"My husband has completed chemo. Lost 80 plus lbs, numerous blood transfusions, etc. Now that's all the medical interventions! Just had repeat ct scan this week and had "slight" increase size in liver tumor. Not so bad for a man off chemo since Oct."
First, I will pray for your husband and may God's Grace upon him and lift and/or reduce his burden of suffering.
Second, ,part of the 80lbs he lost might be the fluids in his abdomen and not completely as the lost of body weight;blood transfusions are used to give your husband for anemia,so he would feel better and make him strong.
"I am asking for suggestions for pain control. He is on Fentanyl patch 25mcg every 72 hours, Oxycontin 5mg every 4-6 hours prn pain. He has been taking more of the Oxycontin lately - about 25 - 30 mg in 24 hour period. Any suggestions or recommendations?"
With regard to the pain management of your husband; Oxycontin IR 5mg q4-6h prn for breakthru pain and Fentanyl 25mcg patch q 72 hrs are relatively indicated to me that your husband's pain is not the acute sharp pain but the heavy dull pain that bothers him the most. BTW, the dose of your husband's pain medication are at the lower end of the scale and you should not worry to much about it.
"His kidney function was damaged as a result of chemo. Stable, producing urine but BUN/CR still elevated."
How high are the BUN/CR? How's his ammonia level? does he show signs of confusion at times? The pain meds at this level may not be enough to cause confusion, and the ammonia level will help to understand what cause the confusion if happened.
I am not a doctor' but I agree that any chemotherapy that contains the platium group(cis,carboplatin and oxaliplatin) will no longer helpful to your husband's CCA due to poor kidney function.But there are many other chemotherapy and targeted agents such as Xeloda, is cleared thru nonrenal mechanisms and unless the CRCL<30; it can be given to patients with renal dysfunction with dose adjustment ;sorafenib is a targeted agent that can be safely given to patients with renal insufficiency,again with adequate monitoring and dose adjustment since it is only partly excreted by the kidneys.Paclitaxel under go minimal renal excretion,and has been safely administered to patients on chronic hemodialysis.(--- from up-to date .com, literature review on Chemotherapy-related nephrotoxicity and dose modification in patients with renal insufficiency.Nov.2012)
What I am trying to say is this, get another opinion from another medical oncologist from a larger hospital ;MD Anderson or other university hospital
for a 2nd opinion to see whether your husband is truly out of chemotherapy or targeted agent to treat him; may be there are still medications that can prolong his life and provide a better quality of life to your husband.
In short and based on the limited info. from you about your husband, I believe there are still options for your husband and MD Anderson may be a place to go to since they are more chemotherapy oriented unless you have already done so.
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.