liver regrowth after resection

lisa42

Sundanceh said:

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

wow
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

cat2025

https://csn.cancer.org/discussion/comment/660929#Comment_660929

To give some hope out there…

I had a function scan on my liver before surgery. Called mebrofinum scan. Mebrofinum is also the name of the nuclear medicine contrast they inject with PET scan of liver, they do a CT with irradiated iodine contrast straight after. The two scans are overlaid to work out how viable your liver would be if particular bits are removed. Surgeon can say if I remove just this bit, this is chance of remnant liver being functional, if I remove these bits, this is probability will be functional.

Surgeon wanted to remove 65% of my liver, if he did so, I only had a calculated "borderline" chance my remaining liver would be enough to survive (ie if do surgery I had borderline chance of surviving the surgery).

I had a PVE Portal Vein Embolisation, short procedure done under general anaesthetic (think sometimes done as twilight anaesthetic) done in hospital as overnight stay. This is where a surgeon (actually a radiographer surgeon, so skilled in imaging and surgery), cuts blood supply to part of liver with cancer that ultimately want to remove. PVE can be done as treatment by itself if liver surgery is otherwise not suitable. PVE stops blood supply to one section of liver, which increases blood flow to the other (healthy) part of the liver. Usually is done going through veins up into liver, in my case the veins were too small and this wasn't going to be viable, so they did through very small cuts through my skin directly into my liver. This helps the healthy part grow before major liver resection surgery.

For reasons I won't get into here, I changed liver surgeons. When I saw the new liver surgeon, who is actually primarily a liver transplant surgeon, I had had PVE done 2 weeks prior, he set surgery date for 3 weeks later. His attitude, if was borderline then, and now had PVE, it will be enough to do liver resection of 65%.

I had ~65% liver removed (open surgery) Tuesday 20 May 2025. I had a CT tri-phasic contrast liver scan done 29 May 2025 (still in hospital post surgery), because my liver blood tests had got worse for a couple of days, and they were checking for bile leaks, infection, DVTs or anything else that might be going on that shouldn't be.

The CT scan showed my remnant liver had approximately doubled from surgery to scan, ie in 8 days, and the drs think bloods were worse because my liver was busy multitasking - regenerating and rebuilding rapidly. I also had (and have) lots of people praying for me, so God's hand is definitely upon me as well.

I wanted to share, to show there can be very quick regeneration. Energy wise I only got out of hospital yesterday, and have moments of being really really tired, but had multiple general anaesthetics in short time period and other medications while in hospital that may have contributed.

However, generally speaking, my energy levels have been good the whole time, and I have generally not felt sick since the resection (nausea controlled by initial Naso-gastric tube, medications, initially only nutrition through IV fluids, then clear fluids by mouth, then nourishing liquid by mouth, then normal diet). I still have a way to go, and don't have pathology results yet, but wanted to give a first hand positive regrowth experience.

(I am in Australia, so some of what I had done may be different to how things are done in the US)