Topic: Wall Stent Question

I am hoping that some of you can shed some light on my question....my dad was diagnosed with bile duct cancer 2 months ago.  He has a fairly large mass that is wrapped around his portal vein, blood vessels and arteries.  Currently he has 2 drain tubes and a plastic stent in the bile duct. He is being treated with his first infection and is continuing to run a low-grade fever off and on.  He will undergo a procedure early next week to remove the plastic stent and then the plan was to have a 2nd procedure to insert a metal wall stent.  I should mention that dad has decided not to undergo chemo treatments.  Yesterday he was asked if he was sure he didn't want to do chemo because once they inserted the metal wall stent that chemo would not be an option.  He was also told the metal stent could not be removed and that eventually the mass would more than like grow over the stent and in the end his liver would stop functioning.  He was told that the average stent would last 6-12 months.  Up until now, dad has not wanted to know how much time he has...but with this news yesterday he feels like he was quietly given one.  The Dr. Also shared that they only install the wall stent for his type of cancer when the patient decides they are basically done fighting ( done with chemo, decides against chemo or not going the holistic route). This is very confusing to all of us!!! 

Can anyone share anything on this?  I know from reading other posts that many have metal stents and that many have lasted much longer.  Was dad given this news because of the nature and location of his tumor?  I know that I have also read that masses wrapped around the portal vein will eventually squeeze the vein closed and the blood will no longer flow through.

Needless to say,  we are all feeling very overwhelmed with all of this!  Hope to hear from some of you to get a better understanding.

Not a so Happy Thanksgiving,
Rena

Re: Wall Stent Question

Hi,
You can choose to have the plastic stents insert every 2-3months depends on whether the doctor wants to that. Did he give you a reason that plastic stent will not be an option if your dad does not mind ? Metal stent usually last longer between 6-18 months,again depends on each patient. In theory, mental stent is permanent  and cannot be removed. But I know some doctor views differently on that.
2nd opinion is  not a bad idea even your dad is in care of by OSU.
Chemotherapy can help,but is not proven its effectiveness for every patient. Therefore I do not disagree with your dad's decision. It is indeed a very tough decision to make to have or have no chemotherapy. However the decision must be his own and not from suggestions by other people who are just afraid of the word"cancer"  and without careful research on the subject of bile duct cancer.
Try to have the best thanksgiving with you dad today and may God really bless you and your family .

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.

3 (edited by marions Thu, 22 Nov 2012 13:33:24)

Re: Wall Stent Question

Rena.....I have learned that if the malignant stricture involves the distal bile duct versus the proximal bile duct it has a tendency to occlude quicker. Having said that, a second, metal, stent can be inserted or, as we have seen with numerous others, physicians insert a plastic stent in the metal stent. Why your Dad could not receive chemotherapy I don't understand because; as you have mentioned many of our patients with metal stents receive treatments. I would make sure to have another consultation with the physician.   
Additionally, dear Rena, people don’t have expiration dates stamped on their feet.  Although, the physician, based on his/her experience can give an estimation of life expectance it is however; not set in stone. 
My heart goes out to you and your family; this was not a good time to hear such devastating news.  Please, remember that generalizations are just that, but this is your Dad’s cancer only and how quickly things continue to develop is true to him only. 
Tons of 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: Wall Stent Question

Hi Rena,

Just thought I would chime in here with my thoughts on the metal stent as my dad had one inserted after his diagnosis. Like Marion says, I too find it strange to hear that your dads doctors say that he would not be able to have chemo if they put the metal stent in. As I said, my dad had a metal stent. He had it for about a year and then his specialist refered him to the onc to see about chemo. As it turned out, my dad could not have the chemo as the jaundice had come back and his stent was blocked, but it wasn't the case that he couldn't have chemo due to him having a metal stent instead of a plastic one. If they couldn't do chemo due to the fact alone that my dad had a metal stent then his specialist wouldn't have advise him to look into the option of chemo and would not have refered him to the onc to look into it. Perhaps you could look for other opinions or at least try and speak with your dads onc about what he said about the metal stent and no chemo.

As to what the Dr said to your dad about that they only use a metal stent when the patient has given up fighting, I have to disagree with that. I find it strange that a Dr would say that to a patient of their family.

