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TX without a biopsy?
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TX without a biopsy?

i'm just wondering, how many here have started tx without having a biopsy first?  personally i think that is crazeeeee since the sides of tx can be bad bad bad and the odds of it working are not very good...

i wonder how much of a cut dr's get from the drug companies hmmmmmmmmmmmmmmmmmm????

sorry im just very suspicious haaa

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Avatar_n_tn
I dint have a bx. I had a scan and there seemed to be no damage.But a scan cant see inside.
I wasnt feeling "GOOD" for a few yrs. Doctor would not say there was a connection. But even a very slight cold has its symptoms.
I did tx 23.92/24 and had all sx ecept the need for procrit {hope thats spelled righ}. I am waking up this morning day 3 1/2 post tx. O.k. cover your ears because I am now going to scream "I feel so ****** good. This is great. I am so glad I did tx and made it through"  I have felt that way for 3 days now.
  I did tx because I had the chance to say I used to have hcv and to eliminate the chace of getting sicker or getting liver cancer starting somewhere deep in the liver that maybe hard to find.
I'm going to work now. Have to drink alot of water today, I hope its not cold... and wet.
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Avatar_f_tn
I wouldn't have considered treating without the biopsy. If I had barely no damage it would be a completely different situation. Instead I turned out to be stage 3.

I never had ANY symptoms that I knew about or anything...so it was a big wake up call.

Unless you just want to kill the virus off either way regardless of damage - I can't imagine how anyone could decide NOT to treat without one.

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Avatar_m_tn
Most people will show damage with a bx even if they don't have hep-c. The liver takes a lot of abuse and drinking is the main problem. Sometimes a lifestyle change is the best way to go.

                                                             Ron
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Avatar_m_tn
Geno 2 and 3 often treat without a biopsy.Doctors recommend geno 2 and 3 treat beause the odds are uite good to clear.  (then there are people like me!) The doctor's thinking is that you have already decided to treat so why take the risk of a biopsy? So there are lots of folks who begin tx sans biopsy.

I started without a biopsy but I sure wish I had been able to get one prior because it would have affected my decision on how long to treat. the doc I see recommends ALL geno 1 have a biopsy due to their poorer chances of success when treating.



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142841_tn?1201978652
SOC treatment is offered to everyone who is infected with HCV.  There are a couple of ways of looking at this...if you have little damage, you may elect to treat before the damage gets worse, or you could decide to wait until better drugs with less side effects.

It really depends on you--if your feeling is that you want to treat regardless of the level of damage, then a liver biopsy is not required, and it's not worth the risk, IMO.  Yes it will assess liver damage, which is reason enough some will say, however, if the biopsy will not add information that will affect your decision to treat, then assuming the not insignificant risk of the biopsy is probably not wise.

The first time I treated (non-pegylated interferon + rivavirin), I did so without a biopsy.  The second time (pegifn + riba) as well.  It wasn't until my AFP level started to rise that my liverdoc recommended the biopsy.  Now I'm on a maint dose of pegasys, and probably will start infergen + riba next summer.

Personally, the transcutaneous liver biopsy scares the bejeezus out of me.  I had a transjugular procedure--much better, full sedation (fentanyl and atavan), and any bleeding was back into a vein.
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131817_tn?1209532911
Kalio says it well; "The doctor's thinking is that you have already decided to treat so why take the risk of a biopsy? So there are lots of folks who begin tx sans biopsy.

I started without a biopsy but I sure wish I had been able to get one prior because it would have affected my decision on how long to treat."

As a Geno 1, I should have had one pre-tx, but my dr thinks there is too much risk and refuses now and after my tx. So where does that leave me? Since I had at least 200 copies of the virus at week 10, I had NO idea what my tx options were. I had no idea the fibrosis. An Ultrasound said Fatty liver versus Cirrhosis. This freaked me out as I continue to decide whether or not to extend tx. Luckily, I had a fibroscan which showed minimal damage stage 1 or 2. It makes my decision to extend have a few more options. Soon Fibroscan will be available to the public and make it an easier option than a biopsy for staging and whether to begin tx.
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Avatar_n_tn
I started treatment without a biopsy. I had two scans and both indicated no apparent damage/problems. Since I had decided to treat regardless, there was no need to take the additional risk of a complication from the biopsey. In my case however, Doctor never really gave me a choice.  

