1 (edited by marions Fri, 20 Jul 2007 13:28:24)

Topic: Interview with an Oncologist re: chemo therapy

My question:

Why are positive responses to chemo therapy so varied?

His answer:
They know that in many other diseases somebody with another cancer would potentially benefit from chemotherapy.

They don't know that in CC partly, because it has not been adequately studied, partly because bile duct cancers are really very much less responsive to chemotherapy - they tend to be inherently sort of resistant to chemotherapy -.

Different organs in the body have different functions, and the bile duct sort of transports all the toxic garbage out of the liver and into the stool, and so you would expect those cells to be pretty resistant to toxins, because if they weren't, everyone else would have a screwed up bile duct. 

That resistance to toxins I think, simplistically at least, makes therapy really largely ineffective.

The same mechanism that makes the cells resistant to the toxins makes them resistant to chemotherapy.


This physician did however, encourage the use of chemo therapy, although with guarded expectations.  Based on his experience, many patients have had favorable results.

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: Interview with an Oncologist re: chemo therapy

What are the favorable results?  Did he give a length of time that the chemo usually works??

Laura

Re: Interview with an Oncologist re: chemo therapy

Laura,

Time varies a great deal by individual.  If you read the chemo threads on this site you'll find patients who have had any where from a few months to a few years holding the cancer at bay with different chemos and cocktails.

A chemo will sometimes work for one person and not another.

Another way of saying we're all unique.

In some cases additional drugs like avastin have had a beneficial effect on the treatment in conjunction with chemo and there is good evidence from other countries that therapies not recognized in the US (or by our insurance companies) have shown improved longevity often in conjunction with a chemo drug.  Check the alternatives threads and also our experiences posts.

best wishes,
Peter

4 (edited by marions Fri, 20 Jul 2007 00:46:43)

Re: Interview with an Oncologist re: chemo therapy

Dear Laura,

no, he was not able to clarify "favorable" results, neither did he mention the length of time necessary for a prescribed protocol to demonstrate it's effectiveness. 

Simply, I believe, he does not know the answer to this, nor do I think, does anyone else have a plausible, factual analyzes of this disease due to the rarity of occurence and the consequently limited published studies. 

Certainly, he would recommmend a chemo therapy protocol if warranted, althought, as he mentioned:  "with guarded expectation" thus , he was not able to guarantee a positive outcome. 

The postings and blogs on this site however, will give you a wealth of information in re: to people being treated with select chemo protocols and it will confirm the variances in treatments and subsequent responses of the individual patient.   

Sorry, I could not be of any more help to you.

Kindly,

Marions

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: Interview with an Oncologist re: chemo therapy

Dear Marions,
Thank you for taking the time to email me back.  I am always searching for more information for my husband, Tommy.  He was diagnosed with CC on January 24, 2007.  They also found a separate cancer in his esophagus that has spread to his liver.  It is all so unusual.  We are still looking for more answers and information.

Thanks again!
Laura

Re: Interview with an Oncologist re: chemo therapy

Dear Peter,
Thank you for taking the time to answer my questions concerning my husband, Tommy.  We are thinking of going to MD Anderson after his second CT scan in August.  We are always searching for more information.  Tommy is a very unusual diagnosis... CC and a separate esophageal cancer with meds to liver. 
Thank you for any additional info. you may have.

We'll keep the faith!
Laura

7 (edited by marions Sun, 22 Jul 2007 11:37:34)

Re: Interview with an Oncologist re: chemo therapy

Dear Laura,

Dr. Venook (oncologist) at UCSF specializes in esophageal and bilary cancer.  Don't quite know whether he will look at your scans without a personal visit by you and your husband however, it is another option for a second opinion.

Wishing you the very best,

Marions

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