varun_tholasi
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Hi Theresa,
My mum did have brachytherapy after the second stenting, as far as the usefulness of it is concerned, I really don’t know for sure. The stent got blocked again after just 9 months after the brachytherapy, whereas the initial stent lasted for 18 months when she had chemo (gemox). We expected it to last much longer, but maybe it did help and the stent would have gotten blocked even sooner if not for that, I have no idea!
They say that brachytherapy is targeted therapy and it really helps since it provides a high dose of radiation in that area killing everything there, I’m not sure if it helped my mom, but maybe it did.
There’s no harm in giving it a try, because she didn’t have any side effects or anything at all. Also, brachytherapy is possible in only some cases when they can reach the place of the tumor, so if they can reach and provide it, you should go for it!
Let me know if you wanna know anything else.
Varun
Hi Rick,
My mom had metal stenting 3 times (she just got back from one today). As for the patency, the first time it lasted for about 18 months and the second time just 9 months, the third one she just finished. We can never say anything about how long a metal stent can last for.. the clogging can happen because of biliary sludge, granulation tissue, strictures due to radiation and the most common of course is tumor growth. So you can never say when? why? or how long?
When the stent gets blocked, another stent is inserted throught the previous stent, that’s how they unblock it again. Re-stenting is definitely an easier process because an older stent is already there, but you can never say, sometimes complications arise.
As far as i know there is no maintenance or anything for metallic stents because they are permanent and the only thing that can be done is restenting, and the doc told me dilation won’t really help. My mum’s was done through a PDT or something, so donno about ERCP.
Let me know if you wanna know anything else?
Varun
Hi Ashley,
Thanks for your response. My mum is back home today after a re-stenting was done again (3rd time) and her fever is off and she’s feeling fine. So i’m sort of relieved, and I have no idea about PSC, i just googled it, and the symptons were very similar, but the doc never mentioned PSC ever. So i’m really confused about that, and a differential diagnosis is impossible because biopsy from the original tumor is a very risky and difficult thing because it’s so embedded inside and is not mass-forming (at least, this is what our doc told us) so we dont have any tumor samples to distinguish cc from PSC. So i have no idea what to do now? But then, the stent getting blocked repeatedly has to be because of cc right? can it be anything else?
Hope the stent will remain unblocked for a long time! thanks for your time and support!
Varun
Hi Gavin,
Thank you so much for giving me all the information. I really appreciate you helping me out with this.
I will do some research on the links you gave me, also I’ll contact the hospitals you’ve mentioned.
PDT for cc has never been tried anywhere in India like the way they have tried in the Uk or the USA specifically for cc, maybe due to low incidence of this cancer. How did it go for your dad? Did it help? Were there any complications?
Thanks so much again for taking time to help me out! God bless you and everyone else who go all out and help people on this site!
Thanks for replying Jeff, mom was diagnosed with cc based on the CT, MRCP and PET scans, and also when she was taken in for surgery (resection) the doc said it can’t be anything else except cc, and they’ve ruled out everything else.
Resection wasn’t possible because it had already infiltrated the blood vessels (portal vein, hepatic artery). The doc says it’s more like a fibrous kind of growth and not a real big mass kind of growth, and that the disease has already advanced. The doc also said the location of the tumor was very bad.
We also pressed the doc about the biopsy a lot, and he said it was just impossible to get a biopsy with a fibrous kind of growth like that and even if we did get a biopsy, there’s every chance that it might turn out negative even if the cancer exists.
As soon as mom was diagnosed, we consulted more than 3 docs (oncologists, surgeons, etc) and they more or less said the same as to how to go about it.
What is the whipple procedure? she’s not got that done. They are gonna try to place the stents again tomorow, I just hope and pray to god that it happens this time.
Thanks for replying and helping me out everyone, I really appreciate it. I’m so glad I found this website.
Sara wrote:Varun,Which biological therapy is the oncologist suggesting? There has been some evidence that combining Avastin with chemo agents makes the chemo agents more effective in cancers like colon and pancreatic. I believe several members of this community have witnessed similar benefits when adding Avastin to their chemo regime for cholangio. (althought I’m not immediately aware of a study indicating the same) Generally, chemotherapy alone keeps the tumors at bay (shrinking and/or stopping growth for a time). However, eventually the tumors may build up an “immunity” against the chemo agents and start growing again. That’s when the oncologist would switch the patient to another chemo regime to see if they can find something else that will work for a time.
My heart goes out to you and your mom. I’m glad that she’s able to find relief from her symptoms.
– Sara
Thanks so much Sara for taking your time and helping me out, the oncologist suggested chemo using gemcitabine along with Avastin and bio-map. He wants to try it all together to give it everything to fight the cancer. Just hope that it works, this has really hit us very hard. We will be taking a few more opinions from other doctors.I’m glad I found all of you.
