(134 replies, posted in General Discussion)

Yes his fever is gone which is good news.  Just waiting for the antibiotics tondo their work!  And you are right Lainy...I think Ben just does it for the attention!


(134 replies, posted in General Discussion)

Marion, all IV administered antibiotics right now.  He's on two:  1) Zosin every 6 hours and 2) vancomycin.


(134 replies, posted in General Discussion)

Yes, a blood and urine culture were done.  They said he has a bacterial infection :  gram negative rods.  Still not exactly sure what that is but could either be from a port infection or could have been a small amount of bile that got stuck in the stent and caused an infection.  He's still on antibiotics and they added Ursodiol to thin his bile. 

As for the stents, he has only metal stents, no plastic so they can't be replaced, but they did a HIDA scan today (a new term I had not heard of before), where they inject him with dye and watch it go through the bile duct and everything looks ok.

So, now we just wait for the antibiotics to do their job.



(134 replies, posted in General Discussion)

So - here I am again...back so soon! 

Unfortunately, not even two hours after my update on here last night Ben came down with another very high fever (102.9) - so off we went to the emergency room again.  As of this writing they still haven't found anything - his liver panel is higher (bilirubin 2.9) but CT scan, blood work, etc. aren't finding anything conclusive.

So, now this is the 3rd time since the end of May that Ben has experienced a high fever, not quite sure what to think of all of it...luckily they can get the fever down pretty quickly and antibiotics seem to work (along with that new stent in May), guess we will wait and see.



(134 replies, posted in General Discussion)

Hello everyone! 

So….Ben and I made it through our vacation in Alaska.  It was a great trip!!  Only one minor "scare" where half way through our cruise he got a high fever (102 degrees) - this had happened in May over Memorial weekend where he ended up in the hospital for a couple new stents…so I was pretty worried.  We met with the ships doctor and he seemed to think it might be a urinary tract infection based on blood work.  Luckily, I had asked our local GI doctor for a prescription to an antibiotic before we left - Levaquin…which worked well in May.   So - with the help of Tylenol and Levaquin we decided to stay - we kinda figured the worst that could happen is a helicopter "rescue" in the middle of Glacier Bay - and what a story that would be!!  Anyway - the rest of the trip was uneventful and truly extraordinary so it was a great break for both of us.

Ben did just have his quarterly checkup at MD Anderson two weeks ago (July 22nd).  We really weren't expecting good news, as we already knew the cancer was "on the move" from the slight growth and new stents in May.  And, as expected - things were growing…..not a huge amount but it was definitely bigger than it was in April but not as much as a year ago in October.  Honestly, I think both of us were somewhat relieved that it wasn't worse.

MD Anderson recommended Ben go back on the CC recommended protocol (Gem/Cis combo) - he really hadn't been on that for almost two years (he was busy curing himself of that pesky Lymphoma last year), and has mostly been on just Gemzar as its not quite as invasive.

While the news wasn't "great" - our doctor (Rachna Shroff - amazing), reiterated that she normally doesn't get to talk to patients at the four year mark - so Ben is still doing quite well (and you would never know he was sick by looking at him).   

So, Ben started the big GEM/CIS combo on Thursday (7/31) - it has hit him pretty hard…he's been sleeping almost the whole time since thursday - he does get up to eat once in a while, and have something to drink but it's definitely been tough.  Luckily, he still doesn't show any of the nastier side effects.

That's the news for now - you are all always in my thoughts….should be an interesting summer!

Take care,



(134 replies, posted in General Discussion)

Lainy, the GI doctor said the biliary tract was slightly blocked again so he put another stent in.  After that and the levequain and a few days rest Ben was back to normal.  His oncologist wanted to put him back on Chemo to not take any chances - he tolerates Gemzar pretty well so he went with a reduced dose. 

Marion - I filled out the Biliary emergency card - thanks for the input.  It was easy....I also plan to put Ben's information in the registry.  Its truly hard to believe he has been on this journey for four years - and also battled and beat Lymphoma during the journey!

