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liver regrowth after resection

lisa42's picture
lisa42
Posts: 3663
Joined: Jul 2008

I had a liver resection just over a year ago. I had read so many articles about how the liver grows back after having a liver resection & have heard people on this board talk about how theirs was growing back too. Interestly, when I asked my liver surgeon if he could see any liver regrowth on my CT scan, he said "not much, but I wasn't really expecting much of it to grow back". I was surprised and asked him why, because I thought the liver always grows back. He said that's not always true in everyone and it can also depend upon how much is removed and where in the liver it's removed. He also said since not everyone's liver regrows, it's his job beforehand to determine if the person will have enough functioning liver left if nothing regrows. I've heard that some people can have as much as 80% of their liver removed. I had just a little under half removed, and am still surprised to discover that mine really hasn't regrown much of anything, even at 9 months after the surgery (it's now been over a year, but it was about 3 months that I saw the liver specialist and asked him this). Has anyone else ever heard that the liver doesn't always grow back? Just curious.

Lisa

Shayenne's picture
Shayenne
Posts: 2370
Joined: Jan 2009

...I have never heard of that either, I thought the liver always regrew itself as well, strange, it's supposed to be this amazing organ that regenerates itself, you got me nervous now, since I have no idea what they're going to do with my liver once chemo is done, I always thought maybe I'd get resected also, if I become a surgical candidate, I'll have to ask my onc about this one.

Buzzard's picture
Buzzard
Posts: 3073
Joined: Aug 2008

Its "some" that don't grow back...Yours will regenerate itself just fine and thats the way you need to look at it...Don't worry about unnecessary items until they become necessary to worry about. We have enough to think about already.....Now, Smile and go make you daughter gag or something fun..........Just kiddin'...... :)

Shayenne's picture
Shayenne
Posts: 2370
Joined: Jan 2009

That just got me rolling here, I do want to make her gag so badly now, but they're busy playing "Rock Band", she's singing, I wonder if I can make her gag while she sings...hmm...lol...

PhillieG's picture
PhillieG
Posts: 4667
Joined: May 2005

I heard that the liver may not grow back to its original size but it regains its functionality.
I would imagine there is no one set of rules that applies to us all.
Remember, you're unique...just like everyone else.
-p

kimby's picture
kimby
Posts: 804
Joined: Oct 2007

Lisa,

The way my liver surgeon explained it to me is that it depends on how the liver is resected. He says you want a surgeon that does liver transplants because they understand and have the skill necessary to resect in a way to promote regrowth. It's true that they need to leave enough healthy liver to be sure you remain healthy, but that is usually for the short term while your liver regenerates. However, if you have enough left to be healthy and all tumors in your liver were removed...YAY! It isn't always possible to remove all disease AND resect in a way to promote regrowth. If you can get both, all the better.

JMHO,

Kimby

lmliess's picture
lmliess
Posts: 331
Joined: Dec 2008

...in April this year. My surgeon said mine would grow back in 6 - 8 weeks. I have not had a CT scan but I noticed at around 6 - 8 weeks I was not so tired all the time. He said I would be VERY sluggish as it grew back. But heck I don't know now!! Now I am wondering if I am just functioning with 1/3 of my liver!

Buzzard's picture
Buzzard
Posts: 3073
Joined: Aug 2008

You know, my wife actually told me that I was functioning on half a brain but I really feel fine also.....So my thinking is, if I feel fine with whatever whole or partial I have left , then its all good, partial or whole whatever it may be....the way I see it..... :)

Paula G.'s picture
Paula G.
Posts: 596
Joined: Apr 2009

This I haven't heard before. My husband isn't a canidate for surgery at least not now. He is doing the FOLFOX + Avastin. Then we will see. I'm glad to see your post because I thought it always grew back. Good luck. Paula G.

snommintj's picture
snommintj
Posts: 602
Joined: Mar 2009

The liver has 8 lobes. Each lobe has it's own identity. If you remove then entire lobe, chances are it won't regenerate. If you leave a little behind, theory is that it will regenerate.

Nana b's picture
Nana b
Posts: 2871
Joined: May 2009

The liver is like a tree, a trunk with two branches, If you get a resection and they take out only part of the branch (not cut completely to the trunk), leaves will grow on the branch (liver regrowth).....however, if you take out the whole branch (cut to the trunk) the leaves can not grow....or the liver will not regenerate itself.

