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Stent in the bile duct after being diagnosed with cancer. Chemotherapy and radiation done. Is gall bladder removal an option?

My brother in law, has had a stent inserted in the bile duct,Nov 2012 after being diagnosed with cancer. He was told the tumour had not spread to other organs. He has had 11 treatments of radiation and chemo of 25 but had to stop because of sickness. Time is of the essence, and they had talked of a whipple procedure op, but have now backtracked. Could he ask for a gall bladder removal and rerouting or replacement of any damaged part of the bile duct. Its knowing the right questions to ask? Is this the best option given that the patient is a fit 62 year old and a lot to live for. Very interested to know your opinion. Janet
Asked On : Fri, 19 Apr 2013
Answers:  2 Views:  82
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General & Family Physician 's  Response
Very sorry to learn that your brother in law is suffering from cancer and most likely it is pancreatic cancer.Since he was not a surgical candidate,your brother in law was subjected to radiation and chemotherapy.biliary stenting means that bile duct got blocked because of local advancement of cancer resulting in pressure on bile duct from surrounding mass of cancer.
Whipple's procedure was also cancelled because doctors must have realised that locally cancer was very much advanced and surgery is not feasible.
Since all near structures are matted with cancerous cells,no surgery is possible.
You should not disturb anything now and let live your brother in law peacefully in his final journey.
Overall, pancreatic cancer has a poor prognosis. Of all those people diagnosed with pancreatic cancer, only 20% are alive 1 year later. Sadly, only about 5 % live  for 5 years after diagnosis. 
For people diagnosed with locally advanced disease, which cannot be removed by an operation, the average life expectancy is about 7 months. For people whose cancer has already spread to another part of their body, the average life expectancy is only a few months.  
Answered: Fri, 19 Apr 2013
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Oncologist, Radiation Dr. Subhas Pandit's  Response
From the reports it seems that your brother in law have advanced bile-duct cancer.Primary treatment of this condition is surgery if possible.But since he may have advanced cancer which was not possible to operate ,he was offered radiotherapy and chemotherapy .This treatment can sometimes reduce the tumor (called down staging) and makes surgery possible.
They may have backtracked from whipples surgery because the tumor is still large and not fit for surgery.Cancer surgery are ususally radical meaning large amount of surrounding tissue needs to be removed.Only removing gall bladder will not help him .
Only treatment for him will be further chemotherapy which will hopefully palliate his problems.
Best regards
Answered: Fri, 19 Apr 2013
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