And now this weekend is our 19th anniversary and we are packing for our Alaskan trip tomorrow - a cruise and train ride up to Denali National Park.  While i'm a little nervous if something goes wrong - we are both in good spirits and Ben seems pretty "normal" at this point so it should be a good trip - besides we've weathered every other storm so i'm sure we can tackle whatever else comes our way.

I will send pics if I figure out how to post them out here!

All my best to you - never give up hope!



(134 replies, posted in General Discussion)

And the journey continues.  My last post in April had Ben just finishing his latest round of chemotherapy with a break approved by MD Anderson and our local oncologist here in Fort Lauderdale. 

Ben has been doing pretty well - the break from chemo was welcomed - unfortunately Memorial weekend he developed a high fever (102.5) so we took him to the ER - where they were able to control the fever while they did additional testing.   

CT scan revealed some very partial blockage of the biliary canal - and our local GI doctor was able to put yet another stent in the prior stents that were done in January (and over three years previously).  I do wonder though if it was really an additional blockage or from an infection that can occur sometimes with all of these stents.

As a precaution our doctor put Ben back on Chemo (gemzar only once again) since he responds quite well to that treatment.  It was somewhat of a disappointment as we have a 2 week cruise/train vacation planned in Alaaska starting this Sunday (june 29th - also coincidentally our 19th anniversary).  Our oncologist is sending us with his blessings as he just wanted to make sure we didn't take too much risk - but it was still a bit tough mentally for Ben (and both of us) since he had just finished in April and we were hoping to have  a few months without a break.  We also wondered was it really the cancer - or just an infection; but his bilirubin had climbed a bit and so probably a safe bet to put him on chemo. 

Anyway - that's my update for now.  Ben is sleeping a lot this week to help him get rested for our vacation in a few days - and I'm crossing all my fingers and toes that our long awaited vacation goes off without a hitch.


(p.s. - I love the look and feel of the new website).  :-)


(134 replies, posted in General Discussion)

I can't believe it has been six months - SIX MONTHS since my last post (almost to the day).  And, to avoid the 25 lashes with a wet noodle from Lainy I figured it's time for an update.

I won't go through all the details of my partner Ben's history with CC (diagnosed over 3.5 years ago) as I have them in my last post for reference and my own chronological history.

Where I left off oh so long ago in October was that Ben had just left MD Anderson with a new metal stent (inserted into his old metal stent) to open up his bile duct.  He was facing starting chemo once again (only Gemcitibine this time vs. the Gem/Cisplatin combo), and he was NOT looking forward to it (who would) and had considered not restarting.

After much encouragement (aka pleading, beating and begging) by yours truly he did restart chemo at the end of October.  (obviously chemo is a personal decision - but my rationale is that he has always responded so well, so now was not the time to give up).

I'm happy to report that after Ben's most recent check-ups at MD Anderson both in January (where they were amazed his cancer had shrunk back again - and where they stated he is in their top 1-2% of patients with success with CC) and again in mid-April where everything was still "holding steady" that Ben has been allowed to go off his chemo regimin once again.  We don't know how long but typically it's 3-6 months depending on how things go.

It continues to be an amazing journey for Ben.  None of us thought he would be here at this point - and if he was we certainly weren't expecting him in the condition he is (you still would not know he is sick by looking at him).  While chemo and the fatigue it brings - along with the mental games terminal cancer can play with your mind can be sometimes debilitating - Ben seems to rise above it all, round after round after round. 

We recently moved back into our completely remodeled house in January (having moved out last May, moving again in December since we lost our temporary lease since remodel took longer than expected and our final move in January).  So moving 3 times in 8 months all while Ben was on chemo!!!  (Lainy, that’s kind of my excuse for not posting – besides the usual craziness at work).  But, my point is – as Ben would say “you can’t put everything on hold because of this because than you just sit around waiting to die”.  And now we have a beautiful home that makes us feel good – and right now he’s off his chemo so it’s all just in time.

