for the past two years. And
I know your dad is very proud of you in taking care of you mum,his wife,for him.You don’t need to thank us,this board,for everything.for they are always gentle,kind and full of love and encouragement like what you have done for this board.
Finally,I do agree with you that it is hard to put into words to describe our feeling;but The way you described the love ,duty and loyalty for you dad in the last paragraph is with deep passion and feeling,especially from a former American football player like you.
You father and son bonding is an example for my kids to follow.
Again, please say hi to your mum for me ,please say I am so sorry for what had happened. but you mum truly have a loving and good son to keep and exceed the promise to care of her. I just not good at words,Gavin. I want to say a lot more,but I ran out of words. For,you know, I am not Lainy,the poet.
May God bless you and you mum,take care,winter is here,put a thick coat on to protect the elements for both of you.
