My dad's fever isn't getting cured even after four changes of antibiotics. We even changed doctors. He was been having fever due to cholongitis first and then he was fine for a while till he deveoped liver abscesses which is really dangerous. I am so upset because all the bad things possible are happening to him. Just one good news that his jaundice is very low now.

Rosy

Hi,
I am writing after a long time. The doctors didn't place the third stent. They just kept draining out some infection for the past 2 weeks from the different segments of his liver. He had developed abscess in his liver. And they say the right stent was only partially blocked and can still drain out the bile properly.
My dad's bilirubin is down to 5.7 now, but his fever is still there. The contineous fever leaves him feeling weak. The doctors did a lab culture of his bile and are changing antibiotics and hoping that the fever goes in another 48 hours.

Rosy.

Hi.

My dad had the metallic stent placement surgery on May 4. And after that his bilirubin count was going down. It had gone down from 34 to 15. The stents were working and he seemed to be recovering. But all this while he always had fever due to remaining infection in his body, which the doctors said would go away with antibiotics.

Then after 2 weeks of the stent placement, his new blood reports showed increasing bilirubin. And scans showed that infection and puss had deveoped in his liver, and the right stent was not working properly to drain out all the bile produced in his liver. The right stent is blocked again. He needs to be operated again this week to place a third stent. Right now the infection is being drained out of his body and into a bag, until his opeartion.

He's been fighting the fever, jaundice and infection for 3 months now. And until the infection and fever are not gone, and he regains his strength, we cannot start the chemo.

Rosy.

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(10 replies, posted in General Discussion)

Dear Deb,

I am so sorry to hear about the rough time your dad is going through. I too hate this horrific disease. Please be strong, and keep writing to us, and expressing what you feel.
You and your family are in my prayers.

Rosy.

Hi.
Louise, it gives me a lot of encouragement after reading your note. Thank you so much for writing in. You are right. Faith, information and family would be the biggest help in these times. I hope my father has the same kind of response.

Rosy

My dad had it 2 weeks ago, and they removed about 2 litres. He immediately felt the relief and he has been taking diuretics called Lacilactone to prevent the liquid from building up again.

His appetite was also better, even though still not normal after removing the ascitic fluid.

Best of luck.

Hi.
We have been telling dad what he has, even though not telling about stages. We are telling whatever he has been asking, and he himself didnt ask about the stages and prognosis, so we understood that he doesn't want those to be discussed much. And on mention of the chemo, he now certainly understands the malignancy of the tumor. You were all right in saying, we simply cannot hide this longer.
My dad is 53 and has always been in good health. And I am situated in Bombay, India. I was earlier in another city, but moved to Bombay because here we have a number of cancer centers.
We spoke to an oncologist a few days back, who was not so keen to have chemo. So, now we have been talking to another oncologist. We may start chemo after my father's jaundice and infection are under control. My father had got severe infection called cholingitis in the biliary tract and liver. Once he is out of it, we will go further.

The sharing of information here helps so much. I thank you so much for your prayers.

Thank you for your prayers and the valuable information.

I will take a print of the news and take it to our doctor.

Deb, My father is still Stage Three. And we aren't able to muster the strength to tell father everything. We are afraid he might become upset and stop fighting. Right now he thinks he just has a benign tumor which made him jaundiced. Please advise me, what should I do?

Recently, his right stent got blocked and he had to be taken back to the hospital because his bilirubin was going up (it was 17 by the time we took him). After external drainage, its now come down to 10.

9

(32 replies, posted in General Discussion)

Deb, I forgot to write in my note above that my father's pleural fluid was drained with a pipe and then he was relieved from the breathing problems.

And after taking Diuretics medicine (Lacilactone), my father's pleural effusion has been under control and hasn't re-occured. The same medicine also gave him relief from ascites. We haven't needed to drain off his ascitic or pleural fluid after taking the diuretics.

10

(32 replies, posted in General Discussion)

Hi Deb, How are you and your father.

My father was diagnosed with CC a month ago and he too had pleural effusion wherein his right pleural cavity was filled with fluid. Pleural effusion is excess fluid that accumulates in the pleural cavity, the fluid-filled space that surrounds the lungs. Excessive amounts of such fluid can impair breathing by limiting the expansion of the lungs during inhalation.

My dad has just been diagnosed and he has not yet started on chemotherapy, so i dont believe that your dad got pleural effusion due to chemo drugs, but its due to the cancer only.

But the pleural effusion fluid is not always malignant, i think because my dad's fluid in lung cavity didnt show cancer cells. It was caused because his veins are getting thrombosed (blood clot in a vein) due to cancer.

My best wishes for you and your dad.

Marions, no other treatment options have been offered yet. The oncologist says its unresectable, and he is also not keen not chemotherapy saying that it doesnt work and that it would make his body further weak.

Hello. Thank you so much for your kind words. Its just been a month that my father's cancer was diagnosed. It has come as a shock to us, and we havent yet revealed it to father because we think it might upset him.

Deb: we havent started on his Chemotherapy yet, and really thinking if we should because we met the oncologist who said these type of cancer have a very poor response to Chemo, and leaves the patient very weak too. The oncologist is not very keen on starting Chemo. Is it true that Chemo doesnt work in CC?

Also, oncologist says that the cough is because of some antibiotics that my father had to take after his operation to place mettalic stents in his right and left bile ducts that makes his respiratory tract very dry. Cough syrup hasnt been working too well, and his cough is still there.

No doctor has agreed to surgery yet. All doctors I met have concluded that my father's CC is unresectable.

Angela and Marions, Thank you so much for your replies. I was also thinking it could be some allergy, but with the recent diagnosis of CC in my father we do not know much about what happens in course of time. We have also started on a cough suppresant. Lets see how my father responds to it.

Hello,

My father is suffering from cholangiocarcinoma. And since the past 2 days, he suddenly started coughing a lot. He is having dry cough without any mucus. What could be the reason for this? - Rosy

Diagnosis
Cholangiocarcinoma - PTBD and 2 SEMS placed.
Status post Cholecystectomy
History:
My father had obstructive jaundice. He had undergone cholecystectomy in recent past. On evaluation he had hilar stricture with cholangitis. ERCP and biliary drainage was attempted but in view of narrowed duodenal lumen, scope could not be negotiated till ampula and hence PTBD was done and after initial external drainage, 2 SEMS were placed in the right and left duct. He had ascites and right pleural effusion which were drained. Brush cytology showed high grade dysplasia. His bile culture grew Pseudomonas which were sensitive to Cilastin and Imipenem which he recieved for 10 days.

Is surgery possible in this case?


Investigations Done:

USG Abdomen (24.04.09)
Status post cholecystectomy
Small ill defined hypoechoic mass lesion in the porta hepatic involving the CBD. Mild IHBD in both lobes of liver.
Portal vein thrombosed. Minimal scites.
BPH

MRI - MRCP (24.04.09)
Common hepatic duct, confluence and proximal hepatic ducts stricturous lesions with upstream dilation - ? Neoplastic

Triphase/Dual Phase CT (25.04.09)
1. Post cholecystectomy status.
2. Poorly enhancing ill defined lesion at hilum with Type IV biliary structure and long segment portal vein thrombosis.
3. Minimal Ascites. No lymphadenopathy.
               D/D - ? Chlongiocarcinoma
                        ? Carcinoma Gall Bladder.

Cytology (Ascitic fluid) (29.04.09)
Inflammatory effusion. Negative for malignancy.

Cytology (Balloon) (01.05.09)
Sparsely cellular smear with high grade dysplasia.
Suggested ERCP and radiological correlation.