Gall Bladder Cancer- Treatment Options.

[ricker]

Dear Dr:

I understand that you've gone through such a torture in the past. Now my 64yr old mother in law(residing in China) had gall bladder removed after years of gallstones(delayed out of fear of surgery due to hypertension). Our information is second hand since drs there aren't that "open" with information. The surgeon also removed portions of pancreas, liver, lymph node. No jaundice. Stage 3+

Pancreas, Liver are clear, but lymph node was affected. Also a golf ball sized tumor outside pancreas(pushing on it) and this same tumor "attached" to major vein(don't know which one). So further surgery thought inappropriate. Undergoing radiation therapy. She tried conventional chemo, but couldn't tolerate(low white cell). Found lump in neck now..drs haven't diagnosed it yet(horrible care)

Now we are trying to figure what kind of chemo targeted treatment to consider. Her current drs only offered Tarceva.

But we know of others which are available in China.

Any ideas on what chemos to consider or any other treatments? We read about S-1 in Japan(similar to 5FU) and use of Cisplatin. But worried about toleration with her heart and risk of stroke. Incidentally, post surgery she's suddenly become insulin dependent, but possibly an underlying condition since family history of diabetes. It seems like choosing drugs is like gambling in Las Vegas!

[Wright]

Yes for some reason both my parents died from this, but in their cases it was rather advanced and caused jaundice. In my mother's case she was very afraid of surgery, but she was close to 91 when she got it. My father was 10 years younger when he got it(also 10 years earlier). Generally the same chemo therapy as for colon cancer is used in such cases. I'm reluctant to give more detailed advice on this since i would then be a back seat driver with limited information. With both diabetes and hypertension involved it is not easy to treat this anyway. That lump should be diagnosed soonest! Easiest with a needle biopsy. If it indeed is cancer related to her gallbladder tumor that would make her case a stage 4 which at present is in principle incurable! Please do keep me posted!  

[Bemelle]

Dear Dr:

I understand that you've gone through such a torture in the past. Now my 64yr old mother in law(residing in China) had gall bladder removed after years of gallstones(delayed out of fear of surgery due to hypertension). Our information is second hand since drs there aren't that "open" with information. The surgeon also removed portions of pancreas, liver, lymph node. No jaundice. Stage 3+

Pancreas, Liver are clear, but lymph node was affected. Also a golf ball sized tumor outside pancreas(pushing on it) and this same tumor "attached" to major vein(don't know which one). So further surgery thought inappropriate. Undergoing radiation therapy. She tried conventional chemo, but couldn't tolerate(low white cell). Found lump in neck now..drs haven't diagnosed it yet(horrible care)

Now we are trying to figure what kind of chemo targeted treatment to consider. Her current drs only offered Tarceva.

But we know of others which are available in China.

Any ideas on what chemos to consider or any other treatments? We read about S-1 in Japan(similar to 5FU) and use of Cisplatin. But worried about toleration with her heart and risk of stroke. Incidentally, post surgery she's suddenly become insulin dependent, but possibly an underlying condition since family history of diabetes. It seems like choosing drugs is like gambling in Las Vegas!