Hope this makes sense.

lisa42's picture
lisa42
Posts: 3663
Joined: Jul 2008

That does make sense. I had my entire left lobe removed, so I guess that's probably why it's not regrown. I had just a wedge resection taken out of my right lobe.
I didn't mean to worry anyone- sorry if I did. It's helpful to know, though, the way it functions and the how/why if it ends up not regrowing.
Thanks, everyone, for your insight and comments.

Take care!

Lisa

mom_2_3's picture
mom_2_3
Posts: 937
Joined: Nov 2008

I have heard that the liver doesn't necessarily grow back but I wasn't concerned about it prior to surgery. I felt I had enough to worry about!!

I had my entire left lobe removed and had a wedge resection of the right. Recent CT scans (about 4 months from surgery) indicate that the liver is completely regrown. It looks just like the liver I had prior to surgery. I know it doesn't answer your question but just relating my experience.

It's strange but I could almost feel like I knew when the liver was re-grown as my energy levels went up dramatically. How is your energy?

dixchi's picture
dixchi
Posts: 438
Joined: Jun 2008

I had a liver transplant specialist for my resection in 2008 and
asked him prior to surgery about regrowth; he said at my age (67)
he does not expect much; but also said that we can live on just
a "sliver" of liver.
Barbara

Sundanceh's picture
Sundanceh
Posts: 4284
Joined: Jun 2009

Hi, All
Just wanted to share my experience with you.

First, you have to be a candidate for liver resection. It depends on where the tumor is located. Generally, only about 10% of the population is a candidate for such a major procedure.

They were going to take 80% of my liver and I hopped up on the gurney with the belief that my liver would "regrow." Looking back, I sure made a leap of faith. I've talked to liver specialists and read where it can regrow, but not to the size of your "original" equipment. It grows to some extent and still functions.

When the surgeon opened me up, it was discovered that I was not a candidate for this type of surgery. What they did instead was an RFA - Radio Frequency Ablation, and they burned as much of the tumor out as they could get to. They use a prong device and then use electricity to "heat up" the tumor to a very hot degree, I forget the temp, but it kills the tumor cells by burning them. Right now, this is only doable with tumors of 5cm or less. But I've heard they are developing newer ones for bigger tumors.

The liver resection is still called "the gold standard", but RFA statistics (and I"m a living one) say that the RFA has equal to nearly better odds of survivaL than a liver resection.

If I had a do over, I'd still take the RFA over the liver resection. They told me that I could have died on the operating table from liver failure with so much of my liver removed. I found that a little unnerving, of course I was unconscious in the OR, so my wife had to make the decision for me - good for her.

Just wanted to let you guys know about this procedure - it is not done everywhere and is know gaining ground as an alternative approach to liver resection.

I had a world renown surgeon at Baylor University Medical Center in Dallas - Dr. Goldstein, who saved my life that day.

Ya'll are great people and it's a pleasure talking with you and trying to help.

No evidence of cancer in my liver for the last 18 months, but 2 spots have showed up in the plura of my lung, so I'm back at it again.

Hope this helped you guys!!!
-Craig

robinvan's picture
robinvan
Posts: 1014
Joined: May 2007

Hi Craig... and all!

Another RFA survivor here. I had it to eliminate a recurrent met 2- years ago. 2/3 Liver Resection 4.5 years ago. It is a great procedure. With multiple deployments of the probe they are now covering larger areas. Here's what I had to say about it in my blog in June 2007.
http://rob-pollock.blogspot.com/2007/06/what-is-rfa.html

Be well...

Rob; in Vancouver.

"What is not cured by the knife may be cured by fire." Hippocrates

Sundanceh's picture
Sundanceh
Posts: 4284
Joined: Jun 2009

Hey, Rob
That was good info you had on your blog on RFA. I'm with you on the fact that people look at you funny when you mention the term RFA - I've had nurses who didn't know what it was.

And like you, I had to have an "open" incision to reach the tumor site.

The only thing we've mine was that we did not get all of the tumor, because it was too close to some blood vessels so they went as far as they could thinking they got it. A subsequent MRI revealed that that the outskirts of the tumor still remained.

So we did another procedure that people "glaze" over too - CyberKnife. This is highly concentrated radiation delivered in laser like precision that can address a very specific aread during the treatment. You wear a vest and the laser actually adjusts for your breathing, so that it stays on track the whole time. $20,000 for each radio surgery if you can believe that.

Anyway,thanks for the reply. I just recently joined a few days ago and have been posting heavily. It's a great site and wish I had found this years earlier when I was getting started. I've gone through my Cancer pretty much alone with just my heart and courage, but it's comforting to find a site like this, where you find out you are not alone.

I'm just trying to help people with what I've found out and that's been rewarding.

