Topic: my father having cc.

my father recently diagonosed having cc.now he has mettalic stents.what should i do now to save him!!!!!!!

faisal

Re: my father having cc.

Dear Faisal, welcome to our family from across the world but sorry you had to find us. We need to know more so that we can try to help. Can you tell us what the diagnosis was? Where is the CC and is your father receiving any treatment other than the stents. Have they given him a stage? What is his age. The more you can tell us the better we can help. Is he comfortable? You can begin by reading up as much as you can as knowledge is our most powerful tool. Also make sure his Oncologist has been treating CC patients not someone who has no experience with CC. Looking forward to finding out more. Be Strong!

Teddy ~In our hearts forever~ATTITUDE is EVERYTHING
Any suggestion I offer is intended as friendly advice based solely on my own experience. Please consult your doctor for professional guidance.

3 (edited by PCL1029 Sat, 23 Nov 2013 09:40:46)

Re: my father having cc.

Hi ,
According to  guide lines.by uptodate.com(a medical web sited for MD )
For advanced  Unrespectable CCA,we suggest chemo radiotherapy  followed by chemotherapy such as 5FU or gemcitabline. For extra hepatic cholangiocarcinoma .
For intrahepatic  CCA ,RFA,chemoembolization ,radioembrolization etc.

For palliation of jaundice patients,who have Unrespectable CCA, STENT placement is recommendation..
Below link may help to guide you what to do on different stages.

http://www.cholangiocarcinoma.org/punbb … 006#p81006

God bless.

Please know that my personal opinion is not intended nor implied to be a substitute for professional medical advice. If  provided, information are for educational purposes.Consult doctor is a MUST for changing of treatment plans.

Re: my father having cc.

Hello!My father age 53yrs old having cholangiocarcinoma(Klatskin Tumor),with hepatic artery involvement.Doctors say it is Type IV.He has been undergone treatment at medanta hospital gurgaon haryana(India), during May this year.That time the MRCP shows the hilar block.The gaestroenterologist that inserted him mettalic stents was Dr. randhir sud.Then they were decided to have surgery to him, but after opening they found that the cancer is unresectable.Then we came back to our home srinagar j&k and then at SKIMS Soura Here,he has undergone chemotherapy 6 cycles of Gemcitabin and cisplatin..during june to september this year...He is now feeling comfortable but here the doctors told us that they  can't give any treatment further..!I wan`t to get your suggestion that what is the further treatment for him...so, that the cancer can`t metastatize his liver or other organs...because fortunately the cancer has not yet invaded his liver or any organs. according to recent ultrasonography! ..I wan`t to save him at any cost!!!!
God Bless us ALL!

faisal

Re: my father having cc.

Hi,

First find out why your father cannot have further treatment.(very important)

Second, get a current CT scan to compare to the last one to check out the current tumor situation to determine the next best treatment plan.

Third if there are no contradiction to continue treatment based on the above information,  if your father 's bilirubin  level is acceptable by the doctor, and the liver enzymes is normal, especially the ALK phosphate ;and your father's lab  work of platelets etc.are ok, and if the CT scan done or will be done after the 6th dose  GEM/Cis and show tumor shrinkage or no further growth of the tumor(stable); and your father is relatively heathly with no other disease like kidney problems; then ask your doctor to continue the GEM/CIS till your father cannot tolerate the GEM/CIS.
or ask your oncologist to consider whether targeted agents such as  Tarceva® (erlotinib) is proper for your dad.
Systemic treatment in your father's case is one of the beast opinionat this point.
Get a second opinion by an other oncologist or GI oncologist to confirm treatment is highly advised.

God bless.

God bless.

Please know that my personal opinion is not intended nor implied to be a substitute for professional medical advice. If  provided, information are for educational purposes.Consult doctor is a MUST for changing of treatment plans.

Re: my father having cc.

Thank u for the information...!

I Will definitely follow the procedure....!that is really precious for my dad at this point of time!!!


God Bless U!

faisal

Re: my father having cc.

my father current CA 19.9 is 128 and CEA 1.36

I will give u the current CT SCAN results up on my new post!!

faisal

Re: my father having cc.

