Hepatoma - Second Opinion

Hi All,

My father has been diagnosed with Hepatoma recently.

Here's some background information about the current situation:

- Two masses (9.1 cm x 7.4 cm) and (7.7cm x 7.5cm)
- The larger of the two ruptured which triggered sharp pain (no such pain now).

- TSB @ 355 umol/L (very high)
- DSB @ 186 umol/L (very high)

After being in the hospital for 10 days, doctor concluded that TACE treatment is currently not an option as serum bilirubin is too high (hasn't gone down) and also main portal vein is obstructed by a clot of coagulated 'semi-solid' blood.

We asked whether anything can be done about lowering the serum bilirubin and they said no. Now he's been out of the hospital and currently at home in bed for another week without any treatment.

They even told us that he probably has a few weeks left in terms of life expectancy. Note that this hospital isn't reputable for liver cancer treatment and it's coming from a general oncologist. We've contacted another hospital which is supposedly the top in the city for liver cancer treatment and awaiting their response on getting a fast track appointment after their assessment.

Current symptoms:

- Lack of appetite (tumor is pushing against stomach which is part of the reason)
- Jaundice (skin is quite yellow)
- Fatigue (in bed for most of the time, tired after sitting for 20-30 mins)
- Short of breath periodically (i.e if he talks too much or tired during that time)

Current home diet & treatment:

- Drinking freshly made juice (i.e apples and spinach mix)
- Eating fresh fruits in between meals (i.e apples and grapes)
- Eating oatmeal with honey for his meals.
- Eating egg whites for additional protein and specifically albumin.
- Taking Chinese Herbal Medicine/Tea to boost immune system and liver functionality.

Concerns:

1) Daily calorie intake is low (approximately 700-800 cal) hence he will continue to lose weight. Since he has low appetite, we need to find ways to increase calorie intake without 'filling' up his stomach too much as he'll end up feeling uncomfortable.

2) I feel the doctors haven't done enough to really explore possible options. Only the typical blood tests, ultrasound, CT Scan and MRI scan were performed. I fail to understand why they haven't explored ways to help lower the serum bilirubin level and effectively treat the jaundice.

Basically what it comes down to is the serum bilirubin level which dictates the functionality of the liver. Although we're still waiting on the other hospital's response, it's still not something that's confirmed so would like to do whatever we can at this point to improve his condition in the meantime.

We're not sure what else we can do at this point. Any feedback regarding this would be appreciated.