Huong-My Nguyen update:
Just decided to transfer my dad to boston, where my sister live because I heard they have more advance in heath care and more doctors that are specialist in CC or klatskin cancer. My dad was determined inoperable as of now due to the tumor site to be in the "y" section and hard to operate, CT/radiation is his next step to hopefully resize and allow for resection. Though, Michigan (grand rapids) is limited in physician specialist in this field. If you know a great doctor in boston please let me know. I heard MAC is the best hospital for cancer patient around in boston, worchester, but i'm not sure how specialized they are in this CC field. If you know of anything please let me know...

PS: I was asked to fax or send all the info/data of my dads in advance, and I dont' even know how to get start with this. Please direct me

2

(45 replies, posted in Hospitals)

My Daddi-->
Please give me some advice on this decision. I just talked to Dr.Chapman office and talked to nurse Velva specifically about my dads condition, she asked to send all his file and scan to the office. I would love to do so but before, I need to clarify something. Is my dad absolutely inoperable???. If he is, then the liver transplant would be the option to go, but what if the doctor will do the resection after CT/radiation? THen which is better, the resection or the liver transplant. Since i'm so new to this-- I'm not sure what to do in this decision. I do know one thing that the protocol for liver transplant is when patient is absolutely inoperable and should I just send my dads data in for Dr.Chappman to review and he will then determine from there? Dr. Chung which told me my dad tumor site is at the Y-site which is hard to resect, said that he want my dad to do Chemo and radiation and would review if my dad is operable or not later on. Should I wait for this, letting my dad go through this CT decision or should I just go straight to Liver transplant.?.. What if the size will go down and be resectable later, then is it a wrong idea to have the liver transplant be in process??>.. this is my biggest concern. Please respond, ANd how about the cost?> My dad has medicaid (molina)... so financial wise is a concern also..  SInce i live in michigan and Dr.Chapman is in MO, (what is the estimation $$)

My Daddi-->
Please give me some advice on this decision. I just talked to Dr.Chapman office and talked to nurse Velva specifically about my dads condition, she asked to send all his file and scan to the office. I would love to do so but before, I need to clarify something. Is my dad absolutely inoperable???. If he is, then the liver transplant would be the option to go, but what if the doctor will do the resection after CT/radiation? THen which is better, the resection or the liver transplant. Since i'm so new to this-- I'm not sure what to do in this decision. I do know one thing that the protocol for liver transplant is when patient is absolutely inoperable and should I just send my dads data in for Dr.Chappman to review and he will then determine from there? Dr. Chung which told me my dad tumor site is at the Y-site which is hard to resect, said that he want my dad to do Chemo and radiation and would review if my dad is operable or not later on. Should I wait for this, letting my dad go through this CT decision or should I just go straight to Liver transplant.?.. What if the size will go down and be resectable later, then is it a wrong idea to have the liver transplant be in process??>.. this is my biggest concern. Please respond

HI Stan and everyone in the forumn. Update one DADDIE..
** We just met with DR. CHUNG and unforntunately Dr. Chung said my dad has to be on Chemotherapy, the operation "resection" would not go as plan b/c it seems the tumor is in the 'branch"... HE hope the CT will decrease the size to a resectable size.... ... I don't know what else to say, other than I dotn' know what to do now... .. I coulnt' ask any more question and would like to know how positive is this and should I get a 2nd specialist to determine the tumor site. I would like your advice on thiS? .... My dad sseem to be very weak for C-T , he had lost 10lbs and I can say can't walk right due to the tiredness adn the pain from The "EXTERNAL" tube that they placed in him to drain the bile since the "stent" doesn't work... --

I'm really frustrate right now... should I entirely trust on soley Dr. Chung...?? Is he workign with a group of specialist to decide on this??? and what is my best option after this?? Should I gather the data and pix and sent it somewhere else to confirm the resection descision prior my dad starting on chemo???.... --> We have a meeting with the "radiology dr" this afternoon to talk about my dad C-T plan and see if he is able to get the C-T... ...


If a second option is best, which is a great place that have team of expert on this and the resection, I really want him to be resect b/c the external drain seem to give him so much pain... Please help

Hi everyone== Thanks again for the response and support. I"m glad I join this forum that have such rich experience and knowledge regarding to this.