Hello! Everyone! my father`s Current CT Scan shows....!
liver:shows evidence of pneumobilia and stent seen in site..No definite focal lesion seen in liver parenchyma...
No definite focal lesion seen in liver parenchyma...
No obvious extraneous mass lesion seen in the region of porta hepatis ...
Pancreas,B/L Kidneys,Spleen----Normal..
B/L adrenals-Unremarkable..
No significant RP-LAP seen.
No Ascites.
Lower Chest Cuts-appear Unremarkable for any lung nodule or pleural effusion..
Bone Window---Visualised part is unremarkable for any lytic/blastic lesion...
Note is made of mild thickening in Pyloric region of stomach(may represent pyloric spasm)--->Advice given EGD consultation...
Important...Pneomobilia and stents in site no obvious extraneous mass lesion seen in porta hepatis....!
Previous CT Scan shows tumour at the level of porta....!
What is your opinion in this regard???
Please give me  timely advice so that i may help my father in overcoming this disease.....!!!
GOD BLESS!

faisal

9 (edited by PCL1029 Wed, 27 Nov 2013 17:05:41)

Re: my father having cc.

Hi, Faisal,

First of all ,I am not a doctor,I am just a patient.
I presume the surgeons that told you your father CCA was unresectable after they opening him up are GI surgeons; did the surgeon told you the REASON why the tumor cannot be resected at that time. Are they LIVER surgeon and not just general GI surgeons. If not ,seek a 2nd opinion by a liver surgeon is my suggestion especially your message above  stated that "liver:shows evidence of pneumobilia(free air,may be  due to the procedure of insertion of the stents) and stent seen in site..No definite FOCAL lesion seen in liver parenchyma...
No obvious extraneous mass lesion seen in the region of porta hepatis ... unless what it means  is EXCEPT the original tumor,the new finding on this scan is irrelevant or unrelated to the subject being dealt with(ie: the original findings of the   tumor.) and if otherwise, this is a very good news.
btw, THE SCAN NEVER REPORTED ANYTHING ABOUT THE COMMON BILE DUCT AND ANYTHING INVOLVED THE LEFT AND RIGHT HEPATIC DUCTS, PORTAL VEIN AND HEPATIC ARTERY JUST BELOW THE PORTA HEPATIS.

I know you may intent to just put out the most important part of the scan and may not the completed (full) report as you use the .... at the end of some sentences and i understand;but if your father did not have any other health related problems, then the following suggestion and the above ones may be of help to you.

"Previous CT Scan shows tumour at the level of porta....! But now the report said:"No obvious extraneous mass lesion seen in the region of porta hepatis ..."
What is your opinion in this regard???" .
This is rather surprising to me too. I guess the GEM/CIS works and shrinks the tumor completely (complete response?)or the stent works .(some stents are coating with chemotherapy agent to block further growth of the tumor at site of insertion. You need  to bring this finding up and ask the oncologist why he/she want to stop the GEM/CIS chemotherapy since according to the recent scan, the tumor is no longer there and it seems the chemotherpy is working, ask for the specific reason not to continue the GEM/CIS.
How about getting another MRCP to confirm the CT scan findings for further treatment plans.
I am not in India, and not familiar how the medical systems work. But I know ,if financial matters is no concern, There are  excellent private hospitals as well as specialty surgeon  and doctors  in most of the Asia countries that can provide the same if not better care for their patient than the States here.

God bless.

Please know that my personal opinion is not intended nor implied to be a substitute for professional medical advice. If  provided, information are for educational purposes.Consult doctor is a MUST for changing of treatment plans.

Re: my father having cc.

Thank u very much for your timely advice....!

I will greatly follow up the procedure..

but one thing is that why CA 19.9 is high that is 129 where as normal level is 36???

faisal

Re: my father having cc.

Hi,
For hilar CCA, it is not uncommon that CA19-9 is >37, the  upper limit of the normal range;, it can go much higher than that (ie: in the thousands).

