Topic: Surgery Not Successful

My mom was diagnosed with Bild Duct Cancer a few weeks back; She lives in Toronto and was going to Toronto General Hospital. They did the CT Scans, MRI, Liver Function Tests, Blood tests and were still not sure to the extent of the cancer. because he rbilirubin count was fine, and she did not really have jaundice, and some blood reports were also okay. MRI was suspicious though.

They Referred to a Liver Transplant surgeon in the same hospital, who then did another MRI and CT scan and after much back n forth on next steps, decided that they were going to do the surgery and take a part of the liver out. We were of course hopeful since surgery seems to be the best course for this anyways.

They did the surgery, spent 4 hours and then the doc came and told us that they decided they could not do much surgically. The doc came and told us the tumor had spread to a couple of lymph nodes, and was in the bile duct right through to the head of the pancreas. So they did not do ANYthing, just tied her up and back to square 1. Interestingly enough, the doc who performed the surgery did not show up even once after the surgery to see my mom in person. A couple of his team mates came by but they were somewhat junior in my mind, and could not provide a lot of detailed explanation. One of them has actually given a written report that indicates he felt that the surgery could have been done, but the senior lead surgeon decided not to go ahead. Anyways, the whole thing seems a little strange since they refused to do a PET Scan, did a complete 4 hour exploratory surgery with no results, and the docs in the same team have a difference of opinion on what should and could have been done.

I am trying to pursue the option of getting a second opinion at Johns Hopkins because I am not sure how latest and current are the docs in Toronto. Any one has any experience with TGH? Also, if this surgery was not done, and Johns Hopkins does recommend a surgery - could she really go through a second surgery in a few weeks? Or now that this surgical attempt has already been made, is her only option chemo/radioation? And finally, since they are not US citizens and have no medical insurance in the US - are there any programs for Financial aid for patients in their situation?

Re: Surgery Not Successful

You might want to check if the canadian government will pay. I know that as a patient in Sweden, the governemt will pay for treatment in another country if that treatment could not be given in Sweden--even if that means that you need a "better" skilled doctor.

I dont think you will find much help funding your parents in the US through programs there. I did a somewhat deep search when I wanted to come back home for treatment.

Check Pubmed as a swear a read an article that said that even with lymph node involvement, there was a statistically significant increase in quanity and quality of life after surgery. The problem is that if you cannot remove all the tumor, it can grow quite quickly after surgury. Your body is doing its best to grown new liver tissue to replace what has been removed, and unfortuneately all those metastisis are in fact liver cells, no matter where they are located. So if you have a spot on your bone, when you remove the
tumor in your liver, the tumor in your bone can grow more quickly than it would if you had left the tumor in the liver alone.....does that make sense?

Best of luck finding a willing doctor who can remove all parts of the tumor.

Kris

Cancer is a word, not a sentence.

36 year old patient with buckets of hope

Re: Surgery Not Successful

vk933,
so sorry to be hearing about your Mom.
There is a Dr. Sean P. Cleary at Princess Margaret Hospital.  His number is: 416 340-5331.  Was he one of the attending physicians? If not you might want to contact his office, for another opinion.  I wll try to e-mail him, also.
Best wishes,
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: Surgery Not Successful

I tried to look up Dr. Cleary but cannot find him online at PMH's web site. I will try his number tomorrow. What is his speciality?

Re: Surgery Not Successful

He is a general surgeon and has been treating several CC patients. 
When you call the given phone number most likely you will be given an e-mail address which will allow you to contact him, personally.   If you need help in connecting with him please, contact me either through the board or, you may e-mail me. 
Wishing for the absolute 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

Re: Surgery Not Successful

vk933,
My dad, was also recently diagnosed with inoperable cc in Toronto.  I know that sinking feeling all too well.  However, we have found a wonderful surgeon that truly has made such an effort to help my father.  He is not at PMH but rather at Sunnybrook and he specializes in these cases.  He has also done a lot of research and worked with the Mayo.   His name is Dr. S. Hanna at the Odette cancer centre.  Google him and you'll see.... Another thing, he allowed us to ask about all kinds of treatments and did not shut us down.
It was unfortunate that the surgery was not successful but not without effort.  He had an ultrasound  going for approx. 90 min during surgery to fully understand the extent of the disease... he also biopsied a lymph node, came back pos., before deciding the benefits did not outweigh the risks.   He then  came to find us in the waiting room to tell us the heartbreaking news. He had spent almost 4 hours trying....even the anesthesiologist apologized to my father for the unsuccessful surgery.
We are now about to start a chemo  protocol and then rads on a specialized machine...the TOMO.  It's the only one in Toronto.
Hang in there
NNV

Re: Surgery Not Successful

did they explain why they could not operate. and what stage did they say his CC was at? thanks for the replies, i will get in touch with both doctors.

the unfortunate part of our case is that the doc who operated is totally missing in action and refusing to even respond after multiple phone calls, messages with his secretary..mom is again in emergency due to some infection but this guy is no where to be found

Re: Surgery Not Successful

the disease had progressed too far into the liver and there was lymph node involvement.....metastatic.   He had stents put in 2 days later and they are working beautifully.     My father had no symptoms.....his GP ran some tests for a kidney stone and got the ball rolling.   This all happened so fast we are still trying to cope because he looks and feels fine, though tired.