Topic: chemoembolization

Sheila finally got approved for two different chemos, embolization and nexavar.  I am just worried that it might be too hard on her now that her liver functions are going south.  She is jaundiced with a bilirubin of 13 ast up to 230 alt at 70.  Ct scans and ultrsound show the bile ducts aren't blocked or dilated so both the oncologist and radiologist say stent or drain wouldn't help with bile.  We are worried that an attempt at finally doing something after these 3 months off chemo will hurt her health more than help......We are desperate to try something........the doctors aren't exactly sure what to do either, but leave the decision up to us.   What to do?????  Does anyone have any experience with how severe the chemoembolization is on the liver functions?  Is it metabolized by the liver?  As for the nexavar, the oncologist says he would try it at a reduced dosage, but how successful would that be when only half the people get any results at full strength????  Just really don't know which way to turn at this point. Appreciate any help,  Thanks, Bob

2 (edited by marions Thu, 08 Mar 2012 15:08:59)

Re: chemoembolization

Bob...what a tough decision to make for you and Sheila.  I can't answer your question in regards to the possible side effects and wonder whether the radiologist should consult with collegues in his profession.
How many of such procedures has the oncology radiology physician performed? Another option is to call the company and speak with a representative. 
Hopefully someone else will come along and share some thoughs with us. 
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

3 (edited by PCL1029 Thu, 08 Mar 2012 22:09:40)

Re: chemoembolization

Hi,
I do not think either chemoembolization and radioembolization can be performed un less the Serum bilirubin is below 2.
Relative contraindications are Serum bilirubin>2;AST>100;ascites;cardiac or kidney problems;tumor burden>50% of the liver etc--from uptodate.com.

For Sorafenib, dose reduction is recommended for patients with bilirubin1.5-3 times the upper limit of the normal(roughly equal 2.5-5.6); Sorafenib cannot be tolerated with more severe hyperbilirubinemia. ---clinical pharmacology.com
Please remember all the above are for palliative purposes only. Drug resistance is common. The above radiations treatments may cause temporally increase of liver enzymes for a period of time.
Your gut instinct may serve well to make this difficult decision.
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.