Unsure about danger of CT scan of liver

[nelson958]

Hi all. I relapsed after  72 week treatment (undetectable around week 16). Biopsy before treatment indicated stage 2-3. I'm having doubts  about a CT scan done now-hitting the  liver  with radiation seems counterproductive if we're trying to  protect it. Any thoughts?

[LeeSone]

My husband has HCC .  After treatment for 1 month, we have check for AFP and  it had fallen down from 3,990 to 3,240.  Is that mean the treatment is effective with him?

[HectorSF]

Best of luck with your next treatment!

Hectorsf

[nelson958]

Hector, the ct was proposed by a doctor  I went to see for a second opinion. I agree with you, and I'm not getting it done.

Nelson

[HectorSF]

Nelson, I am sorry to hear about your relapse after 72 weeks. That has got to be difficult after all of that effort on your part.

One thing... I missed exactly why you are having a CT scan(s)?

If you are not stage 4 there is no reason to have a any type of scan for HCC. Or worry about AFP. Liver fibrosis increases more quickly after age forty but if you were stage 2-3 a year ago, you probably have many years before reaching stage 4. Before then the new protease and polymerase inhibitors will be on the market.

For us cirrhotics the benefits of scans out weight the risks. HCC is a fast spreading, deadly cancer that if not caught early can spread outside of the liver, and at that point a liver transplant is usually not an option. So catching HCC when the tumors are small and it has not spread outside the liver can be a matter of life and death. We have scans every 6 months as the chances of getting HCC increase every year that we live with cirrhosis.

Take care.
Hectorsf

[nelson958]

Thanks for the kind words. My riba wasn't weight based (started at 177lbs ended 162) just 1200 per day.I was und around week 16.I had a ct at beginning of treatment (April '07) and biopsy.
My plan now is either go for a trial (not liking the chance of 48 weeks on placebo) or just waiting for new drugs.

Nelson

[nygirl7]

Wow Nelson I am so sorry. I did 72 a few years ago and know how difficult it is.  Was your riba weight based? It is essential for it to be, especially in the first few weeks and also one more question - what week did you get to UND at? The Peg shouldn't have hurt your chances that long down the road.

Just trying to figure out what could have been the culprit - it's a damn shame and I'm so sorry this happened to you.

When was your last catscan? i would assume if anything that your liver had seen some improvement being on the meds for so long and at stage 2/3 it just might not be necessary because I would think that you haven't progressed to HCC or tumors or cirrhosis.

Do you have a new plan in mind?  

[merryBe]

you are welcome, here's a primer on the whole screening process i FOUND HELPFUL.

the main thing is shows is that each screen has it's up and down side. None are 100% accurate. The AFP only picks up 65-75% of the time for instance.

http://www.liverdisordersfocus.com/articles/liver-cancer/liver-cancer-diagnosis.php

I should add that I opted out of regular MRI's for 2 easons. one should concern everyone while on tx and that is that riba is hard on kidneys already, and gandolinium can cause kidneys failure...why push an already taxed set of organs. Since the SOC on riba is set at 1200 largely because the higher doses which produce higher SVRs also produce 20% kidney failures as the swedish study by Karan Lindahl revealed.

secondly I already have a large renal cyst...
A HUGE percentage of adult have renal cysts and do NOT KNOW IT.

urine pools in renal cysts, meaning any gandolimium getting in there could hang out for days not hours making my kidneys more vunerable to fibrosis which gando is on record for causing, and cancer as well due to it's radioactivity.
Unfortunately most doctors don't see the connection as to why this would be a concern to me...which only proves they do not do their homework when ordering these scans for people.  rolleyes.

anyway, each decision is personal, it's your body, make them as wisely and well informed as you can.

mb

[nelson958]

The only reduction was around 60 weeks the pegasys reduced to about 150 from 180. Ribavirin at 1200 per  day throughout.
Thanks merryBe, I've been  leaning toward ultrasound.

nelson

[jmjm530]

I don't think the concern should necessarily be for the liver, but for the overall added radiation that CT scans produce. As HCA points out, it's a matter of risk/reward, but before you get a CT Scan, you might consider an MRI or even another liver biopsy if it's been a few years. My understanding of CTScans, MRI's and Ultra Sounds is that they are most useful for screening HCC (liver cancer) which means a life long program )every 6-12 monts) according to some. For that reason I stopped CatScan's at the advice of a hepatologist who felt that ultra-sounds and MRI's were enough verus the accumulative radiation of CT Scans over the years. That said, if I was told that a CT Scan was the best way to get useful information at a certain point in time  I would of course reconsider.

-- Jim

[merryBe]

I've the same concerns. I had one CT scan before tx...stage 3/4....so more radiation would raise the tumor risks.

solution: I had an ultasound, and am watching my AFP levels. Ultrasound is not as reliable as CT scan for catching small tumors, expecially if you are overweight or have fibrosis already, but in combo with a normal AFP they give you a safer way to keep a check on things.

The AFP reotein marker is known for showing up, levels rising, whenever HCC, hepatic cancer is present. There are actually several different test for this, you'll have to talk to your doc about what they are willing to do.

I opted to have the CT every 2nd or 3rd year, but the ultrasound I will probably do every 6 months to year in between. There's no perfect solution here, CT radiation does risk tumor cells forming while it tells you if you have an right then, it does not tell you if you have any 2 weeks later, when the mutated radiated cells start growing.

Normally the body recognizes and gets rid of cancer cells before they form cancer...you make thousands of these mutant cells every day and the body disposes of them. However, a sick liver, particularly one that is iron laden or fat and scar tissue laden is at a much higner risk than other more normal body tissues of having the aberant cell turn into growing clusters. Liver cancer spreads rather rapidly and cannot be treated unless caught early.  For this reason at LEAST get as many cancer marker tests as your doc and insurance will allow and be regular about it.

go to labtestsonline.org for a tutorial on all your labs.

mb

[HCA]

Virtually all medications and procedures are either contra-indicated are cautioned in the prescence of liver disease, in which case we would never get anything done.
Personally I would have (and have had) the CAT scan without giving it a second thought.It's not as though the procedure is going to be repeated on a regular basis.
Bad luck on relapsing after a 72 week treatment.Was your medication,particularly the ribavirin reduced in any way?