Although I don't post too often, given this site has provided much support over the past couple of years I just wanted to give a bit of an update of how everything has been going and next steps...
Last update on my Dad was that he'd had a successful Whipple procedure (in July 2012) with negative margins and no lymph node involvment. After adjuvant chemo with Gem, he started showing an increase in his tumour markers (although clean scans).
Update from this was that a 1cm tumour was found where the ends of his bile duct had been stapled together from his surgery (this was late last year). Given it's location and arteries nearby, surgery was not an option to his oncologist elected to go with radio therapy and xeloda. When prepping him for the radiotherapy, there was a suspect spot shown in his liver however the decision was made to treat what was visible and following treatment this tumour was classed as 'dead'.
Unfortunately a few months later (March this year), his tumour markers had risen to 3,000 and subsequent scans showed a 3cm tumour in his level. Given he had already been through a Whipple Procedure resection wasn't recommended, and his oncologist wanted to explore RFA treatment. In the period of time between getting the ultrasound done for the RFA his tumour had grown and 2 more spots had shown up. The oncologist had advised that it was spreading very quickly and aggressively and that he may not have much time left (tumour markers at this point had risen to 130,000).
His oncologist recommended FOLFOX as an option (with SIRT being a back up option should this not work). Luckily Dad hasn't experiences very many side effects from the FOLFOX some hairloss and pins and needles in his fingertips has been as bad as it's got. His placets have remained stable throughout his treatment and his tumour markers dropped quite rapidly. At the conclusion of his treatment (last week), his tumour markers had dropped down to 700 and both scans that he'd had during treatment had shown shrinkage of his tumour.
Given that he didn't experience any serious ill effects from the treatment, he's elected to keep going for the time being. In the meantime he's also been registered on a trial list for PENAO which I believe works by inhibiting glucose uptake by cancer calls. However, while his current treatment regime is working they see no need to go down this path at this stage.
Above all though, his health and spirits have been very good. He goes about every day as he used to prior to his diagnosis without any ill effects. I think this has been the positive to take out of all of this... Especially given that in March the future didn't look too great.
A positive update for those looking for some hope