To treat or not to treat

[sschell]

I finally, 5 weeks later rec'd the results of my genotypes test. I am 1A. I have no symtoms, I am 54 next month and I figure I have had this for at least 30 years. My wbc are 3.8 but no other symtoms. I am scheduled for a liver biopsy in mid Nov. I am wondering do I really need to risk having this procedure? I am healthy! What are the chances that the doctor's will not put me through treatment? Do I have to have the treament?  What criteria do doctors look at? Do they ever conclude that treatment is not needed because there are no symptoms. Thanks if anyone can answer my questions. Sandy

[Willy50]

Substantial agreement with all Jim said.  There is nothing to decide until you get an evaluation.  Once you get one you'll get more tests.  In addition to the biopsy you might consider getting a Fibrosure II test or similar.  They'll be doing other LFT tests anyway and it may provide a more well rounded picure of the state of the liver.  It is a simple blood test and inexpensive enough that you can continue to monitor your condition perhaps even annually.  They are considered to be about 85% accuracy of a biopsy.  They cost about 300 dollars and mine was about 25 bucks after insurance; not bad.

I particularly echo Jims assessment that if you treat go with the best doctor you can get.  This is no place to scrimp on what is convenient or cheaper.  

Use this board to search for answers to questions.  You'll find that questions such as what you've asked get asked often and there are many different and valid ways making a decision.

Personally I am waiting for a bit.  There is risk in doing so but there may also be some rewards in doing so that make the risk tempting to me.  Due to the nature of HCV and the varied condition of us all in a group of 100 people that will be a good decision for some and it could be a potentially very poor decision for others.  How does one tell what group YOU are in?  Go see a great doctor, get your tests........and start reading.  : )

best,
Willy

[sschell]

I emailed Dr Shiffman a few weeks ago, late one night and he responded at 10:30pm. He had his scheduling dept contact me and worked me in for next week. Normally, it would have been Jan. I go this Thurs 11/15 for liver biopsy with gastro dr and then I will take my slides to Shiffman. I found several friends he has treated and I have heard nothing but good. Thank you for prompting me to contact him and not to settle. I am curious how long does it take to the results of the biopsy? Did I mention both of my parents had cancer of the liver and pancreas? Is there always going to be a time when I am waiting for test results?  Thanks agoin Jm Jm

[sunspot]

It takes about 2-3 months from the first positive test to taking your first shot. Lots of time to wait and worry  ;>)

[jmjm530]

Glad you got such a timely appointment.

Why don't you contact the pathology department directly, and ask how long until your biopsy report will be ready, and probably more important, how soon you can pick up the slides. You might tell them your appointment date to get them moving a little faster. Also, if there is any paperwork to fill out, you might get that in advance. If they won't deal with you directly, then you'll have to do the same through your gastro's office, but I'd try direct first.

I say getting hold of the slides is probably more important because Schiff will probably have his own pathologist look at them anyway. So don't let the process get held up just because the original pathologist hasn't finished doing the report yet. They can always be returned if necessary. Lastly, make sure you get the entire slide set -- around 4-6 slides. The first time I asked, they handed me only one slide and that was inadequate to get a proper second evaluation.

Let us know how things work out with Shiffman.

All the best,

-- Jim

[Susie2007]

Jim did such a good job, I have nothing to add except the best thing you can do is see Dr Shiffman at MCV. I have been there twice at biopsies he has done and he makes it very easy. He is a wonderful doctor and you can't go wrong using him as your hepatologist.

[jmjm530]

Thanks Susie. Didn't realize that Shiffman biopsied you. I think Sandy is being biopsied elsewhere and then will see Shiffman for the consult. Alternatvely, I suppose Sandy could get the biopsy from Shiffman, but not sure how that would work logistically or insurance wise.

-- Jim