Gavin, thank you for posting this study.
Here's the part of the study that I found very interesting:
Similar to HCC, increased levels of IL-6 have been demonstrated in serum from CCA patients. IL-6 levels in one study were not only elevated in CCA patients compared to healthy controls, but they were elevated to a greater extent in CCA than in HCC or colorectal cancer patients (121). In addition, serum IL-6 levels correlated with tumor burden and were significantly decreased two weeks after surgical resection of CCA. Other studies have evaluated the potential for IL-6 as a diagnostic and prognostic tool in CCA. Tangkijvanich et al. showed that detectable levels of IL-6 (0.18 ng/mL) were able to distinguish between CCA and benign biliary disease with a sensitivity and specificity of 71.1% and 90%, respectively (122). The authors propose that IL-6 in combination with CA-19-9, a conventional tumor marker for CCA, may provide superior diagnostic accuracy and sensitivity. It should be noted that this study was performed using patients from Thailand where CCA is particularly prevalent, presumably due to high rates of Opisthorchis viverrini infestation. Another study performed in Korea showed that IL-6, at a cut-off value of 0.25 ng/ml, provides a sensitivity and specificity of 73% and 92%, respectively. This study also examined the effect of photodynamic therapy (PDT) on levels of IL-6. PDT is an emerging treatment for CCA in which an intravenous photosensitizer is administered followed by illumination at the appropriate wavelength. This treatment leads to an apoptotic and anti-angiogenic response (123). Interestingly, in CCA patients following PDT, IL-6 serum levels dropped approximately 7-fold, again suggesting an important relationship between IL-6 and CCA (124).
My wife is starting the next round of chemo on Tuesday. She doesn't have a measurable tumor that can be used to monitor chemo effectiveness. Our oncologist already told us that CA-19-9 isn't a reliable test. Too many false positives/negatives. So, basically, we will be "shooting in the dark". Endure six cycles of very toxic regimen and hope for the best.
I want to ask the oncologist to start testing CA-19-9 and IL-6. It's possible that we won't get any useful feedback from the tests. But, at the very least, we will establish a baseline that can be used for future surveillance.
Percy or anyone else:
How common is IL-6 blood test?
Can a regular hospital lab test it?
Is it expensive to test?