My dad's concern for is that if he were to be admitted to the hospital after the ER visit, would that affect his surgery date. which is on the 5/14. In addition his pre-operative clearance date is this following tuesday. The pre-operative clearane is when his primary doctor will look at his overall health with lab values and etc to determine if he is healthy enough for surgery. If this also got push back then it might affect his surgery date.

Stan- and everyone that reply :: thanks so much for everyones comment and suggestion.... Here is my update...

=== My dad seem to be resectable, the nurse call to let me know to call dad's primary doctor for a "pre-operative" clearance and it will be this coming tuesday. She also said to wait for a phone call - the dr will placed a tube from outside into his liver to drain the bile and said that this will direct him for surgery. The set date is 05/14... Dr. Chung-- seem to be very knowledgable, and after reading Stan's comment, I thank you for giving me some thoughts into this. and I agree-- he seem to be very clear and firm in his stands and ability. He explained everythign very clearly and I think i will give him a try, My dad's condition , fatigue, headache and N/V is getting worse with losing weights, I think I couldnt' afford to switch him around at this time. I will gather his info in need after the surgery though. .... Dr. Chung suggest that my dad has to stay healthy, eat and not to lose weight and be ready for surgery. However, THIS IS MY CONCERN AS OF RIGHT NOW>>>
DADDIs condition scared me this past few days after Wedns talkign to Dr. Chung.... today is Sunday --- My dads keep complaining of headache, severe headache, and he felt his body so uncomfortable and fatigue tired... I can see the veins showing on top of his forehead - moving adn beating, in touching it i can feel the heart beat from the vein... I took him to the near by pharmacy to test his BP but it was normal..... IS THIS A NORMAL SYMPTOMS ? and HOW TO HELP HIM??.. He is right now can't sleep and just sit and couldnt' sleep sayign his body doesnt' feel right... ?. He is scared to go to the Emergency again, and I couldn't convince him too -- He  lost 4 lbs already in 4 days. and that is not good.. IS THERE ANY WAY TO RELIEVE HIS SYMPTOMS? I Tried to give him ice packs for his Headache, but not help much and I dotn' know wat to do for his body symptoms.. uncomfortable that he said he cant' explain.. He look so pale.. it is so heart breaking lookign at him.. I Wanted to give him some sleeping pills so he cna just sleep and forget the body symptoms.. but he is scared of the med also...?? Can you guide me..?..

JASOn-- please tell me more of DR. CHUNG... thanks everyone so much once again.

Hi, PCL and everyone that reply, thanks so much for yours response, I live in Grand rapids, Michigan. My dad has an appointment with Dr. Chung at Spectrum Downtown this coming wednesday for the discussion and review of his labs/DX. Should I wait to see how he is and what he have to say about my dad condition before deciding to transfer my dad somewhere else.. Yes, I'm suspecting also b/c Dr. Chung is the only dr in the area that are able to do this surgery-- I am scare and worried b/c I do want to fasten the process before his condition become mestasisize

My senses are mixed with reality and dreaming-- feel like in a coma- after my dads is diagnosed of this cancer, in another term "intrahepatic bile duct cancer" just last week thursday of (04/19)---> I recall the Dr. waiting for me to translate to my dad since my father barely speak english at all. I was shaking heavily, nervous and afraid and translating to my dad had never been so hard, holding my tears and hiding the fact he only have 6 more months if the resection are not possible and even if they can get the tumor out it is only 10% of success rate. I"m still in a dream right now and search here for some comfort, some knowledge and understanding of how to go from here, I hope to get some good advice and guidance about my dads road from here, what is the best Dr and hospital and treatment for him? The Dr said that he will be transferred down to spectrum where there is only one dr in the area that can help my dad with this cancer (resect the tumor) and only with 10% success rate and if the Dr accept this challenge since the tumor is intrahepatic so it will be too deep into the liver. I read somewhere that mayoclinic and karmanos cancer center in detroit, MI are two great hospital specialist in this bile duct cancer. I'm looking for some guidance/alternatives if the Dr. at spectrum refuse to dissect the tumor out, what should I do??? I'm scare to think of that and since his tumor is not metasis, is that good enough for the resect to take place?? n is it true only 6 months? and if the surgery is possible and after that, how long in average how long does he have to be with us family stilll.. please give me some guidance and comfort, i'm going crazy and can't focus to study, finals are coming up and my rotation is starting soon.