Good luck too you!

Pat

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131817_tn?1209532911
What type of scans did you have?
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163305_tn?1333672171
I start treated today and I didn't have a biopsy.  Because I didn't get diagnosed until I had ascites, I can't have a biopsy. But I asked my doctor if the results of a biopsy would change his adivce to me, and he said no. My Dr. is so damn busy that he could care less about getting an extra few bucks from a biopsy.
   However, I am suspicious about some other things, like why the pharmaceutical companies have programs to allow us free drugs while the rest of the world has to pay thier outrageous prices. Just to keep us quiet, I assume.
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Avatar_f_tn
Hey....did you do your shot yet?    Let us know how it goes.
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Avatar_m_tn
I never had a biopsy. And I'm in week 34 of my second Tx. My first Tx was 4 years ago, after which I relapsed.

But I had several FibroSure tests, countless Ultrasounds, 3-4 CAT scans and 2 MRIs. So I think the level of my liver damage is quite well established. All the hepatologists I consulted in the last several years advised me to treat ASAP.

So having a biopsy is not necessarily a prerequisite for starting Tx. There are (many) cases when having Tx is your ONLY option.
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Avatar_f_tn
No biopsy here,,,,just bloodwork with ultra sound!  In my case,,it was due to a dr that should have had my best interest in mind but I followed his lead and he said geno 1,,,,you treat regardless so lets get started on tx!  I did 52 weeks and cleared but that biopsy would be nice to have had to see if I did have any kind of damage!
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Avatar_f_tn
if you have all the signs of cirrhosis then a biopsy might not be needed. if you are in the midstages, that is more difficult to diagnose than the extreme levels.  If the tx is not working fast enough once you have started, you want to know if you are stage 3 grade 3, for example, to determine the need for more aggressive intervention.
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Avatar_n_tn
Honey... I didn't know you didn't have a biopsy!!!
WoW...

My Doc wouldn't treat without one...

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Avatar_m_tn
They give out free drugs because they get a big hue tax break.

It isn't about keeping the masses appeased as much as it is about the bottom line and corporate tax advantages.


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Avatar_f_tn
Don't count the feeling really bad and not working as the status quo.   Everyone is different.  I have been working but have only been at it about 10 weeks.  Some do have bad sides and can't work.   You may surprise yourself.  Think...I can,   I can,   I can.   Be positive.
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131817_tn?1209532911
You started! What time did you take your shot? Or have you just started the Riba? Congrats on getting it started...I don't think you will regret it.
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Avatar_n_tn
hcv2 and no biopsy.Since tx I still dont comprehend much so could be off on what your asking.   My doctor told me that I had a 60% chance of nothing ever happening to me if no tx and a 20% of something happening bad without tx.
  I though about all he said and read what I could. I looked back the past few years and realized I have been slowing down way to much even given aging.  Plus and big plus he told me I will be able to say I used to have hcv.
  I wanted to have that chance and completly remove farther liver damage and any chance of future problems.
  Hereing all the talk about hcv never really leaving if true does change things a bit but so far it seems theres not enough proof.
So, I wanted to do what I could for my future health. And I made the best decsion I could with the information I had.
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Avatar_n_tn
Its easy?  Say it ten different ways I one of them I may find easy. Is this the cost I may pay for doing tx ? Just to remove a 40% chance of future problems and being in better shape today.
  I am having a real hard time putting sentences together and understanding things.  I knew I was struggling during tx and maybe now Im waking up more and more so its becoming more evident.
But I'm sure I will clear up.
Rev can you interpit what I just said and give me your opinion ?
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