BTW, tomorrow is the Thanksgiving day holiday in the States, it is one of the  most important holiday for family and friends to get together and enjoy each other's company. So happy Thanksgiving to you too.

God bless.

Please know that my personal opinion is not intended nor implied to be a substitute for professional medical advice. If  provided, information are for educational purposes.Consult doctor is a MUST for changing of treatment plans.

Re: my father having cc.

Thank u very much !! for your valuable suggestions.

I pray to God to relieve you and our all the troubles and make our life healthy and wealthy ....!

faisal

Re: my father having cc.

hello once again !!!My father having cc inoperable is being given cyberknife radiotherapy !!!is that good for treating cancer or not?

faisal

Re: my father having cc.

Dear Faisal, my husband had Cyber Knife. He was 76 at the time and it bought him an extra 2 1/2 years. That was 5 years ago and today there are other treatments if the CC returns after Cyber Knife. It is literally a painless procedure and only takes 3 -5 days of treatment. I always felt C.K. was a miracle to us. I wish for your Father a successful procedure and please keep us updated on his progress as we really care.

Teddy ~In our hearts forever~ATTITUDE is EVERYTHING
Any suggestion I offer is intended as friendly advice based solely on my own experience. Please consult your doctor for professional guidance.

Re: my father having cc.

Faisal,

Yes, that is good and as Lainy mentioned, after this there are still other options.  Things have progressed in the past 5 years with treatment of CC.
Wishing your dad the best with this treatment and you also.  Take care.

Love & Hugs,
Darla

"One Day At A Time"

All of my comments and suggestions are just my opinions and are not a substitute for professional medical advice.   You should always seek the advice of your physician or other qualified health care providers.

Re: my father having cc.

Faisal....your father is fortunate to fit the criteria for Stereotactic Radiosurgery.  Good luck and please keep us posted.
Hugs,
Marion

THIS INFORMATION IS NOT INTENDED NOR IMPLIED TO BE A SUBSTITUTE FOR PROFESSIONAL MEDICAL ADVICE. YOU SHOULD ALWAYS SEEK THE ADVICE OF YOUR PHYSICIAN OR OTHER QUALIFIED HEALTH CARE PROVIDER

Re: my father having cc.

thank u all for your valuable suggestions!!!

faisal

Re: my father having cc.

Hello All Of You After a long time!!

My father`s recent triple phasic CT Of abdomen revels:::

CT IMPRESSION: ct findings reveal ill defined mildly enhanced soft tissue at the common hepatic duct confluence,porta and along the stent abutting the right and left portal vein and encasing the segment 4 artery and RHA with obstructed two metallic endobiliary stent with proximal bilobal intrahepatic radicles dilatation and Pneumobilia with subcentimeter abdominal lymphadenopathy

Please Comment on this for any review!!!
This is after chemotherapy and Cyberknife Radiotherapy!!!

What do you think!!Is that improved or not??

faisal

Re: my father having cc.

Hi, Faisal,

At best,  it is disease stable, but most likely the disease is in a slow progress mode. The chemotherapy at best, if it is working, is to slow the growth of the tumor but not cure it.
The "ill defined mildly enhanced soft tissue" mostl likely is the early signs of mets at the surrounding area.(ie. lymph node metastasis )
"Obstructed metallic biliary stent......with dilatation " may require insertion of plastic stents through the metal stents to release the blockage if jaundice occur.
But I am not sure if it can be done if the location of the endobiliary stents is Way up inside the liver as compare to the lower locations near the left and right hepatic bile ducts.
God bless.

Please know that my personal opinion is not intended nor implied to be a substitute for professional medical advice. If  provided, information are for educational purposes.Consult doctor is a MUST for changing of treatment plans.

Re: my father having cc.

thank u for your suggestions!!

God Bless U!!

faisal

Re: my father having cc.

Hello Everyone!! My father was very well after Cyberknife radio surgery, but from previous week he has been continously on fever and some vomitting.He is like having some weight loss..Please provide some suggestions as latest improvements in the research of  advanced Hilar cholangiocarcinoma as i m really scared of his future health..

Thanks and regards.

Faisal

faisal