So, the journey continues – uphill, downhill, sideways and so forth……but at the end of the day, I guess that’s life anyway with our without cancer.

Until next time – all my best (and I hope I don’t break a new personal record for time between my posts here.

All my best – and anyone can contact me at anytime for anything….



I'm a bit late to the trough - but I am soooo happy to read your news.  Congrautlations!  It's just awesome!


(19 replies, posted in General Discussion)


i agree with some of the others - you really need to get a second opinion.  I have been told by the experts (at MD Anderson - who treat more of this cancer than anyone else), that CC does not show up well on PET scans.

Since you are in Oklahoma, if its possible you should try to see the doctors at MD Anderson in Houston.  They are incredibly knowledgeable.  If you need any help just contact me through email or you can text - 954-401-1069. 



(134 replies, posted in General Discussion)

After another "dry spell", here I am back with another post on the CC board.  Unfortunately, Ben's good ride had had been enjoying now has a few bumps in it. 

Just a reminder - after battling Stage IV CC for three years, Ben was diagnosed with Lymphoma in January.  His chemo regimen switched to a different protocol to clear that up first as it was quite agressive (but at least curable).

At the end of June - chemo was done and PET scans showed no signs of Lymphoma - and they couldn't really see the CC (although PET scans don't show CC as well as CT scans).

Ben was "chemo free" for the summer which was a nice break and allowed us to focus on a few other things for a change (a little travel and the remodel of our house).

On October 7th we returned to MD Anderson in Houston for a quarterly checkup.  Their PET scan revealed that the Lymphoma is still gone (they consider that in remission), but it did show some lesions in the liver again - which they assumed is CC.  They did a biopsy of the liver just to make sure it was CC vs. Lymphoma - and the test came back positive. 

A couple weeks before heading to MD - Ben was complaining of digestion problems and a bit of stomach pain (so we were a little suspicious, but hoping it was nothing).

It turns out the new lesions were once again blocking his bile duct and he started to turn Jaundice (it's amazing how quickly that can come on - really started while at MD Anderson and got worse over the next few days).  Luckily the doctors at MD were able to put another metal stent into the biliary tract to open up the bile duct again. 

While we were certainly discouraged about the news - the doctors were still positive.  They said they would have been surprised not to see any growth because Ben had been off Gemcitibine since last December - so it had been almost 10 months for the CC chemo (since the treatment for Lymphoma doesn't work on CC).   The GI Oncologist at MD (Dr. Shroff) said she wasn't nervous about what she saw....and since Ben has always responded to chemo well - she was hoping it would be the same.

We have since returned from MD - Ben has a plastic stent in his Pancreas that has to come out next week (this was temporary to prevent pancreatitis from the procedure to put in the metal stent).  Chemo will start again on November 1st.  The doctors have recommended that he only take the GEM (vs the GEM/Cisplatin combo) as it's easier to tolerate then the combination and they consider GEM as the "workhorse of the two.

Ben's spirits certainly don't seem to be the same - and while his jaundice is gone, he does still have some stomach pain - and he just hasn't felt that great since returning (I'm sure the combination of both the physical and mental toll of it all).

So, not the best situation - but certainly could be worse given the circumstances.  We are both pragmatic enough that we didn't think CC would be gone permanently through Chemotherapy (as I've never read a case where that has happened), but we were hoping it would stay away a little longer to at least get through a holiday season without chemo. 

I'm a little worried this time - how long can the body take chemo?  But - luckily Ben is a strong man and hoping he endures it as well this time as he always has.

All my best to all of you.



(134 replies, posted in General Discussion)

Thanks everyone - it really is amazing, but realize we never know where the journey ends.  And, when we finish this remodel (hopefully November) if any of you are in the fort lauderdale area you MUST come to our party.



