HCC with cirrhosis

offunspirit

My husband survived liver failure 13 years ago and up to now has lived a healthy and normal life. He has Hep C and cirrhosis. He was diagnosed by MRI two weeks ago with a 5 cm tumor in section 8 of the liver suspicious for HCC. UVA wants to do a biopsy but I read that a biopsy can cause the cancer cells to spread within the liver or seed to outside the liver. The treatment I was hoping for would be shrinking the tumor and then a resection. We cancelled the liver biopsy and have sent his test results (MRI,ultrasound and labs) to Johns Hopkins for review and a second opinion on the biopsy. Any comments on the biopsy and treatment at UVA and Johns Hopkins?

Mako181

Biopsy
Offunspirit,

My husband was diagnosed in June of 2008 with HCC w/portal vein intrusion. He did not have any invasive procedures including having had no biopsies. He was prescribed Nexavar which he still takes due to having HepC and the doctor's desire to ward off any new cancer cells. He is now cancer free and I believe the fact that he had nothing invasive has a lot to do with his recovery. As a matter of fact, his doctor told us he would not do a biopsy for the exact reason you mention. He said as a biopsy needle is withdrawn from the liver, it is almost inevitable that some of the harvested cells escape into the blood stream which can open a whole new can of worms.

I am sure others have different thoughts on this subject, but, in hindsight, I am content with the fact we did not insist a biopsy be done.

offunspirit

Mako181 said:

Biopsy
Offunspirit,

My husband was diagnosed in June of 2008 with HCC w/portal vein intrusion. He did not have any invasive procedures including having had no biopsies. He was prescribed Nexavar which he still takes due to having HepC and the doctor's desire to ward off any new cancer cells. He is now cancer free and I believe the fact that he had nothing invasive has a lot to do with his recovery. As a matter of fact, his doctor told us he would not do a biopsy for the exact reason you mention. He said as a biopsy needle is withdrawn from the liver, it is almost inevitable that some of the harvested cells escape into the blood stream which can open a whole new can of worms.

I am sure others have different thoughts on this subject, but, in hindsight, I am content with the fact we did not insist a biopsy be done.

biopsy
Mako,
It is impressive and encouraging that your husband is cancer free with just the Nexavar. Thank you for responding. I had been second guessing cancelling the biopsy @ UVA until we meet with the docs at Johns Hopkins but I just had a "gut feeling" that was the right thing to do.

Betta

Hi there,
Hope your husband is OK.

Last week, my mother was diagnosed with primary HCC+ hep B, C and 6 cm tumour on seg 7. We have been to 3 specialists and two of them suggested resection and other was suggested that she should have the banding (to stop the blood flow to the cancerous cells). We have not decided on the treatment yet but considering the resection.
They did not offer biopsy either. So I would like to know what kind of treatments you are choosing and how you are getting on at the moment.
My mother has naps a lot, and I am really worried it will spread to her other organs. She sleeps while she is sitting...

Thank you

offunspirit

Betta said:

Hi there,
Hope your husband is OK.

Last week, my mother was diagnosed with primary HCC+ hep B, C and 6 cm tumour on seg 7. We have been to 3 specialists and two of them suggested resection and other was suggested that she should have the banding (to stop the blood flow to the cancerous cells). We have not decided on the treatment yet but considering the resection.
They did not offer biopsy either. So I would like to know what kind of treatments you are choosing and how you are getting on at the moment.
My mother has naps a lot, and I am really worried it will spread to her other organs. She sleeps while she is sitting...

Thank you

treatment
My husband is being treated at Johns Hopkins in Baltimore. It is a 5 hr drive but #3 liver cancer treatment center in the country. If it is close enough to where you live, I would highly recommend it. If not, Google the top ten liver cancer treatment centers to see if any are close to you. The specialists you have seen have offered the treatments that are being used for HCC, resection and TACE. Currently, my husband is participating in a research trial @ Johns Hopkins for sorafenib (Nexavar) and next week he is going to have the TACE (transarterial chemoembolization) procedure. He was told that he is a good candidate for liver transplant but we will have to jump through some financial hoops to get to that. He is feeling fine physically, slight discomfort around the liver. The TACE has side effects so we are anticipating those for a couple weeks but so far he has not experienced any upsetting side effects from the sorafenib other than high blood pressure which he is controlling with his meds. Fatigue is a side effect of liver disease so the sleeping your mom is doing is normal. Will try to post back and let you know how things are going. Hope all goes well for your mom.

zekeb

Hep C and cirrhosis
I too have Hep C and cirrhosis, and was diagnosed with a 2.5 cm tumor last April. I had inquired about resection and was told that resection was not an option due to the cirrhosis. Biopsy was never considered for the reasons stated by other respondees to your posting. I've been through two CE treatments, which kept the tumor in check for a few months. However, I just had another MRI and have two more small tumers (< 2 cm). My only option at this point is transplant (I've been on the list since July). I hope your husband gets through this ok!

XtremediverHCC

I, too, have had Hep-c and
I, too, have had Hep-c and cirrhosis which resulted in HCC with 2 primary tumors (one was attached to the portal vein). My liver was biopsied once with the cirrhosis diagnosis and a 2nd time for the HCC diagnosis with the tumor being biopsied with ultrasound guided technique being used. No problems off "seeding" ever occurred. It is my understanding that as of this year, HCC can be determined most of the time based on the MRI results without having to perform a biopsy if the tumor has certain characteristics. You can research those characteristics on the internet if you really want to know what they are. Good luck and keep the faith.

offunspirit

offunspirit said:

treatment
My husband is being treated at Johns Hopkins in Baltimore. It is a 5 hr drive but #3 liver cancer treatment center in the country. If it is close enough to where you live, I would highly recommend it. If not, Google the top ten liver cancer treatment centers to see if any are close to you. The specialists you have seen have offered the treatments that are being used for HCC, resection and TACE. Currently, my husband is participating in a research trial @ Johns Hopkins for sorafenib (Nexavar) and next week he is going to have the TACE (transarterial chemoembolization) procedure. He was told that he is a good candidate for liver transplant but we will have to jump through some financial hoops to get to that. He is feeling fine physically, slight discomfort around the liver. The TACE has side effects so we are anticipating those for a couple weeks but so far he has not experienced any upsetting side effects from the sorafenib other than high blood pressure which he is controlling with his meds. Fatigue is a side effect of liver disease so the sleeping your mom is doing is normal. Will try to post back and let you know how things are going. Hope all goes well for your mom.

update
My husband had the TACE procedure on Nov 10th and experienced no side effects which amazed us. He was on sorafenib/nexavar 1 week before and 1 week after the procedure then was taken off for one week and is now back on it. An MRI this week showed the tumor was dying. Docs say he is a good candidate for liver transplant but we are still waiting to hear from the transplant team.