Biopsy Results Stage 4, Grade 4 what does it mean?

[Debbeav]

My doctor called me last week and told me my biopsy results were Grade 4, stage 4 and scared me to death.  My last biopsy was Grade 2-3, stage 2 in 2002.  I have done 3 different treatments, the last being 2002, the combination therapy.  I'm genotype 1 and was diagnosed in 1983.  Dr. is checking on trials and said he wants to try me at a low dose of interferon daily.  My appt. is not for two weeks so I have been left hanging.  I have never responsed to treatment before by the way in the past.  Any suggestions or insights????  
Thanks, I am a nervous wreck

[HepCat]

Well, stage 4 means cirrhosis and grade 4 means the inflammation is pretty high which may suggest a faster rate of progression of liver damage.  Your doctor wants to see if he can slow down progression with "maintenance dosage" because assuming you have compensated cirrhosis (liver still works ok) he wants to keep it that way and not progress to decompensated cirrhosis (liver not doing its job to some extent and on) which is usually the point where liver transplant is indicated. They would normally consider maintenance dosage where regular tx has proven not to work or cannot be tolerated. It seems what some people are questioning is whether you have really taken convential treatment (pegalated interferon with ribavirin and/or daily infergen with riba) as far as it could go and whether your biopsy is accurate.  I was surprised at the difference in JM's results.  I also thought maintenance dosing is usually done with a weekly dose of pegalated interferon and not daily of what? But you weren't very specific.

Studies of maintenance dosing have shown it can slow the progression so that would be something to consider if trying regular treatment is not an option but you can tolerate a maintenance dose.  

I understand how you feel because that is truly a bad diagnosis but not the worst it could be.  Don't give up hope that maintenance dosing sounds like a good option for now.  If you can supply a few details of your past treatment people could better evaluate your situation.  Some doctors are alot better than others in treating Hepatitis C.

Take care.  

[fresnoborn]

hi i have noticed on this site that you seem to know quit a bit so i am asking you if you caninterpret this to me in plain english. it's the results of an x-ray i had done recently because of my hurting, swollen hip.  here goes:
FINDINGS: EXAM IS COMPARED TO 6/6/05 AP PELVIS DEMONSTRATING SIMILAR SLIGHT IRREGULARITY OF THE SUPERIOR LATERAL ACETABULAR(what's a lateral acetabular?) ASPECT TO SUGGEST POSSIBLY A TINY COMPACT BONE ISLAND OR LOOSE BODY OVER THE SUPERIOR LATERAL HIP JOINT.(what?) AP AND FROG CONED VIEWS SHOW MILD SPURRING OF THE INFERIOR FEMORAL HEAD,(do you know where the femoral head is?) ALMOST CIRCUMFERENTIAL HIP JOINT NARROWING IN RETROSPECT ON THE FROG(whats frog?)VIEW. MILD ILEAL WHISKERING (what's that?) IS NOTED INCIDENTALLY ON THE AP AND FROG PROJECTIONS TO SUGGEST RHEUMATIOD VARIANT ARTHRITIS FOR INSTANCE AND THERE IS NO ACUTE FRACTURE OR DISLOCATION SEEN.MILD OSTEOPENIA IS NOTED.(what's that?)NO ABNORMAL SOFT TISSUE CALCIFICATIONS ARE NOTED DISTANT FROM THE HIP JOINT.
IMPRESSION: MILD SPURRING FEMORAL (what's a femoral?) HEAD ASSOCIATED WITH LACK OF SUPERIOR HIP JOINT NARROWING TYPICAL OF OSTEOARTHRITIS RATHER SUSPECT RHEUMATIOD ARTHRITIS OR RHEUMATIOD VARIANT, WITH MILD OSTEOPENIA.
can you help me with this one?

[Forseegood]

Sorry you had some bad news, but as someone said, it's certainly not as bad as some have had. All I can tell you is that I know of some people who were 3 4 even 5 time non-responders and relapsers that have been helped by low-dose treatments and/or infergen. One five time non-responder I know who is a manager at one of the other boards has responded to infergen. Of course there are all the other things, taking excellent care of yourself, diet considerations, etc. Hope you find something that works for you. Good luck to you.

[cquest]

I will check the medical dictionary when I get to work but off hand I know 'femoral' is your leg bone and 'femoral head' is the end where it fits into your hip socket. Any word with 'osteo' in it relates to bone (as in osteoporosis: poris bone). 'Ileal' is also a part of the bone, whiskering probably means there are little fragments that looks like whiskers...the 'island' sounds like you have some sort of bone fragment floating around...All in all, if you don't see words like 'severe' 'extensive' or 'extreme' etc, you are probably doing ok, it could be worse...Why don't type in those words and do a search on the web?
Cin

[jmjm530]

The diagonosis is suggestive of osteoarthritis with mild bone loss (osteopenia). Like cquest says, it doesn't sound too serious but we don't have any doctors here and mostly are familiar with hepatitis c treatment issues. Again, as suggested you could look up each term in a medical dictionary online but that will still only give you the "what" and not the "what does it mean."

If you don't get the answers you're looking for here, try going to the main page of this site http://www.medhelp.org/
and click on "arthritis" (bar on left) you can ask a doctor the same question for a very small fee.

Good luck and hopefully it's simply one of those normal things that happen to all of us as we age.

-- Jim

[rearfang]

Great news!!!
Lauren