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cancer and radiation for cat scans
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cancer and radiation for cat scans

Can anyone tell me if a person with hep c has liver cancer but it can't be seen by a cat scan could the radiation you receive by the cat scan cause cancer to grow more aggressively?
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Avatar_f_tn
I don't know the answer to your question and the only reason I'm writing is because often it is very slow on this board on the weekends.  

As there are blood tests such as the AFP that indicate there might be a tumor but no blood test that can definitively diagnose liver tumors there is no alternative but to have a CT scan.  If you had the scan and no tumors were found, YAY.

I'm sure smarter people will stop by to answer your question.
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Avatar_f_tn
I would think an MRI would be better than a CT scan in diagnosing a small tumor. All of these imaging tests use radiation but what's the choice we have? Why do you think you may have a cancer that is too small to be seen?
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446474_tn?1385271190
Hi Ralph.

Can't be seen by a "cat scan"? How was it diagnosed?

In order to reduce the amount of radiation a patient receives, patients usually alternate imaging methods (ultrasound, CT scan with contrast) every 6 months with an AFP reading each time. All patients with hepatitis C and cirrhosis should undergo surveillance for liver cancer (hepatocellular carcinoma or HCC) . THe sub-group of co-infected patients have the highest risk of HCC. HCV & HBV. HCV & HIV.

The challenge is that an ultrasound's resolution is not as high as a multiphase CT scan with contrast and is very operator-dependent. So it is a compromise and an issue of risk assessment (risk vs benefit) as to how often a CT scan with contrast is performed. Although a high AFP reading isn't always indicative of liver cancer (and can be caused by chronic hepatitis itself), it is used in combination with imaging to increase the chances of finding the cancer if it exists before it become larger or spreads.

This is an area of research. Better ways to diagnose hepatocellular carcinoma are being studied. Serological studies with other markers for HCC seems to be the most promising for the future.

Hectorsf
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Avatar_m_tn
Hi Susie,

The reason I think I may have liver cancer is because I have had three cat scans in about a eight month period because they saw a spot on my liver but on my last cat scan the spot was no longer visualized. But then I found out that my AFP level was elevated and that i am good candidate for cancer because i am elderly "72" and that i have had hep.C  for over 40 years.

The reason I can't have a MRI is because I have a defibrillator in my chest.

thank you for replying to my message
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Avatar_m_tn
Hi Hector thanks for replying to my message and for the information.

I  have had three cat scans in about a 8 month period because of a spot on my liver. On my last cat scan the spot was not visualized. they think it was a regenerating nodule. Now my blood test showed that I have an elevated  AFP level and I just assumed I have  liver cancer because i read that thats a indication for cancer and l also heard that the elderly and length of time you had Hep.C makes a person a good candidate for liver cancer. I am 72 and have had the disease for over 40 years. So I was worried that if I had cancer the radiation might make it more aggressive and that maybe I would be better off  not  taking anymore cat scans. Maybe I will die of something else before the cancer gets me.
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Avatar_m_tn
Hi Carol,

I can see now that my question was far from clear but thank you for replying to my message it was nice getting feed back and I bet there isn't that many people smarter than you.

  
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446474_tn?1385271190
Ralph,

Thanks for the details. This is helpful.

I believe you are making some assumptions that may not be necessarily true.

"l also heard that the elderly and length of time you had Hep.C makes a person a good candidate for liver cancer."
The length of time that you have had chronic HCV is not the important factor. Having bridging fibrosis or cirrhosis is the main factor. If you have had HCV for 40 or 60 years it doesn't matter, it is the amount of damage your liver has sustained over time. IE progressing to stage 4 cirrhosis. If you don't have cirrhosis or bridging fibrosis the chances of developing HCC are the same as in the general population. Very, very low.

Do you have cirrhosis of the liver? Stage 4? As determined by biopsy or other means.
Having stage 4 cirrhosis or stage 3 bridging fibrosis are when HCC is is most likely to happen. 20 times more likely then in the general public. Also patients that are co-infected with hepatitis B or HIV are more likely to develop HCC. Are you co-infected?

How high is your AFP?
"an elevated AFP level ....a indication for cancer". HCV with a constantly elevated AFP is a risk factor for HCC. But it does not indicate that one has HCC. AFP is diagostic of HCC 60% of the time. That is why AFP is never used by itself to diagnose HCC. It is used to confirm what the scan shows. Occasionally HCC may be undetected by the scan. An AFP over 500 would indicate that HCC is there somewhere but was somehow missed by the scan.  

"... worried that if I had cancer the radiation might make it more aggressive and that maybe I would be better off  not  taking anymore cat scans."
The risk that the radiation used in scanning will make your cancer worse (remember it takes many years for cancers to grow after the damage is done) is low compared to the risk of missing the cancer and having it getting larger or in the worst case spread beyond the liver. As in many cancers, if caught early survival rates are good. If HCC is found after symptoms appear, the survival rate 5 years after detection is less than 10%. The truly scary thing, at least for me, is that once the cancer spreads beyond the liver you will no longer be able to receive a liver transplant which can save your life.Bluntly speaking it is a death sentence I'm afraid.

Whether a growth on the liver is HCC or not is largely dependent on the size of the growth.
Lesions less than 1 cm are not usually HCC. They are usually groups of vessels. If found it should be watched more carefully as it could in time become malignant. If it doesn't grow in 2 years then it is not HCC.
Lesions between 1 cm - 2 cm are difficult to determine if they are HCC or not.
Lesions bigger than 2 cm and with an AFP over 200 are most likely HCC.

So in summary your condition maybe much better than you have thought previously depending on your answers to some of the questions above.

I am hoping this is the case.
Best of luck!
Hectorsf

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Avatar_m_tn
Hi Hector,

The information you gave me greatly eased my mind. Thank you so much.

ralph444
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