I can sure understand why you are all feeling very overwhelmed right now having heard what you have. But please do not give up hope. Try and stay strong and know that we are all here for you.

Hugs,

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: Wall Stent Question

Dear Rena, this is certainly not the news you wanted but I have to agree with what everyone said, we don't believe in time limits and please get another opinion,  I have not heard of this problem either. I also have not heard of an ONC advising to go the holistic route. Please, get another opinion and make sure it is an ONC who is very experienced with CC. Sounds to me like Dad is not quitting but his ONC is. Sending you the best and be 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: Wall Stent Question

Thanks so much for all of your thoughts, suggestions and advice on this!  On some of it, I just need a confirmation.  My parents do plan to consult with dad's onc dr tomorrow.  The radiology Dr. was the one who gave them the information about the metal wall stent.  I hope he can clear up the confusion for us.  Based on some your input and other we have made a list of questions to ask. 

Lainy, the Dr mentioned holistic care as an example....she was not advising to go that route.  Mom said that she was trying to explain to them that they only insert the wall stents when all other options have failed, the patient chooses not to do or try or the patient is not able to endure for whatever reason.

Dad has not had much of an appetite for the past week, which I am quickly learning can be par for course with this horrible disease.  He only ate a couple bites of turkey today and pushed his plate away.  It is mind boggling how this disease can change a life so quickly!  I feel like the life has been sucked right out of my dad...and mom too as far as that goes!

One day at a time...right?  Thanks again!  It is great to have all of you support!  You have already helped more than you know!

Rena

Re: Wall Stent Question

Rena, for Dad when he doesn't feel like eating, Mom might try Carnation Instant Breakfast. Teddy loved the vanilla and I would blend in a banana. It has all the nutrients needed and can take the place of any meal. Hospice had recommended it. You are so right that this Cancer takes it all out of everyone. The best we can do is try to be very strong. I don't know where there are more courageous people than on our CC Board!

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: Wall Stent Question

Rena,

My Dad had 3 metal stents with the hope of chemo, so I would definately check this fact with the Doctor.  They can clean metal stents out if they get blocked with sludge etc, and can also either add another metal stent or put a plastic one inside the metal, depending on where the tumour is.  My Dads was right in the middle of the Y section of the bile duct, hence why he ended up with 3 metal stents. 


When my Dad didn't have much appetite the Doctor prescribed a fruit drink with all the vitamins and mineral he needed, they are called Ensure in the UK.  My dad enjoyed little and often rather than big meals, soups, jacket potatoes, and rice puddings.

Thinking of you

Andie

Devoted Daughter to the most wonderful Dad a girl could ask for.  Sadly lost his battle on 19.02.11, peacefully in the arms of Mom and I.  As requested by Dad "we will keep on smiling".

Re: Wall Stent Question

Is this my Dear Andie? How are you, girl? I am over the moon to see your bright shining face! I miss both you and Jen. It is so good to see you chime in here. I hope everyone and everything is good at your end. OK, I give up, what are jacket potatoes? Are they like our baked potato with the skin on? Stay well and wishing you the very best.

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: Wall Stent Question

Andie....same here.  I am thrilled to see your posting.  How is life moving along?  How is your little guy?  And, how is your Mum?
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: Wall Stent Question

I wanted to give an update....mom called day's Dr. Today and everything is cleared up...thank goodness.  Apparently it was a nurse in radiology that shared the bad information.  Dad's Dr. was not happy at all and basically he shared what Andie shared above (thank you Andie!!!). 

Thank you guys so much!  Your guidance has been so helpful getting through all of this!

Rena

Re: Wall Stent Question

Good news, Rena. It just didn't sound right. You can now put that one behind you. Good for Mom for being pro active!

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: Wall Stent Question

Good to hear, Rena.  The statements made had me doubt the care your Dad is receiving.  So glad it turned out alright.
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: Wall Stent Question

That's great news Rena! I hope the Doctor will be putting the Nurse in Radiology right!! Keep positive :-)

Hi Lainy & Marion, I have posted in members section as I don't want to take over Renas post lol xx

Devoted Daughter to the most wonderful Dad a girl could ask for.  Sadly lost his battle on 19.02.11, peacefully in the arms of Mom and I.  As requested by Dad "we will keep on smiling".

Re: Wall Stent Question

Oh yea...Dad's Dr took immediate action with the nurse!