(134 replies, posted in General Discussion)

Ben 2 - Cancer 0

Probably should be posting this in the good news section - but I like the continuity on this post.

I realize not everyone is familiar with my partner's Ben situation so I will try to recap as briefly as possible:

1)  August 2010 - diagnosed with intrahepatic Stage IV CC.  Standard prognosis of 6-18 months to live.
2) On and off chemotherapy with the GEM/CIS protocol - no severe side effects, but has had the usual rollercoaster ride of hospitalizations, pain - one surgery to bypass CC at the end of his stomach.
3)  Was to restart chemo in January of 2013 and was diagnosed with Lymphoma (large type B) - curable, but WTF?  CC chemo was stopped to target Lymphoma.

The big news - Ben just finished the standard protocol chemotherapy for his Lymphoma, had a PET scan last Monday and we received the results Friday.  No lymphoma is present. So - Ben has kicked the Lymphoma. 

The PET scan didn't show anything in the liver either - although CC never showed up well on PET scans - but they don't see anything at this point. Given he has been through so much chemo - and they don't see anything, Ben is considered in kind of "remission". 

The doctors are kind of amazed - still currently you would not know by looking at him that Ben has been battling cancer for 3 years - and kicked it's butt twice!

Who knows what tomorrow will bring, I'm pragmatic enough to know that CC is likely lurking around - but right now it seems to be kicked into a deep dark hole....

That's the news for now - its pretty astounding.



(134 replies, posted in General Discussion)

So, it's been a while again since I've posted.  I was on the other day but after the news of Lauren, I wasn't in the mood to post.

Ben continues on his journey with Lymphoma - he's settled into his new chemo regimen - and has finished 5 of the 6 recommended rounds for this protocol.

After three rounds - he had a PET scan and the scan didn't detect any lymphoma.  WOW!?  Really?  We were quite surprised and I think our oncologist was as well.  While Ben does have a curable (although agressive) form of Lymphoma, I don't think any of us were expecting it to undetectable after 3 rounds of chemo. (two weeks on, one week off).

Ben is contiuning with chemo, as we all know that with any cancer not everything is detectable through a scan, so they will continue the standard protocol.  We are going to visit MD Anderson again after his sixth round - they may decide to do two additional rounds of chemo just to ensure the Lymphoma is gone for good.

No sign of the CC rearing it's ugly head right now. Ben seems to endure this chemo pretty well.  We recently moved out of our house to do some major renovations.  We had been planning before he got sick, but now it's been so long we decided just to go forward.  Ben is kind of making it all happen - which is truly amazing. 

In August it will be three years since Ben was diagnosed with Stage IV, Intrahapetic CC.  Despite all the sadness and prognosis....you just never know what will happen.  You just have to hang in there, live your life and hope.



(167 replies, posted in General Discussion)

I haven't been here for so long and today, I felt compelled to check the board.  There are no words.



(134 replies, posted in General Discussion)

Hello everyone, I thought I better not go another three months before an update - thus incurring the wrath of the wet noodle from Lainy.  I guess 6 weeks isn't so bad (for me).

Actually there isn't too much to report (luckily).  As I said in my last post - Ben was diagnosed with a very agressive form of Lymphoma - so the chemo treatment has now changed to address that (he has a curable form; "type B").  The standard protocol is six cycles (one day of chemo, the next week a "lumbar puncture" of chemo in his spine, then week three off).  Ben has completed two full cycles of the chemo - and this is the start of cycle 3.

Ben continues to tolerate chemotherapy pretty well - he rarely gets nausea or sick...just really tired.  At this point we are still hoping that the CC cancer is just sitting there bored.....our fear is that it will start growing again since his current chemo regimen isn't known to fight CC - so it's kind of a "wait and see" game, but so far it's not showing any signs.

Unfortunately, our dog of 15 years (our beloved dalmation named Zack) died this week - definitely a mental setback for both of us....he has been Ben's companion through this journey day in and day out - and since Ben is home alone so much I'm a little worried how it will effect him - so will try to keep him occupied with our friends.

