Re: Time for my experience and help

Mustangmort, Pam, Marion, thanks for your comments and support.

Best wishes for you.

Carlos

Re: Time for my experience and help

Hi everybody again.

I´m going to update my mom(77 years old) situation.

As you know in October 2009 she had a surgery removing half of the liver and gallbladder.

All CT scan were ok until today, since doctor told her that it was found 2 cm spot in the liver but saying her that he had no clear the area and for this my mom should do another CT scan in 3 months(until now every 6 months)

Which are your thouhts? It is normal waiting 3 months doing nothing more?

My mother is in perfect health, with a normal life. For this reason she is in a shock moment.

Thanks;
Carlos

Re: Time for my experience and help

Hi again;

Today by surprise Doctor told her for a endoscopy on June 20th wednesday.

I have to say that today is my mom birthday, 77 years old, and she has remenbered weeks before to the surgery on 2009.She called me to give me the news crying.

After leaving the factory where i work  I'll buy a bouquet of flowers ...

Thanks to all of you;
Carlos

Re: Time for my experience and help

Carlos...Happy Birthday to your sweet Mom.  I will be thinking of her today.
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

Re: Time for my experience and help

HAPPY BIRTHDAY to your wonderful Mother! Mmmm flowers sound great to me.
Sometimes the spots are so small they have to wait just a bit. Not sure what the waiting will do, everything and everyone is so different.  I know we had a situtuation also where we had to wait a bit as the Radiologist and ONC just were not sure. Did he say why he wants to do the Endoscopy?

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: Time for my experience and help

Happy Birthday to your mum, Carlos smile A great lady, with a great son.

I hope the doctors can reassure her.

Julia x

"Time may be a great healer, but it's a lousy beautician."

Re: Time for my experience and help

Marion, Lainy, Julia, thanks for your words.

I guess they want to be sure about what CT Scan showed 3 weeks ago and for this reason endoscopy is usefull tool for future decisions.

Doctor told her about another CT Scan in September 3 weeks ago, therefore today Doctor phone call to my mom has been a surprise.

As you know my mom surgery remove half of the liver and gallbladder and portal vein reconstruccion. I suppose another surgery it would be not an option... and chemo...

RIght now I am really confused.

regards;
Carlos

Re: Time for my experience and help

Carlos....The next CT scan will put things into perspective.  It is too early to speculate at this point.  Try to relax and enjoy your Mom's Birthday.

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

Re: Time for my experience and help

Hi Carlos,

A happy birthday to your mum from me as well! Get your mum the flowers and try and relax and enjoy this day with her.

Best wishes,

Gavin

Any advice or comments I give are based on personal experiences and knowledge and are my opinions only, they are not to be substituted for professional medical advice. Please seek professional advice from a qualified doctor or medical professional.

Re: Time for my experience and help

Gavin, Marion and all I will send all your support to my mum.

Regards;
Carlos

Re: Time for my experience and help

Hi everybody again;

After an endoscopy with biopsy and Pet scan in the last weeks, cancer has returned to my mom.

Doctor told us that surgeon team will meet next week to take the best decision for my mom.According to him another surgery would not be an option...

She is 77 years old and after 3 years form the surgery she is in perfect health without any symptom.

What can we expect from the doctors decision next week?

Regars to all of you;
Carlos

Re: Time for my experience and help

Hello, Carlos - it's good to hear from you but I'm sorry to hear the cancer has reared its ugly head again.

Sorry I can't answer your question but I'll be thinking of you and your mum and hope next week's meeting goes well.

Julia x

"Time may be a great healer, but it's a lousy beautician."

Re: Time for my experience and help

Hi,
I think you should ask the following questions after the oncologist and doctors' speaking to you at  next meeting.
1. If the tumor is only confined to the liver and no metastasis to other part of the body. ask the interventional radiologist the possibility of RFA or  chemoembo or radioembolization. (for intrahepatic tumor)
2. if the tumor is only confined in the bile duct and is <4cm; and nometastasis,
ask the interventional radiologist whether IMRT oer cyberknife or PDT is an option.(this is for extrahepatic tumor)
If your mom can qualify for either one of the above  procedure,then it is much better for her in terms of side effects as compare to chemotherapy and the quality of life is much better than having chemo. 2nd opinion from an "interventional radiologist "is recommended before the start of chemotherapy.
But if your mom's cancer is spread or metastasized to other part of the body, then systemic chemotherapy and targeted agents will be the only logical choice.
Again, i am only a patient and not a doctor. the final decision should be your mother's and yours to make after concultation with the doctors.
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.

Re: Time for my experience and help

Thanks for the answers.

PCL1029, I don´t think in our hospital(public) can have these trataments, but I will ask. I´ve just read that a private hospital close to our city can have those treataments but it must be very expensive for us.

Anyway, do you know a new chemo treatament would be the best option taking into account that she is in perfect health?At this moment I prefer do nothing...
I've heard so many stories how the chemo actually made things more painful.

What is your opinion?

