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Please, Please can anyone help answer - Shadows?
by Mystic_lady, Jan 12, 2008 08:13PM
An MRI scan has shown shadows on my brother's Liver. ........his own Dr have said "prepare for the worst" - However the radiographer at the time of the scan told him they were not able to get a very good scan as he fell asleep...
He originally was taken into hospital months ago with very severe swelling of his body, especially his legs. He had numerous tests was told it was his heart, and then they dismissed it. Told it was definitely renal, and then dismissed it. Then his liver and was told "by a liver specialist at a leading Unit (different from the hospital he was in) that he was doing fine". This has taken place in an eight-month period.
His legs have kept swelling, the hospital and own Dr said it was a reversal action due to drugs they had given him, but his own Dr decided on another MRI scan. He'd had two previous, showed nothing but the latest "shadows".
He went to the original hospital to hear the results, where he was met by the consultant and MacMillan Nurse (cancer nurse)?????
Due to the many miss-diagnosis Is this definitely Cancer or could it possible be something not so sinister???? If it is cancer what’s the likely outcome?
He originally was taken into hospital months ago with very severe swelling of his body, especially his legs. He had numerous tests was told it was his heart, and then they dismissed it. Told it was definitely renal, and then dismissed it. Then his liver and was told "by a liver specialist at a leading Unit (different from the hospital he was in) that he was doing fine". This has taken place in an eight-month period.
His legs have kept swelling, the hospital and own Dr said it was a reversal action due to drugs they had given him, but his own Dr decided on another MRI scan. He'd had two previous, showed nothing but the latest "shadows".
He went to the original hospital to hear the results, where he was met by the consultant and MacMillan Nurse (cancer nurse)?????
Due to the many miss-diagnosis Is this definitely Cancer or could it possible be something not so sinister???? If it is cancer what’s the likely outcome?
Imaging of the liver especially in the setting of cirrhosis (which is a chronic condition of progressive liver damage - usually due to alcohol or chronic hepatitis) is pretty difficult. The appearance of liver cancer tends to look similar to other lesions which are not necessarily malignant. In cirrhosis, it is not unusual to see nodules which are not clearly malignant.
The MRI seems to offer the best images - there are several views available and most of them have opposite findings. What appears as shadow on one view appears as lighted on the alternate view. But if the doctor said prepare for the worst, the most likely scenario is that the image is not definitely benign. The doctor cannot say it looks definitely malignant. To make the diagnosis, other things need to be done.
If the doctors are contemplating a primary liver malignancy, there is a blood test which could be performed and may eliminate the need for a biopsy. The test is called alpha fetoprotein.
Should the test result be not significantly high - then a biopsy should be done.
The outcomes for liver cancer are good in the setting of surgical candidates, however, if the cancer cannot be resected - the expected survival is limited- a function of a few months.
Discuss also the status of the liver itself, part of the reason why the outcomes are poor is that most patients are also likely to die of liver disease not simply due to cancer.
The descriptions you give make me imagine that the patient is pretty much bedridden? I hope I'm wrong. Its hard to say what is sinister or not - because in the final analysis - even if this is not cancer, it may be an indolent infection, it may be immune-mediated, if the liver reserve is too little- this will be the determinant of over-all outcomes.
Stay positive.
..they have told him that he has cirrhosis of the liver due to what they said was his "drinking" and that his body is lacking or not being able to retain protein. He does have nodules on his liver...However, were stunned/stumped with the fact my brother doesn't drink....The other cause they felt, bitten by an insect whilst in a tropical country...Only place he ever went to was Australia for a months holiday, some 20 year ago...
...It’s so confusing and frightening, the initial hospital dismissed him as his case baffled them and they never got down to any route cause.
He was then given an appointment to see a leading liver consultant, after numerous tests, blood tests etc, who said he was doing well and that the liver is a great organ for regenerating itself….. that they would write to him if any untoward showed up…never heard anything.
Then this latest MRI (he’s had several) showed shadows….from what his own GP says, it doesn’t look very promising, but ….well, what can one say???
try to find out if there was a blood test called alpha fetoprotein already performed. This will help clear up things.
If the test did not reach threshold value to diagnose liver cancer, then the biopsy is the next step. We need to find out if the nodules are indeed malignant- because as you said, there is a reason to believe the liver will pull out of this until the new finding emerged.
If there are several shadows, it may also be possible to be cancer from somewhere else with the liver being the site of metastasis. The alpha fetoprotein will not help in this scenario - but the biopsy certainly will.
Try to come up with a plan that is acceptable to your brother, but keep an open mind, as new findings tend to raise new questions.
From what I understand from one of the numerous tests in hospital, they tested him for retention of protein and found that his body wasn’t retaining it, so they put him on protein drips scheduled one every 12 hours. However, not too sure how closely he was being monitored as more often than not, they missed out complete days which resulted in him having two bags every 12 hours – said they were short staffed.
At one stage, a biopsy was mentioned and dismissed. Even the leading liver consultant (different hospital) dismissed it.
He has taken his partner to every appointment so he’s had somebody with him…. They were told they have found two small shadows (from this recent MRI scan) on his liver which they think may possibly be tumours though not sure – no mention of a biopsy. He visited his own GP to speak to him about it…again took is partner. Their GP has told them that he’s not sure what’s going on either, but to prepare themselves for the worst because if it is anything sinister they will be somewhat prepared. One can only draw conclusion that they must have a very good incline…although again, I may be wrong, and hope this is the case, however, true gut feeling though tells me otherwise….if they truly were uncertain - Why introduce him to a Macmillan nurse????
He appears to have gone into an overload mode, not being able to sleep at nights but during the day gets very tired, very quickly
I know it is very difficult for you to make a diagnosis based on the limited information contained within my pleas…but do you feel its cancer? More advanced than they are letting on…or could they still be genuinely uncertain?
You really don’t know how much your responses have meant to me…..you’ve been my silent angel and the answer to my prayers… Again, thank you so, so much for your help and time.