Anyway - just wanted to check in - as I said, nothing too dramatic to discuss which of course on this board is GOOD NEWS! 

Take care everyone.


(134 replies, posted in General Discussion)

Another 3 months has flown by and here I am.  Interesting news with this post.

Recap - my partner Ben was diagnosed with Stage IV CC in August 2010....a long journey (not surprising), but he's still hanging in there (I have a lot of history if you search on my name for those interested in details).  Ben started his 3rd round of the standard protocol of Gemcitibine and Cisplatin in October.  Even now as I type this nobody would look at Ben and think he was sick.  While he is tired a lot, he still seems to be managing on a day to day basis. 

After visiting MD Anderson in December, they recommended dropping the Cisplatin and focusing on GEM (which they called the "workhorse") to help with quality of life.  The combination was really wearing Ben out - and with the Cisplatin it would mean seven hours of Chemo and fluids, fluids for two days afterwards along with shots to increase his white blood counts.  So just doing GEM would free him up a bit more and not be so debilitating.

Shortly after Christmas Ben started feeling pain in his shoulder and arm - he thought he had pulled a muscle, etc.  Fast forward after more tests, chiropractor (Ben's idea - clearly not the oncologist's, ;-) bone scans, spinal biopsy and another trip to MD Anderson. 

Of course my first thought was "mets to the spine" which I know can happen.  The biopsy seemed to indicate something but not Cholangio.

So - off to MD Anderson last week, (and now this week).  Long story short - it turns out Ben also has Lymphoma!  Wow - two cancers for the price of one! 

Unfortunately I couldn't make the trip this week - but Ben's brother met him in Houston and  I was able to Facetime (video conference) during the doctors visits - which was awesome.  T

The Lymphoma doctor (Luis Fayad - amazing) was quite amazed.  He said "you know - most people don't live so long with CC, so maybe you have had both cancers all along - and what they were seeing outside your liver was lymphoma and not CC".  Huh.

Anyway - not conclusive; they are doing more tests this week to determine the exact type of Lymphoma - they believe it's agressive, but the doctor said he thinks they can treat it.  Lymphoma has a high success rate - and our CC Oncologist at MD said he is one of the best in the business.  He said "when I'm done with you, you will need to figure out how to deal with your CC, but hopefully it's contained to your liver". 

So - there you have it - a whole quarter boiled down to a few rambling paragraphs.  Not too much to report up until today. (besides the usual cancer drama - but that's not very exciting anymore).

More to come - I'll be back soon with an update to see how it turns out.  We meet with the doctor again on Thursday (me via Facetime).  All my best to all of you.



(134 replies, posted in General Discussion)

Speaking of red sauce - throw some on Lainy and beat me with it - because here it is - another 3 months without a post.  Unbelievable how time flies.  This continues to be one of the busiest times at work in my career I think so I definitely don't get out here as much as I should.

So - I'm posting here because I still have the synopsis of my partner Ben's journey the last couple of years posted a few posts above.

Since that time; we never were approved for Tarceva (after two appeals to the insurance I went to our benefits partner in my companies Human Resources department - they said I could do a third "peer to peer" appeal where our doctor could talk to a doctor at the insurance company to determine if Tarceva could be a fit.  (The cost was $500, but my company said they would pay for that).

Meanwhile - to even get a ruling on a 3rd appeal was too long so our local oncologist in Fort Lauderdale put Ben back on the Gemcitibine/Cisplatin combo; although he goes with about 80% of the dose so it doesn't whack (technical term) Ben out too much.  That all started on October 20th.

Since Ben restarted chemo, things have been going fine.  He just finished his 3rd round (of 8) today.  Overall his mental state, fatigue, etc seems to be under control.  At the start of this protocol he went off his pain patch (low dosage 12.5 mcg Fentanyl) and has been without it ever since. 

