Topic: What Will You Do After Adjuvant Chemotherapy Is Done.
After resection and adjuvant chemotherapy was done,doctor say you are clean and you are a cancer survivor,if so then what will you do ?
May be you will do as most oncologists suggested,follow up with blood work every month and CT scan or MRI every 3 -6 months to monitor the cancer; when the cancer comes back,(which in our case of cholangiocarcinoma,the recurrence rate is about 50% for extrahepatic and 75% for intrahepatic CCA.);then start with different chemotherapy agents or targeted agents and fight it allover again since there is no CURE is available at this time.
if you choose the above approach. do you think you may be just playing the "waiting game" or like "taking a long chemo break"? According to one study,90% of the patients,especially the educated one,who have a college degree will explore other options such as complimentary and alternative therapy (CAM) ;immunotherapy etc. to further their treatment needs. Most likely,even if we try hard, we will not find what we wanted except a few of those lucky ones.
How do you improve the odds to delay the recurrence of this cancer and may be the odds of longer overall survival?
Then it comes to the topic of " Maintenance chemotherapy " or "Switch maintenance therapy".
In short, that means after the assigned cycles of adjuvant chemotherapy, even if you are clear , you will follow with " a lower maintenance dose" of the same chemotherapy or " switch to a maintenance dose" of a different chemotherapy or targeted agent such as Capecitabine continuously daily right after you stop the adjuvant treatment. It has not been proven that "maintenance chemotherapy" had worked for hepatobiliary cancers but may have worked on other cancer like colon or lung cancer.
See link below
In short I think this is a more active approach for me than like a sitting duck awaiting for the dismal outcome; besides, it is more like treating a chronic disease like hypertension or diabetes that required daily administration of medications to control the symptoms; in doing so, I hope it can provide a longer disease control period for me , a better quality of life and in time for the cure.
But please remember ,it is just a suggestion and you should discuss this unproven concept next time you see your oncologist.