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Treatment without biopsy??

Friends,
I'm trying to get it to see my gastro doc as soon as possible. However, I don't want to waste valuable time getting a biopsy and waiting for results. I want to get started with treatment now. To me the fact this virus is wrecking my liver is all I need. Any damage done to my liver is done. I think cirrohsis is irreversible and fibrosis is possibly treatable. But slaying the dragon thats devastating my kingdom (my liver) is more important than finding out how much damage was done. There is damage, i feel the pain and i can see my Lichen Planus skin lesions. Can a biopsy be done after tx or during tx? The liver damage will have to be dealt with after treatment anyway.  I've had an ultrasound already and have PCR confirmed HCV I'm only waiting on viral load and genotype results. Would like to hear your opinions on importance of biopsy before tx.
Thanks
BronxRican007
13 Responses
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Avatar universal
Bronx,,,I didn't get one either and it drives me crazy to have gone through treatment and now to not even have known the condition of my liver. That was my biggest mistake,,,putting all my trust into a dr that didn't have my best interest in mind!  Good Luck!

DallasStar,,,Hey there!!!  Did you say SVR??  Yeahhhhhh!!  I'm sure you are so happy to put all that behind you.  You have been through so much and are so strong! I know that you have been an inspiration to me and so many others!  Thank you!
Helpful - 0
Avatar universal
if you are having extra hepatic symptoms, tx is probably a good choice regardless of the condition of your liver.  But I would still want to know the condition of my liver prior to treating.  It would be a baseline to gauge if there was any histological benefit after tx.  and as it was stated, it might influence the length of your tx.
hang in a little longer, you want to know EVERYTHING it is possible about the state of HCV in your body.
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Avatar universal
Personally I would get a biopsy first. I waited a few months after I found out I had HCV to begin Tx. I was Stage 2 on my first Biopsy, I began Tx 2 weeks after I received the results.
I went from Stage 2 back to Stage 0, after a year of TX.

Now 11 months after Tx, I am SVR, and have no liver damage.

Research everthing you can, I am sure you will make the right decesion, as all of us here have done. Its a personal choice, only you can decide to make.

Take Care,
Dallas
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Avatar universal
I appreciate the advice especially the liver damage reversal info. Still want to start fast. My liver damage,(Like DeNiro would says in mafia movies), "Is what is it is". I want to deal with the causes not the symptoms. I'm military maybe it's my military mind at work. Please keep it coming though I want to hear all points of view...this is great "therapy" too.
PEACE

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Avatar universal
Man, you say: "it is what it is".. Hmm, what is it, cause you don't know? That is the point we are all trying to state. The length of your treatment depends on the condition of your liver. What medications your DR might prescribe to you during tx to counteract the side effects, might depend on the condition of your liver.
When I got to my GI center, it was ONE week before I had my biopsy. I had the ultrasound the same week. Started tx within ONE month. I started with ALL the info, not "unarmed" and "unprepared" for a merciless and evasive enemy.. If you currently have chirrosis or bridging fibrosis, 48 weeks of tx is not enough. You only want to treat ONCE, not make a carreer out of it.
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Avatar universal
I admire the decision to eradicate the virus. That being said, the biopsy will tell you better then anything else we have available what shape your liver is in. Tx is'nt just side effects and cure-it can cause thyroid failure and a list of continuing problems when you're done if you happen to be unlucky and you may not get SVR also. The biopsy will tell you if you can wait for something better. The biopsy will tell you what degree of fibrosis you have and later if it was improved. Biopsy results will give you reason to continue if tx is harsher then expected.And if you don't svr like me you will probably need a biopsy anyway to decide whether to treat again. It's just plain useful info and won't delay tx that much. The tx is too serious to take without being sure you need to. The disease is too serious not to treat if you need to. good luck, frank
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Avatar universal
I have no doubt that you'll come to regret that decision if you do indeed begin treatment without a biopsy.  Just ask Scruffy.  I'm sure he'll be around soon to tell you his story.

HCV is very slow-moving.  Waiting a couple more months to get a biopsy before starting treatment won't make much, if any, difference in the damage done to your liver. For all you know, there might not be ANY damage right now.

Being hasty and skipping critical steps like a biopsy is not a very good way to approach this.  Do it right the first time.

Susan
Helpful - 0
Avatar universal
I also agree that a BX is very essential. Waiting 1-2 months will not effect your liver, but could change the way your treated. I would want the Treating Physician to have all the information he needs to give you the proper TX..

                   God Bless


                   TonyZ
Helpful - 0
Avatar universal
All military leaders, generals, admirals and even the prez, listens to their advisors before going into combat. Right? Your advisors are here too. They've been in your shoes, gone to battle, some have won and some are still fighting. They know how to prepare for the war against HCV. You came to this forum for advice and these good folks here are straight shooters. Listen to what they say. Good luck.
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Avatar universal
They've said it all...great advice, take it to heart!  The only thing I would add is that most of us fully understand the incredible impatience you are feeling to "just get started right now".  I waited 4 years between diagnosis and biopsy, followed by treatment.  Once I made the decision to treat, despite the 4 years of avoiding it...now, it just couldn't happen fast enough!  Waiting on biopsy results during Christmas holidays...then my dr turned out to be a jerk and I had to find another one.  Then....  By the time I got started, I was WAY past ready.  But I followed the advice given here about what was important to do prior to treatment, and it's been a very good thing for me.  I can only recommend that you follow it too.

Get the biopsy so you can know what you're dealing with.

Laika

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Avatar universal
WOW!!! I got the message. When I talk to my gastro Doc at the end of May I'll pressure him to be quick with the biopsy and get press on with tx. Thanks ALL!
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Avatar universal
I don't understand why you think getting a biopsy would be wasting valuable time.  A biopsy is the only way to determine the condition of your liver.  I would not recommend anyone starting treatment without a biopsy, as a good liver specialist will use the results of your biopsy to help determine your prognosis and treatment.
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Avatar universal
Personally, I would want the biopsy. I would want to KNOW exactly where I stand before going in. See, if you have chirrosis, or bridging fibrosis, extended treatment may be needed to obtain SVR, or possibly reverse damage. It has been proven that treatment can reverse damage by as much as two stages.. Do some google searches on the web about extended tx, or on reversal of fibrosis.
I know exactly how you feel though about stopping the damn virus RIGHT now!! But I wanted to know ALL my statistics before undergoing tx, so I was prepared for whatever might happen.
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