Even now - to look at Ben you would never know he is sick, he looks good (just a bit of hair loss this time), his mental acuity almost seems normal (which it hasn't for a long time) and he is driving again (small trips, etc).

This Monday (12/10), we made our quarterly (or so) trip to MD Anderson to check in with the GI Oncologist who has been monitoring him.  We like their radiology department there better so we have scans done there as well. 

MERRY CHRISTMAS!  The doctors saw the scans and as of now everything continues to be stable since the last round of chemo ended in June.  When we reminded them that Ben took the summer off of chemo (about 3.5 months) they were AMAZED.  That's what the said - "well that's amazing" no growth and no chemo for that long doesn't happen often.  They said Ben was in their very small percentage of "Marathoners".  So all that adds up to a Merry Christmas!!!

With all that good news including Ben's well being we are going home to see my family in Sioux City, Iowa for Christmas - I haven't been home for Christmas in 3 years, so it truly is almost a miracle consider last year Ben slept through most of Christmas.

Anyway - that's my update for now; probably should be in the GOOD NEWS section - but I like the continuity here.

I see our Moderators are still all here - and we've added Pamela - what a team; your relentless devotion is truly inspirational.

As always, I'm always willing to share email or talk - just email me from here and I will respond as clearly I don't get out here as often as I should...but who knows - maybe this time will be different (but Lainy keep the noodles wet).



(134 replies, posted in General Discussion)

Thanks everyone for your support...and I completely expected the big wet noodle lashing from Lainy!  I will TRY to visit more often!


Hello MMML,

My partner Ben has gone through two full protocols - 8 cycles in Dec-April 2011 and just recently Jan through June of 2012) of Gemzar/Cisplatin.  He had very few side effects through both regimens.  Not everyone experiences hair loss.  Ben did experience some hair loss on the first regimen a after the first two rounds of chemo....eventually he shaved his head as it became more noticeable (but as a man with short hair I think that's an easier decision).

Unlike other chemos - from what I know with GEM/CIS not everyone experiences hair loss - and it doesn't all just fall out at once if they do; so I would recommend just hang in there until you see what happens.

(if you care to look through some of my historical posts I did post more details on the chemo - but to save you time - it was mostly a long day, and he felt tired a lot of the time throughout chemo but still able to function).


It's always a great day - when we see all the hard work pay off with positive results!!


(134 replies, posted in General Discussion)

Someone pinch me, smack me and slap me around.  Has it really been March since I have given an update on Ben?  I'm a little ashamed and embarrassed but if I know this board I hope to be forgiven.

I am fairly certain I could write a book about what has happened since my last update, but for those of you who don't have time to read - here are the cliff notes of the journey regarding my partner:

1)  Diagnosed on 8/30/2010 with Stage IV intrahapetic CC at Mayo Clinic
2)  Finished complete cycle of GEM/CIS protocol on 4/1/2011 - 25-40% shrinkage of primary tumor (depending on who you ask - but obviously good).
3)  Surgery in October 2011 as CC grew back and blocked stomach.
4)  Restarted GEM/CIS in January of 2012 and finished on June 28th 2012 (a long 8 cycles - and he handled most of it very well again)!
5)  Visit to MD Anderson (who we now consult with) in July 2012 - Primary Tumor continues to shrink a bit and nothing else detected - yahoo!!! (you would think)
6)  Tom and Ben embark on 3 week vacation through Denmark, Fjords of Norway - cruise, and Italy.  (if any of you visit fort lauderdale and want to share a bottle of wine I will share with you the joy, sorrow, angst and tears of this trip).
7) Current - as of 9/19/12 - MD Anderson recommends Tarceva as a maintenance regimen (back in July) between GEM/CIS regimens.  Insurance won't approve so Tom is fighting appeals and now trying with the manufacturer itself.

