OK...so today my husband and I marched our fanny's into his appt. with the surgeions to have his staples removed with a list of questions. All went well...questions answered to clarify/confirm understanding of the resection that was not to be. The tumor encasing the three "things" outside of the liver were the bile duct, the hepatic artery, and the portal vein. Could not pursue the resection because they could not get at the bile duct to complete the work needed outside of the liver for the resection to be successful. Intrahepatic and extrahepatic cancer. Surgery team relinquished us back to the on-cologist but said if we felt we needed to talk to them about anything in person or over the phone to just call.
Next the oncologist came in (love the guys attitude)...we had three pages of questions for him and he answered each and every one! Found out that there are actually two tumors in the right lobe, 1 = 5"x7" and the other is 4"x4". He thought that direct radiation would be the plan until I brought up the other treatments...to include SIR-SPHERES & theraspheres (which Cleveland Clinic does do). He also wants to pursue chemotherapy for 6 months after radiation. He mentioned Gemzar as the drug he would choose best for my husband. I then informed him of the study regarding using Gemzar and Cisplatin to which he smiled and stated he was aware of that was in agreement with this if my husband felt he wanted this more agressive treatment (2 vs 1 drug). He walks out and discusses what we discussed with the internventional radiologist and his team.
Interventional radiologist and team walks in stating there was a minor disagreement and discussed using therashperes to treat the tumors in the right lobe and schedule an appointment with another radiologist to treat the tumors outside of the liver in other ways. He also discussed SIR-Spheres as well and noted they would be completing their first procedure using SIR-Spheres next week and if that is what we wanted...he would listen. He did point out the differences and the increased risk of SIR-Spheres for my husbands case. Also informed about the Clinic's needed Board Approval & then FDA approval but has not ran into too much difficulty in getting the procedure/drug approved by both. Found out today that my husband now has a lesion on the left lower rib! So the thought is that the oncology radiologist will treat the tumor encasing the bile cut/portal vein/hepatic artery along with the two lymph nodes, if possible, and the lesion on the rib.
Tomorrow we have an appointment with the radiology oncologist to discuss treatment plans for the extrahepactic tumors/lesions.
I've read some of the previous postings about theraspheres and some difficulty's with the insurance company's approving the procedure. One discussion noted Cigna's position with a link but when I clicked on the link in the discussion I got the good old "page not found" signal. I'll call our case worker at Cigna tomorrow and ask her.
FYI...after discussing our latest nutritional journey (1 week as vegans) with the oncologist...we've decided to again enjoy, although in moderation, the wonderful American diet! I did and do enjoy alot of the receipes we had tried and will continue many...but the diet was decreasing my husbands appitite (already lost 20 lbs) and depressing him which wasn't good for his moral. So...we enjoyed a moderate mid afternoon dinner at Olive Garden! It's funny...before the diet we could have eaten everything on our plates...today we only ate half of our meals before filling fully satisfied. After eating...we both began to feel a bit sick to our stomach's. Probably shocked our systems a bit with the change. That only lasted 2 hours but it was well worth the taste of that yummy grilled salmon!
Keeping you all in my thoughts & prayers....