DLBCL with liver cirrhosis

Kim Eunki

1. 

I am not a cancer patient but a son of one looking for support and to hear stories from other patients.

My mom(65 years old) was diagnosed with diffused large B cell lymphoma(DLBCL, left upper arm) a month ago.

 

DLBCL was discovered during liver transplantation preparation due to liver cirrhosis.

So, liver transplantation is aborted.

Chemotherapy is not possible because her liver failure by cirrhosis is severe.

Doctor said, radiotherapy will not be treated because there’s no possibility of complete recovery. And he stopped all active treatment.

 

He said her life expectancy would be less than 1 month.

 

Is there any possible way to treat it?

Any new drug, or experimental treatment methods?

 

 

2. current condition and medical history 

current>

#. r/o PRES

#. r/o stercoral colitis

#. r/o PSE

#. pancytopenia

r/o BM involvement

r/o LC progression

r/o hematologic dz

 

#. Approx. 9.3cm sized enhancing mass with inner hemorrhage or necrosis,

Lt. upper arm

d/t DLBCL

 

underlying>

#. HBV-LC with multiple nodules, decompensated, child C10

#. HCC
- s/p outside RFA #1 (3.2015.)

#. h/o recurrent SBP

#. E.varix Gr II with RCS

-s/p EVL(21.11.2017.)

#. Rt. femur fracture(6.2017.) : bedridden state

# POP

-s/p pessary

# colon cancer

-s/p Rt. hemicolectomy(2011)

# Inguinal hernia

-s/p hernia repair(2013)

 

3. Blood test

 

CRP 3.45<3.98<0.5<0.65<1<2.74<2.57<3.73<2.05<1.70<2.20<1.99

T.Bil.

4.2<4.6<5.3<6.7<7<7.1<6<5.4<4.1<3.7<2.5<2.4<2.8<3.5<3.4<3.3<2.7<2.7<3.2<2.8<3.4<3.4<2.8<3.2<3.0<3.3<4.0

PT INR 2.61<2.68<3.01<2.4<1.81<2.08<2.1<2<1.94<1.96<1.92<2.13<2.01<1.95<2.01<1.96<1.97<2.21<2.05<2<2.07<1.75<2.02<1.77<1.78<1.62

 

CBC

27/12/2017 0.87-8.8-26k ANC 592

26/12/2017 0.88-8.4-23k ANC 739

25/12/2017 1.19-7.9-31k ANC 879 < RBC 1

25/12/2017 1.15-8.4-8k ANC 863 < LDPLT 1

24/12/2017 1.85-9.2-29k ANC 1571

23/12/2017 1.61-9.6-41k ANC 1304

22/12/2017 0.81-7.8-36k ANC 654 < RBC 1

22/12/2017 0.97-8.1-17k ANC 770 < LDPLT 2, FFP 3

21/12/2017 0.77-7.8-39k ANC 624

21/12/2017 0.94-8.4-10k ANC 790 < LDPLT 2, RBC 1

20/12/2017 1.01-9.7-13k ANC 879

Kim Eunki

please

please

PBL

Be strong

Hello Kim,

I am truly sorry for you and your mom. It seems she has been through quite a lot for nearly the last decade... 

Unfortunately, DLBCL requires urgent chemotherapy, and chemotherapy requires a functioning liver. A liver transplant is heavy surgery and subsequent immunosuppressive treatment, and does not even guarantee that the recipient is out of the woods after a successful procedure, so it seems pointlessly cruel to submit your mom to that kind of ordeal in her present state.

Someone in my family suffered a freak reaction to a blood thinner after a stroke, which caused liver failure. Even with a liver transplant, he never regained sufficient health to be able to feed himself - let alone leave the hospital. A couple of months after the transplant, he asked his doctors to let him go, which they finally agreed to do. He died over a year after suffering that initial stroke, having never left the hospital, and having been put through so much pain.  He was in his mid-fifties, and had no other pathology. 

It is very much normal for you not to want to let go of your mom, but perhaps if she is still conscious and aware of the situation, you would find that she is ready to stop living in such misery.

I wish you all the courage in the world in these difficult times. I hope you and your mom can still, at this point, find a way of parting that will enable her to leave  this life in peace, and you to carry on with fond remembrance.

PBL

ShadyGuy

So sorry

The only suggestion I can come up with is to have everything double checked to make sure nothing is being overlooked. Otherwise the cards are definitely stacked against her. I lost my mother in April 2013. Its hard. The thing that helped me was a talk I had with her the evening before she died. She said “I am ready. It happens to all of us.”  Spend as much time as you can with her.

Kim Eunki

PBL & ShadyGuy

PBL & ShadyGuy,

Thank you for your heartful advice.

I haven't yet told mom the details of her condition. But I'm preparing to tell the truth. I dicussed with the doctor to continue radiation therapy again. I know it's hard to be completely recovered through radiotherapy in her medical condition, but I’m trying to believe a miracle. 

And as you advised, I’m trying to spend as much time as I can with her.  Your advice was a great help. 

Thanks again.

 

Max Former Hodgkins Stage 3

Mom

Kim,

Unless your mom is legally incompetent (from dementia or something similiar), the doctor should have been giving her the results directly.

She is not old, and had a right to the information from the first test results.  That does not make telling her any easier, just a legal and ethical necessity.

max

PBL

Radiotherapy & the truth

Kim,

I don't know about any miracles, but who knows...

Although radiotherapy does not likely offer the possibility for a cure with a tumor that size in a hematological cancer, it may at least spare your mom some arm pain. I suppose this is the kind of information her doctor has given you. 

Regarding telling her the truth, Max is right of course in saying that she is entitled to it and it is normally her doctor's duty.  One reason why s/he hasn't done that may be because she has a deteriorating mental state due to the liver failure. You may want to discuss this with her doctor.

Wishing you continued fortitude.

PBL