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Our husband, father, and grandpa, Rick Hyams, was diagnosed with cholangiocarcinoma on April 25, 2018. Cholangiocarcinoma is a rare cancer that impacts the liver, gallbladder and bile ducts. The news came as a shock and our family is still processing the diagnosis and prognosis.
Rick was asymptomatic prior to the diagnosis and was having routine pre-op blood work done on Friday, April 20, before having a reparative surgery on his right shoulder the following week. The blood work came back with elevated liver enzymes. This triggered his primary care physician to cancel the shoulder surgery and run additional tests, including an ultrasound of his liver. His ultrasound occurred on Tuesday, April 24, and revealed 4 masses in the liver. On Wednesday, April 25, Rick had a CT scan that led to the preliminary diagnosis of cholangiocarcinoma. It appears that the originating tumor surrounds the bile ducts and was cutting off the removal of bile from his liver. This has caused a build of bilirubin in his liver, resulting in jaundice.
On Thursday, April 26, Rick went in to Jewish Hospital in Cincinnati, OH, which is affiliated with Oncology Hematology Care (OHC), to have a biopsy performed and a stent/drainage tube placed to assist draining bile from the liver. We had originally thought this would be an outpatient procedure; however, he was admitted after the stent/drainage tube was placed. The biopsy results did confirm his preliminary diagnosis. The drainage tube has been adjusted twice (so far) and still has not sufficiently reduced his bilirubin levels. Additionally, the pain from the stent, biopsy, and the disease itself has been significant, so the hospital staff is working hard to manage his pain levels.
As far as treatment goes, the cancer is invasive so our options are quite limited. Additionally, until his liver is functioning properly, he is not a candidate for chemotherapy. The liver is responsible for processing toxins, so chemotherapy would do more harm than good at this point. The OHC team has begun to perform pinpoint radiation, as of Thursday, May 3, specifically on the tumor encasing the bile ducts. The hope is to allow the bile ducts to dilate and let bile drain naturally. It will take quite a few radiation treatments before we know if this option is viable. Whatever the result, we'll have to reassess Rick's situation at that point in time. Right now, we're just taking it day by day.
Unfortunately, this disease is palliative, therefore we are focused on treating the symptoms of the disease and managing the pain. We are hopeful that we can extend his life with minimally causing him more pain. We want him to be able to enjoy his family and friends with whatever time he has left.
We know that he is well loved by all of his friends and family so if you wish to visit, please reach out to Debbie, Sara (Ryan) or Charlie (Rachelle) to see if he is up for visitors. He has good days and bad days just like the rest of us.
