xepalomero

I finally had an appointment with the other oncologist. He was quite optimistic (well, relatively), he said that he wouldn’t expect the tumor to grow rapidly(mainly because of my grandma’s age) and that , considering the fact that the tumor mass wasn’t visible neither on her CT or on MR scan, it had to be rather small and localized, so he said.
He recommended a combination of chemo- and radiotherapy. ( We still don’t know if such a combined therapy will be offered to her by her hospital oncologist, so we’ll see what to do after her check-up in the hospital next week).
He suggested it would be much more appropriate for my grandma to take Xeloda pills at home (instead of 5-FU that has to be administered intravenously in a daily hospital, which in her case would mean 1,5 hour drive every day to the daily hospital and back, for, I don’t know ..two weeks or even more..) I asked him about the possible side effects and how to prevent them, and he said that they’re usually mild for a small dose of capecitabin so we don’t have to worry about that…
I couldn’t resist bringing up cyber knife therapy during our conversation…He said he basically has nothing against it but thinks that the classical radiotherapy would, in her case, probably show similar effects – still, I’m not so convinced about that…so I’ll keep collecting additional info). He confirmed that megestrol acetate would help her gain appetite and (hopefully) some weight so we’re getting it first thing next week…
In the meanwhile my grandma’s fine..no pain, no sickness, no chills, no jaundice. She’s still weak, her apptite’s still poor. Yesterday she was even out shopping and at the hairdresser’s…
She asked me (she always asks ME because I’m her “doctor” ( I’m a dentist ) about all sorts of things that concern her “new” illness) should she be lifting heavy objects or bending over and stuff like that because of her stent? Should she be worrying about making some wrong move in fear it might get displaced? I wasn’t sure what to say (probably it’s impossible to effect the stents from the outside (just by moving), but I’m not 100% sure)…..

Her MRCP showed no signs of tumor mass , only a 1,5” long stenosis (stricture) near the bile duct bifurcation. No signs of tumor mass in liver too (US/CT/EUS/MRCP), no elevated ESR, no abdominal pain. Mild jaundice combined with elevated liver enzymes…is that really enough to diagnose Klatskin tumor? Maybe I’m just having false hopes, but I’ve been reading some scientific papers on this subject on PubMed and some studies have shown that postoperative PHD-s show up to 15-16% benign lesions among all those who have been diagnosed with Klatskin tumor. ?
Today I spent a whole day with her, talking, actually trying to make her eat more… since she came back from hospital she eats three times a day but I think it’s still not enough. She has started drinking the tahitian NONI juice, Omega 3 fatty acids (purified fish oil), we’re adding some additional proteins to her meals (egg whites, meat). I made a suggestion to her GP that she should perhaps try to improve her appetite by prescribing her megestrol acetate (sold as suspension Megostat here in Europe) but she has refused to do so, saying that Megostat suspension is only for those who have lost much more weight (???? and my grandmother has “only” lost 35 pounds!!!! ???). She also said she is uncertain how it would effect her condition, generally because it’s a hormonal medication with some side effects, even if she hasn’t got even one of all the contraindications listed for Megostat. I would appreciate it a lot if I could get any information from any of you who have been taking megestrol acetate— how did it effect you, your appetite, how were the things with side effects…basically has it worked for you….would you recommend it to others…..
Tomorrow I’m seeing another oncologist for a second opinion on this matter…
i feel as if i’m trying to just buy her two or three more days…it’s desperate….