Topic: Help, need some options.

I am new to this site and have been reading a lot of the posts. 
My husband was diagnosis in March 2008 at 49 years old.  All indications were that it did not spread based on PET and CT scans.
On April 28 the whipple was attempted but stopped because of two spots on the liver. 
I still can not understand why the surgeon did not continue with the resections and we would deal with the liver spots after.  We do know the spots are cancer  but they are so small that as of his last PET scan on September 4 it still has not lite up. 
It seems that based on what i've read that some surgeons would have done the resections.  Has anyone else been in a similar condition and their doctor did the whipple?
My husband had four rounds of gemzar and xeloda and it did not help, it only got worse. 
He started a new regimen of chemo and we are hoping this time it will do something.
He is still fighting and has strength and courage that i could only dream of having. I admire him so much.
I will never give up that there is a way to get him in remission.
Also, what does everyone think of a doctor that tells his patients wife and I quote " I know you want your husband around for a long time, but it's not going to happen"
I think it's time to get a new doctor....are oncologists that harsh? 
I just want a doctor with some fire.

Thanks for listening.
Lulu

I miss you more and more everyday. 
RFL 6/28/58-12/27/08

Re: Help, need some options.

Hello Lulu and welcome. So sorry to hear about your husbands aborted resection.  I have learned that this is not an uncommon occurrence as the true extent of the disease can only be observed by the surgeon at the time of surgery.   Although I don

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: Help, need some options.

Hi Luluu and welcome to the best club in the world that no one wants to join!
My husband had a Whipple 3 years ago and the doctor said if the cancer had spread he would abort the surgery. The reason he gave was that this is the largest surgery to the human body, not life threatening but huge! If he saw that the cancer had spread he would not put Teddy through this massive surgery and that is the thinking of most of the surgeons. He did abort due to a destruction of the pancreas caused by the dye leaking from the endoscopy. He gave the pancreas 3 weeks to heal as he had to cut the head of the pancreas off to get to the bile duct valve where the cancer was. He then went in and fortunately the cancer was contained and the surgery was successful.  It came back this last April where the duodenum used to be. As  far as his "remark" he certainly had no tact. I would definitely get a second opinion. And no, I believe most Oncologists are not like that. We have worked with 4 here in Phoenix and I have found each one to be very compassionate. Stay 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.

Re: Help, need some options.

I think the reason the surgery was aborted is that if there is cancer remaining after surgery, the grown and spread faster. Your body is telling itself grow liver, grow liver and it doesnt know the difference between healthy cells and cancerous cells so the cancerous liver cells multiply at the same rate as the healthy liver cells. If you think how quickly and how much this happens after surgery, you can see how fast the cancer could spread.

However, some people have had chemo and radiation and then had the resection attemped again. So there still is hope.

Kris

Cancer is a word, not a sentence.

36 year old patient with buckets of hope

Re: Help, need some options.

Here is an interesting article from the UK which talks about the impact of invasive biopsies before attempted liver resection. The authors of this letter seem to suggest that invasive diagnostic techniques reduce the chances of success when the liver is resected. I  would imagine that this is for the same reasons that Kris has mentioned....

http://www.bmj.com/cgi/content/full/329/7473/1045-c

Apparently this is the matter of some debate in the BMJ (British Medical Journal)

Re: Help, need some options.

Frogspawn wrote:

The authors of this letter seem to suggest that invasive diagnostic techniques reduce the chances of success when the liver is resected. I  would imagine that this is for the same reasons that Kris has mentioned....

Actually, I think the letter in the BMJ is more about "tumor seeding" caused by biopsies, which is a different issue than what Kris addressed.  Prior to my transplant, my radiation oncologist and the surgeon battled over whether I should have brachytherapy due to the risk of tumor seeding from the procedure.  As you note, this is apparently a contentious issue in cancer treatment.  For me, it was unsettling that my doctors were so diametrically opposed on what was the "right" course of treatment for me, but everything turned out okay.

Re: Help, need some options.

Gene or anyone, please explain how you you become a candidate for a liver transplant or resection. Also, tell me about radiation, what tumor did they target.  Is the tumor still in your bile duct?
I think my husband was not treated aggresively, 4cc tumor in bile duct, aboarted resection because mets to liver, small enough they didn't show up on PET or CT.  So can someone tell me why they wouldn't do anything surgically. Did we just pick the wrong surgeon?

I miss you more and more everyday. 
RFL 6/28/58-12/27/08

Re: Help, need some options.

LuLuu,
I thought that this was one of the most comprehensive postings on this siite and it came from Gene.  Gene, I hope that you don't mind me pullling this up and posting it, again?   

it depends on how many tumors there are, where and how big they are, and whether any have metasticized outside the liver.  I was diagnosed with CC in June and transplanted in August after undergoing radiation and chemo.  I only had one tumor measuring 1 cm.  If there are mets outside the liver that weren't picked up by the CT or Pet scans prior to my transplant, I was told that they will grow and spread like wildfire now that I'm on immunosuppressants.  I am also at increased risk for other types of cancer (skin and colon, to name two) due to the anti-rejection drugs.  That's the major risk of having a transplant.  You can read about the Mayo tx protocol for CC here: http://www.mayoclinic.org/news2005-rst/3026.html

Gene (4 months out from tx, fingers crossed)

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