AFP

[sarwar75]

My mother has liver chirrosis with multiple hepatic tumors and level of AFP is 20204.she is unable to go through MRI procedure due to sever respiratory issues.Doctors say that MRI is necessary for making decision for the procedure of Liver TACE.
Is there any expert opinion available? Please.................

[sarwar75]

Hector SF thanks a lot for sparing your time to write the details.
Yes she had multiple hepatic tumors. On 3rd of June a board of doctors will decide in a conference whether liver TACE is possible or not.Liver transplant is not yet decided by the doctors. But it is too expensive that I cannot afford even after  selling my home.
She has unbearable abdominal pain in the right side where the liver lies.
At the moment only symptomatic treatment is given.

[HectorSF]

I am sorry I see now that she can NOT have an MRI due to breathing issues. Is this your main concern right now?

Is the MRI contrast that is the problem? Do you know?
Do you know what is causing her respiratory issues.
Is this your main concern. That they can't use MRI as they normally would? Do they have a work around?

Assuming this is a liver transplant center they should be able to figure something out as I am sure they have had similar issues before.
Perhaps they could use an angiogram, a real-time X-ray that highlights where blood flows, in the liver at the tumors. This is what they use during TACE to find there way to the tumors through the arteries?

I am sorry that I missed this concern in my first post.

Hector

[HectorSF]

Hi.

I am very sorry to hear this. I developed liver cancer (HCC) while having cirrhosis caused by hepatitis C. I had HCC for 2 1/2 years until my liver transplant 6 months ago. I had 8 different liver cancer treatments including 4 TACE treatments over those years in order to manage my cancer until I was able to get a transplant. It was the most difficult experience of my life. My cancer become untreatable last year with standard HCC treatments and it was only because of an experimental radiation treatment and a liver transplant that I had that I am still alive today. I am extremely lucky.  

I assume your mother is being treated at a liver transplant center?

Yes, your mother needs treatment for her liver cancer (Hepatocellular carcinoma) ASAP. I assume she has multiple tumors? Her AFP is very high.

An MRI with and without contrast is used to view the tumors to see the location and size. This will help the doctors to know where to go when they do the TACE (Transarterial Chemoembolization) procedure. What happens with TACE is the Interventional Radiology team will insert catheters into her groin, into the femoral artery, and feed the catheters up into the liver through the arteries that are feeding the tumor(s) with blood. When they get the catheter right to the tumor they will then inject microbeads that have chemo medicine on them. The beads will clog the artery and cut off the blood supply to the tumor(s) which helps to kill them and at the same time the chemo will be slowly released from the beads over a period of weeks. The chemo will also kill the tumor(s). In about a month after the treatment she will have another MRI performed to view the affect the treatment has made on the tumors. Hopefully killing most if not all of the tumor(s). TACE can be performed multiple times should they need to do it again to get any remaining parts of the tumor(s).

The procedure sounds worse than it is. She will feel no pain during it.  After the treatment people will usually stay in the hospital overnight so they can be watched for any issues that might arise. Some people feel nauseous afterwards and will be given IV meds that will stop the nausea. Some people also experience pain. I did. IV opiates will be given to help manage the pain. When they are discharged the patient will be given anti-nausea and pain meds when they go home. The patient may feel tired and have some pain for up to a week and then they will start to feel better. It is best for the patient to get plenty of rest and take it easy.

The first time this is done is the toughest as people don't know what to expect and if this is the first major procedure a person has had it can be very scary. The good news is that this treatment is highly effective. Liver cancer (HCC) is a very serious form a cancer and needs to be treated as soon as possible so I am glad she is having this done.

I am so sorry to hear of your mother's diagnosis. Please try to support and comfort her in any way you can. Liver cancer as with all cancers is difficult to deal with mentally. It can be the greatest challenge any of us has to ever face. Support from others is vital. We only have so much control over out cancer. We do what we have to do but the outcome is out of our hands. As we say..."Nobody does this alone." This is when our loved ones and their care and support can make a world of difference.

Has the doctor talked about the possibility of a liver transplant?

Please help your mother with this very difficult diagnosis. I am sure this is very frightening especially if it is all very new. Please talk to her doctor so you can understand what to expect.

Here is a link to the American Cancer Institute and a manual on liver cancer you may find helpful.
http://www.cancer.gov/cancertopics/wyntk/liver

Again I am deeply sorry to hear this. I wish your mother all of the best. If there is any way I can help you can send me a private message.

I hope this helps.

Hector