I know I don't have to tell any of you that there is a mountain of details and stress between 1 and 7 (including a couple of other hospital stays and ER visits).  However,  that being said -given the challenges others have faced with this cancer, Ben's physical experience and current physical state has certainly been above anything we were expecting.

As of this writing everything continues to be stable, as I stated - I am trying to get approval for Tarceva - and if that doesn't happen I am fairly certain Ben will go back on GEM/CIS (which we know will happen someday - but while he tolerates it well, it's still physically demanding). 

The biggest challenge Ben faces right now is high ammonia levels in his liver which I have written about before.  I know not everyone experiences that - but he has battled that off and on.  The side effect of this is that he sleeps A LOT, and sometimes he loses his train of thought - I equate to sometimes feeling like he has a mild case of Alzcheimers.  Given his current state - the doctor has asked him not to drive - which of course makes everything a bit more chaotic for both of us (and makes it more depressing for Ben).

It's an interesting dilemma - Ben has now survived over 2 years since being diagnosed - come through two rounds of very strong chemo, and if you would look at him would have no idea he was sick......sounds like this should be in the GOOD NEWS section, but all of the doctors, chemo, chemo brain, takes it's toll and it's been a long difficult road (even though somewhat easier when compared to others).

So - that's my update.  The last few months at work for me have been some of the busiest of my career, that's my lame excuse for not posting here more often - but I do browse around once in a while.

I wish the best for everyone here - despite my lack of posts, incredibly I still think about this board every single day.  Hopefully I will get here more often so I don't have to write such long posts!!!

All my best,


That's frustrating..... turns out caregivers aren't perfect (please see me for a list of examples).  Meanwhile, a breakfast, shopping, naps and dinner don't sound too bad, sounds like you turned lemons into lemonade.  And we all need more lemonade.


(12 replies, posted in General Discussion)


My parter Ben was diagnosed 19 months ago with ICC he had about a 7.5cm tumor in his liver with metastesis to the surrounding lymph nodes and the lining of the stomach.  His original symptoms were a full stomach and some vomiting, and he started to turn yellow (because the tumor was blocking his bile duct).  In some of my original posts I was fairly detailed about his symptoms, treatments, etc. so if you do a search (advanced search) under my user name you can see all my posts.  Ben finished his first round of GEM/CIS last April and is currently just over halfway through the same protocol since he seems to respond to it fairly well.

Let us know if you need anything.



(19 replies, posted in General Discussion)

Hi Trevor,

I received your email earlier today and thought I would reply here for future reference.  I do believe my Ben's case is similar to yours - stage IV with mets to the surrounding lymph nodes and Omentum.  He was diagnosed on 8/30/2010, underwent chemo from November 2010 until April 1st, 2011.  (Gem/Cis standard protocol - made it through all 8 cycles with very little side effects).

Some additional growth in October caused blockage (and some surgery) along with some additional pain in December.  Ben restarted the same Gem/CIS protocol in January.  In the beginning he had some nausea (which he hadn't had before), but after the first couple of rounds that's no longer an issue.  At this point he is halfway through the 8 cycle regimen.  He definitely gets fatigued but so far is exhibiting no other side effects (hair loss isn't as bad as last time), although chemo brain is lurking around.

As for what to do after the primary protocols become ineffective, it does seem that it's still kind of a guessing game.  Ben and I were at MD Anderson last week and they stated that once the standard protocol is done - they potentially recommend oral Xeoleda or possibly Tarceva.  Apparently MD tracks CC closely with pancreatic cancer - they told us that they are finding that there are certain people with a certain genetic mutation that seem to respond well to Tarceva (at least for pancreatic) so they were exploring that for CC. They are going to do some tests on Ben's tumor to see if it's favorable in that direction - however, they recommended he continues with the GEM/CIS since he is responding so well - and Tarceva was just an option for when this regimen is over.

That's all I have to add for now, feel free to email or reply with any additional questions (email is sometimes faster because I don't come out here everyday...or sometimes weeks - but I will definitely respond to email).