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Biopsy or not?
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Biopsy or not?

I have been diagnosed, genotype 1b, viral load 10.3 million.

AST/ALT just slightly elevated.  

The doc has deteremined we should start treatment.  He wants to do a biopsy, but says it is up to me.  Says that "if it were him, he would want to know to the extent his liver had been damaged already."   My question is, why put myself through that, if the treatment will be the same any way?   Maybe it is information I don't want to know???

Thoughts, please!!  I am thinking of canceling the biopsy appointment.

Jean
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96938_tn?1189803458
I would, mainly for the reason your doc mentioned.  It could be beneficail for other decisions too; in case you have insurance woes you would understand your situation if you needed to wait, if your resonse to the meds were to be too adverse or if you had to stop treatment for any other reason you'd have an idea of your condition in full.  The condition of your live along with teh response to the meds could have a bearing on the treatment checkpoints down the road.

The biopsy is not as bad as it sounds.  Since it's a invasive procedure there is some risk, but it's not great.  Make sure that who wields the syringe-thing has lots of experience in liver biopsy.  Unlike other things in life, you don't want this to be the first time for the other person too.
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408795_tn?1324939275
It's not that big of a deal, at least your doctor has advised you to get treatment, some doctors don't.  The only downside to taking a liver biopsy is the time involved, it takes a whole day.  At least it worked that way for me, I went in early in the morning and I didn't get out till a little after 5pm, that was my last biopsy.  The other side is that huge needle, but I've always turned my head, besides they put one of those paper towel looking things up on you.  You can ask for a fibroscan, which I've never had but, if your doctor wants you to have a liver biopsy.  Personally I would do it, also with your viral load being that high, I feel your doctor is helping you out.  God Bless
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412873_tn?1329178055
For all the thought, time and worry I put into having my biopsy-it was almost anticlimatic because it only took about 1 minute.  I was there from 10 in the morning until 3:30 that afternoon.  My room had a riverfront view, I had a good book-actually quite relaxing.

Having accurate information on my disease progression made it much easier for me mentally.  :-)

Best of luck in whatever you decide!

Isobella
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Avatar_f_tn
I optd for the bx. b/c i figured i had hep c for a long time, wanting to know what i was looking at for tx purposes.  Glad i did ended up stage 4, well compensated, appears rt side of liver mainly affected.  With this info i decided to do extended tx. on the first go round.  Did 96wks and have been clear for almost 2 yrs.  Tough but i found it best to get it over with the first time, I will re-bx at the 5 yr mark, my liver has greatly improved already, back to a normal size, all pretx symptoms now gone.  Good Luck in what you decide, but honestly the bx was the easiest part of this whole 2 yr. long ordeal i went through. I would not reccomend bx. if your clotting factors are out of whack....Leah  
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Avatar_m_tn
If you plan on treating regardless of what a bx would show, then I would skip the risk and move on to treatment, just as you said.  The only purpose it would serve in this scenario would be to satisfy your curiosity, which is basically what your doc told you.

At this juncture in time, with the drug pipeline such as it is, I would personally want to know how necessary and urgent tx may be for me right now and I would have a biopsy performed. If I could afford to wait, and be reasonably safe in doing so, I most likely would. The newer therapies on the horizon will be shorter and the less time exposed to any and all of these meds, the better.

regards

.
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350279_tn?1208017145
I didn't know it was possible to get genotype without biopsy. A biopsy is not the only to  determine extent of damage, it's usually to confirm a diagnose or confirm.
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374652_tn?1311302831
The biopsy is the gold standard to determine the health of the liver or extent of damage that can help you to decide to treat at this time.  
The biopsy was nothing for me, except the anticipation of the results.  I think it is an important part of the process.  Unfortunately there is not a better way to determine the damage at this point.  it literally takes 5 minutes then you have to lay there for a couple hours so they can monitor you and prevent bleeding, it is a tiny puncture, and the sedative they give you transcends any discomfort.. and the health care teams are usually so professional and helpful,, do it...
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387294_tn?1207623785
I really didn't want the biopsy, particularly since I was type 3 and I had already decided to treat.  Let me tell you through the continuous (and still continuous) up and downs of treating and waiting to see if it worked, I am glad I know (I am fortunately mild liver damage).  Also, while the hospital I went to it was slow and it took the better part of the day to wait around, the procedure itself and recovery was no big deal at all.  So my advice it is better to know.
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350279_tn?1208017145
I was suspected of HepC in 1989 by blood test. I had a laproscopic biopsy. If your going to do it get it dome the best way.
With Laproscopic biopsy the Dr. can see the liver, and pick the areas where he sees the best location. Not only that biopsy but had two other needle biopsies where he could see well enough.
With just a needle biopsy, it is mostly hit or miss.
In 1994 I was thought to be cirrhotic. But no Biopsy was needed and I was not a candidate for treatment because of major depression.
In 2004 I needed to have my gallbladder removed, again laproscopicly. I asked the Dr. to try and get a biopsy of my liver if he could. Upon recovery, he said that a biopsy was not necessare, he could see it clearly.
Actually, Ultrasound, CT Scans and MRI's are all very good tools to determine liver damage.
It is import to get a biopsy as a reference point. I thought a biopsy would be a requirement.
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Avatar_f_tn
Just as others have said do a biopsy.  It really is nothing.  Boring if anything.  Take a book and take a snooze.   The word biopsy has more of a bite than the actual procedure.  At least you will know where you stand after it.  I think most people want to know everything so you  can treat and deal with it.  Up to you.
If it was me I would.
Good luck
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190885_tn?1333029491
get the biopsy...you'll feel much better knowing whats up...i had two different samples taken...that way you get a better look at the liver....when i found out i was only stage 1 to 2 and grade 2 i was real happy...and am now trying to get as healthy as possible for a while...have you done your a and b shot's? ....billy
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Avatar_f_tn
I did it!  

Had the biopsy yesterday.  You were ALL right!!  The anticipation was worse than the actual procedure.  Not a FUN thing to do, but they made me very comfortable with the versad (sp?).  Even gave me extra because I was being whiney.....

Doc told me afterwards that my tissue "looked good"  and he felt I would have positive results on Wednesday.  Told me he wanted me to think about WAITING for treatment.....he wants to get me in on his trial with teleprivir that starts this summer for hep c 1b patients that have not had any previous treatment.  I might go for it.

Thanks for all your support!!!!
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