Loved the quote from Hipprocates - that's a good one - alot of truth there too, as we both can attest.

From one RFA man to another....
-Craig

lisa42's picture
lisa42
Posts: 3663
Joined: Jul 2008

To answer your question on my energy, it's fine. I noticed about three months after my liver resection that I gained a lot of energy, which is why I was surprised to hear that my liver really hadn't regrown much. I'll be curious to check it this next scan, which is due in late July. Oh well, I guess I'm functioning well and have enough energy, so it probably really doesn't matter whether the liver's fully regrown or not. Just thought it'd be interesting to hear if anyone else had heard about this. Thanks, everyone, for your input!

Lisa

robinvan's picture
robinvan
Posts: 1014
Joined: May 2007

Hi Lisa,

My surgeon has said much the same to me. Regeneration is a bonus. He makes sure there is enough residual liver to do the job. Actually he calls it "hepatic reserve" but you know how they are!! He has told me that it is amazing how effective liver tissue is. Mine has shown regeneration, which does give some comfort in knowing the "hepatic reserve" is being increased. But I've had pretty good energy throughout.

TTFN... Rob

lisa42's picture
lisa42
Posts: 3663
Joined: Jul 2008

Hi Craig,

Just a question re. your RFA and then cyberknife. I know about cyberknife- had considered it at one point for liver tumors before deciding upon the liver resection. How come they didn't do cyberknife on you in the first place instead of the RFA? One dr. I spoke with said cyberknife usually has better results than RFA and he doesn't like to do RFA "anymore"- he said he hasn't had it done on any patients in over a year & prefers to do the cyberknife or other sterotactical radiation treatments when surgery is not an option or warranted. Just curious what your doc thinks about the two procedures.

Lisa

Sundanceh's picture
Sundanceh
Posts: 4284
Joined: Jun 2009

Hi, Lisa

In my case, the liver tumor had grown at a very fast rate in a very short time period. Was doubling every 2 months, so it had gotten quite large.

My doctor was going to send me next door to the local hospital, but I told him I had been researching a doctor in Atlanta, GA, whose name escapes me now, but he was primary liver surgeon and transplant. He asked me why did I want to do this; I told him because I wanted a chance at living and this guy specializes in only that.

He changed his mind and gave me a referral of this other Liver and transplant surgeon at Baylor Medical. He has world renown credentials and travels to other parts of the globe to teach about RFA to others; he has write ups in some magazines and was voted one of the best in the DFW area. This doctor immediately told me liver resection as well and told me he was taking 80% of my liver with him; I took a leap of faith and said OK; I just did not have enough information and looking back I cannot believe I did that, but I wanted so bad to cut this killer out of my body.

When surgery started, they discovered I had a fatty liver and was not eligible for a liver resection, so he switched gears and went with the RFA procedure after presenting this option to my wife - I was under anesthesia opened up on the operating table, so I could not speak for myself, but would have said Yes to RFA. The tumor was in a precarious spot near some major portal veins and arteries, so they burned out as much as they could get to; their thinking initially was that they got all of it.

However, as a precaution, the surgeon had laid in my liver, radioactive seed markers around the liver area they were burning out. The theory was if some of the tumor still happened to be there, they would then get it with CyberKnife.

My tumor was too big for the CyberKnife by itself treatment was what we were told. There were remants of the tumor the MRI revealed, and they ordered 3 of these CyberKnife treatments to eliminate the tumor locally.

My surgeon was one of the early pioneers of the RFA procedure and he developed it and taught it all over the world, so this was his preference. He liked CyberKnife as a follow up to this procedure.

CyberKnife treatments get you tired like any radiation, but it does not last as long and you recover a little more quickly. What got to me was that I had to lay in this uncomfortable form they make for you. Your arms are up over your head for 2-3 hours each treatment and they go numb - and I mean go numb - I could barely lift my arms after the 3rd day. And if you had to go to the bathroom, they really got mad, because they had to reset all of the machinery and it would take 30 minutes or so to do that. I was constantly having them stop so I could pull my arms down for a rest, but after awhile nothing helps.

Anyway, that is how it went down and what my doctor wanted to do. I think each doctor follows his own protocol and prefers one thing or another.

RFA worked for me fortunately. And so did CyberKnife - the 1-2 punch.

Hope this helps, Lisa
-Craig

lisa42's picture
lisa42
Posts: 3663
Joined: Jul 2008

Wow, Craig! Thanks for your indepth description of both procedures. It does give me info & also of what to expect w/ cyberknife, if I ever should experience or consider it.

Take care!!
Lisa

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