1 (edited by zuzuby Wed, 27 Jun 2007 21:23:55)

Topic: Dad had whipple in April and now considering chemo

My dad, who's 75, was diagnosed with a bile duct tumor in March and had the Whipple procedure at the Mayo in Jacksonville in April.  During surgery they found some spots (largest was 1 cm) in his liver which on initial biopsy were reported as benign, but the final pathology report said that 2 of them were indeed cancer that had metastasized from the bile duct.  The primary tumor was about 1.5cm and had attached to the portal vein.  The surgeon was able to resect from the portal vein and also removed the 4 spots he saw on the liver.  Due to the involvement of the portal vein and the metastases in the liver, his cancer was categorized as Stage IV.  His lymph nodes and his pancreas were clean, so it's just the liver at this point.

The oncologist at Mayo is recommending chemo.  He has offered my dad to participate in a clinical trial of avastin and tarceva or he could go a standard protocol of chemo with Gemzar.  I am a bit worried by the potentially serious side effects of the Avastin and was wondering if anyone has had any experience with this trial or either of these drugs. 

My dad feels so good right now and it's unclear to me as to whether this treatment will prolong his life significantly and if it's worth the potential serious risks and side effects.  We're also having trouble deciding what to do next because we don't really know if he has any visible tumors in the liver right now, since the surgeon said he removed the spots he did see during the surgery.  I realize that there probably is some cancer in his liver, but it's difficult deciding just how aggressive we should be.

My parents are really counting on me to help them decide.  I have some background in science (I work in a research lab and have some friends that are doctors I can consult), so I can at least understand what the doctors are saying and what the drug descriptions mean. 

My parents live in Florida and I live near Boston, which makes it difficult for me being so far away.  I was able to fly down during the initial consult at the Mayo and was there for 3 weeks after his surgery.  I just go back from my 3rd trip last week when we met with the oncologist.  I'm plan to call him back with some questions once I look into what's out there and look up these drugs.

If anyone has experience with these drugs and their sides effects I would really love to hear from you.  Also any thoughts in general on whether to go with the chemo at all at this point would be much appreciated.

Thanks so much,