Regards;
Carlos

140 (edited by PCL1029 Fri, 27 Jul 2012 23:59:28)

Re: Time for my experience and help

Hi,
For chemotherapy , The relatively easy to take without major side effects is capecitabine+ oxaliplatin(CAPOX) . But make sure you understand I am only a patient like you mom and not a doctor. The recommendation should be discuss with your oncologist. But if gemcitabine and CISPLATIN  will be prescribed by the oncologist, it will not hurt to ask for the pros  and cons of both regimens . The CAPOX is less toxic to the kidney and the hearing function and less hematologic (blood cells) side effects than CISPLATIN  ,but gem / CIS is the most commonly prescribed regimen for CCA. As a patient ,between the two, I will choose CAPOX for convenience (capecitabine) is taken by mouth and for the age factor of your mom; gem/cap is also a good choice as well as GEMOX . Doing nothing as you mentioned is not a good idea, for the tumor will keep on growing. Unless the chemotherapy is free and cost you nothing, otherwise my suggestion on the last message to you to go with RFA or IBRT may not be as expensive as you think when you add the cost of each chemotherapy together an d compare to RFA or IMRT one - 2 times  treatment .
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.

Re: Time for my experience and help

Thanks PCL1029.

At the moment chemotherapy is for free in Spain.

The last news is that Doctors want to do more tests(after CAT scan,endoscopy and PET scan), new blood test and another CAT scan exactly.

I dont understand very well since one month ago my mom had a PET scan that I think it is more powerfull than CAT scan.

The new appointement with the doctor is on August 30th for the results.

¿What should i be think?

Thanks for your support once again;
Carlos

Re: Time for my experience and help

Hi;

In today's meeting with the surgeon told us that the new tumor after 3 years with clear images is in a bad place for a second surgery and the best thing is to make an appointment with the oncologist next week.

PCL1029,If I understood correctly, in this meeting we will have to address the following;

-RFA or  chemoembo or radioembolization
-IMRT or cyberknife or PDT
-chemotherapy(CAPOX, gem/CIS ¿?)

My mom took just Gem after surgery 3 years ago for 6 months, 1 hour per week without any side effects.

Thanks for your support;
Carlos

Re: Time for my experience and help

hI.
1.  for surgery or interventional radiologisst purpose. I NEED YOU TO TELL ME WHERE THE EXACT LOCATION OF THE TUMOR.
Usually it is on the CT scan report if you can quote i" word by word"
so I can have more understanding about the location of the tumor.
this is for  the RFA,chemoembolization,IMRT or cyberknife or PDT--all of this are performed by the interventional radiologist and not by oncologist.they may even know about theses options.

2. Chemotherapy is order by  the oncologist.
    6month is not enough,I took gemzar for 18 month and the tumor still came back.
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.

Re: Time for my experience and help

Hi to all of you;

After firts appointment with the ocologist the decision has been Gemzar for 6 months. 30 minutes per week for 3 weeks and 1 week off.
The new tumor is 30x30mm and is close to portal vein.

Asking for interventional radiologist the answer has been that "it is not an option".

She says that in the last months she has sometimes heartburn and she gets tired quckly otherwise nothing else.

today I'm really sad seeing my mother crying tell the doctor all the information about how is a normal day in his life before to take a decison about chemo.

Thanks for your support.

Re: Time for my experience and help

Dear Carlos, thank you for the update on your Mother although I am so sorry to hear about the size of the tumor. She is a very strong woman for her age and you are a loving and strong son. Teddy used to get very tired and the ONC ordered Vitamin B12 shots once a month and they really did help. There are things the ONC can give her for heartburn. No need for her to suffer with anything. Yes, to take chemo or not is a really tough decision. You are sure entitled to feel sad now and then we have all been there. Have courage, be strong and please keep us updated on Mom.

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: Time for my experience and help

Thanks Lainy.

Re: Time for my experience and help

Hi,
Just take it one day at a time.
I think your oncologist did take your mom's current health status into account and prescribed 6month of Gemzar  for your mum. that is ok as far as keeping the cancer at bay and also provide a better quality of life treatment plan for your mom.I still don't know the exact location of the 3x3cm tumor;but if it is the only tumor in the LIVER, unless the radiologist feel otherwise, I don't see why chemoembo is not an option unless he/she has difficulty in reaching the hepatic artery. or the past portal vein reconstruction preclude the procedure.
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.

148 (edited by marions Mon, 10 Sep 2012 12:52:12)

Re: Time for my experience and help

Carlos....I so much understand your Mom's feelings of sadness of having her life altered by this cancer.  My heart goes out to her.  Please, tell her that we understand and  support her. 
In regard to the heartburn, as Lainy has mentioned numerous medications are available to help ease the discomfort.  Our Percy is a great resource for this.
You might also want to ask your Mom to record the incidences of the heartburn occurrences as it may be related to certain foods especially, food high in fat content and/or other food difficult to digest.  To aid the digestive system small meals taken intermittently throughout the day might prove to be beneficial.  And, moving around (small walks) will help.
As always, I would like to point out that the information received on this site must be brought to the attention of the physician.
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

Re: Time for my experience and help

PCL1029, Marions thanks.

Re: Time for my experience and help

Hugs to you and your mum, Carlos. X

"Time may be a great healer, but it's a lousy beautician."