Topic: update on tom

hello everyone,

its bin a rollercaoster...in october tom had 70% of his right liver removed...microscopic he has rest tumor.. they advised adjuvante chemo.. in holland they wont give the chemo ... the dokters and onc gives us not good advice..what to do...its almost they have given up on him...what must we do... the insiurence want pay the chemo.. dont now how much money it wil be for chemo... i think a lot of money... we are so scared... help us please what to do...

thanks everyone moontje

Re: update on tom

Hi,

Sorry I do not know the financial or charity assitance in your country. But according to the ESMO(giudelines from the European Socierty of Medical Oncology):

For post-op treatment after a noncurative resection of intrahepatic or extrapetic cholangiocarcinoma,supportive care alone, chemotherapy alone and radiotherapy  with or without chemotherapy are aceptable options.

In the States, clinical trials are encouraged;otherwise, chemotherapy with GEM or 5FU based  or supportive care. for intrahepatic CCA with positive margin,options include reresection,ablation,or5fu sensitized chemoradiation.

Happy Thanksgiving holiday and

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: update on tom

moontje....I am trying to understand.  Had the physician spoken of residual tumor tissue?   Or, is this a question of adjuvant therapy based on suspicion rather than clinical indication? 
The later points to the unanswered question as to whether adjuvant therapy is actually helpful?  Although, the majority of physicians in the US are leaning toward adjuvant therapy,  many other countries do not.
Several clinical trials are underway however; we have yet to see conclusive data.  The UK is conducting a clinical trial Gem vs  no treatment post resection and we expect this data to be released sometime in 2014. 
Please share more information with us. 
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: update on tom

hi marion,and pcl1029

the  T.N.M.classification is..G2,ypT3,pN1 (2/7), L1,V0,pN1,R1 the onc says that  the chemo will not help to be cured or to live longer!!! there are no evidence of that in the hole world..
that is what they say in holland. in germany they say to give us a chance.. 2 different options whe don't now anymore what to believe..and what the best thing is to do..

thanks

gr moontje

5 (edited by PCL1029 Fri, 29 Nov 2013 22:20:07)

Re: update on tom

PCL1029 wrote:

Hi,

Sorry I do not know the financial or charity assitance in your country. But according to the ESMO(giudelines from the European Socierty of Medical Oncology):

For post-op treatment after a noncurative resection of intrahepatic or extrapetic cholangiocarcinoma,supportive care alone, chemotherapy alone and radiotherapy  with or without chemotherapy are aceptable options.


That means both opinions from your Holland doctor as well as the Germany one are correct.

The choice is difficult between "quality or quantity of life.|

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: update on tom

thanks for the information, it is indeed very difficult to make a choice... but the cancer is microscopisch so must we do the chemo now or later if the scan detected tumors... is the chemo better when there are microscopische cells ...or when there are tumors??? please advice us... tom is not sick he feels like he can do everything ....

again thanks very much to you all,for the advice..   tomorrow whe are going to see the dokter and onc.. hope they give us more information.. and whe let you now what they say..

god bless moontje