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

[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

[Debbeav]

Hi and thanks for all of your comments.  I feel so much better having some people to talk to who are in my circumstances.  The past treatments I did were Intron A monotherapy and then Peg-Intron and then the last was the Rebetron Combination therapy.  My ALT and AST's never normalized but went down for a few months and then rebounded back up as well as my viral load.  I had such severe side effects with the last two therapys that they stopped me after 5 months due to white blood cell counts and weight loss and depression.  How do I know if it is compensated or decomensated cirrhosis?  Can anyone tell me about staging of cirrhosis and the time periods involved generally with advancing from one stage to another?  Thanks for giving me a deep breath -whew!

[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.  

[DRAGON SLAYER]

GREAT NEWS.....CONGRATS. PLS REJOICE. Ben

[Tallblonde]

Congratulations Monte on your wonderful news.  I'm really happy for you!

Susan

[stc1993]

Sorry for butting in on your question but it was full for today.  I got my 48 weeks results today. undetectable, he said all my liver functions were normal & all my blood work was good. he seem to think I have a good chance of being "cured" his word.  Thanks everyone its been a long year. over with in a flash.

Monte