Where to Find The Best Care/surgeons For Bile Duct Cancer

Susan--can you share with us WHAT EXACTLY Dr Marshall has recommended? We, too, are going to see him for a treatment regime. /Liz

Hi Liz,
We went to see Dr. Marshall and have been on a consultation basis with him. He has worked with our doctors to come up with the last two treatment plans for my husband. I would imagine his treatments would vary by patient but I can tell you what they came up with us. The first round was FOLFOX6 with Erbitux. The Erbitux gave my husband a really bad rash so they switched out Erbitux for Avastin on the second round, still continuing the FOLFOX 6. The first round seemed to be working but the second round did not so we are deciding what to do next. The other treatment recommended by Dr. Marshall was Gemcitibine combined with some other agent. We do not have time to go see Dr. Marshall this round but our doctor talked to him. Dr. Marshall thought it might be time to skip the chemo and try some Phase I trials he has at Georgetown but after consulting with our other doctors we decided to try one more round of chemo and then see about trials. I am going to run the combo on message 30 by our doctors and see if that is an option. They are recommending Gemcitibine and Cisplatine or Gemcitibine and Taxotere. Apparentely the Taxotere is supposed to be pretty rough so we are leaning towards Cisplatin. There are so many options, it's hard to know what to do. It's nice to be given choices but very stressful to have to make them. Good Luck!

Thanks for the info, Susan. As another data point for you, my fiance started with a chemo treatment of Gemcitabine and Xeloda. It was a big zero. His cancer spread. We were then going to do a 2nd chemo round with Cisplatin--but THAT has very harsh side effects.(Check that out carefully.) So, we then looked into other options and ultimately went into a Phase I trial at Johns Hopkins. That took 6 weeks to get in, then they bounced us out after 2 weeks because he didn't have perfect organ conditions. (That's the downside of trials--they can dismiss you in a NY minute. So, we're going to see Dr. Marshall. Take a look at the National Cancer Institute. www.cancer.gov. You can fill out a form online or on the phone, and they'll match you up with NIH trials. So, you don't need to research, you don't need to call. They call you. In fact, I just rec'd 2 new trials today via email from them. Makes research MUCH easier. /Liz

Who is the excellent surgeon you mentioned in Memphis TN? My brother-in-law was just diagnosed with cholangiocarcinoma. We live in the Chattanooga area. Thanks for you help.
Robby

Jeff_s
You seem to know a lot about cholangiocarcinoma. Just wondered if you might know a great surgical oncologist in the Tennessee area? Would greatly appreciate your help.
Thanks, Robin

Sorry to say I do not know of anyone in your area. But since messaging on this topic last, I have become aware of an excellent interventional radiologist who does a radiation treatment called Therasphere at Northwestern Memorial Hospital in Chicago. His name is Riad Salem. Very smart and a good guy as well. Therasphere involves injecting microscopic radioactive particles directly into the blood supply of the tumor. The particles lodge in the capillaries of the tumor and radiate at a high level for about 10 days, then go inert. The advantage over conventional external radiation is that the intensity within the tumor is very high, but the collateral damage to good tissue is very low. If they can get it all, surgery is still by far the best option - the only one with real potential for cure. But if surgery is impossible, this is worth considering. My wife just had it done and we are about a month away from re-imaging to see how well it worked. Good Luck. Jeff_S.

 

On 3/19/2006 Jeff_s wrote:

Sorry to say I do not know of anyone in your area. But since messaging on this topic last, I have become aware of an excellent interventional radiologist who does a radiation treatment called Therasphere at Northwestern Memorial Hospital in Chicago. His name is Riad Salem. Very smart and a good guy as well. Therasphere involves injecting microscopic radioactive particles directly into the blood supply of the tumor. The particles lodge in the capillaries of the tumor and radiate at a high level for about 10 days, then go inert. The advantage over conventional external radiation is that the intensity within the tumor is very high, but the collateral damage to good tissue is very low. If they can get it all, surgery is still by far the best option - the only one with real potential for cure. But if surgery is impossible, this is worth considering. My wife just had it done and we are about a month away from re-imaging to see how well it worked. Good Luck. Jeff_S.

Hello,

My father's tumor is not resectable and is currently taking radiation theraphy at UIC- Chicago. I was wondering if your wife's radiation was a success.

 

Thanks,