Reservations about liver biopsy.

jackwebb · New User Joined: 27 Feb 2005 Posts: 3

I was diagnosed with cirhosis nearly four years ago. Past October I had a CT-Scan and the doctor informed me I had three or four spots on my liver about the diameters of golf balls. He said they had probably been there for some time.

He informed me those spots might be cancerous and the only way to know for certain was to have a liver biopsy. I declined on the spot.

The reason for this is that in the past I was a member of a visitaion committee for a service organization in which I went to various hospitals to visit members of our organization or their kin who were hospitalized for one reason or another. I recall more than a few older men (I am sixty eight) that did not fair well at all after having surgeries on their vital organs; liver, gall bladder, kidnies etc. etc. In fact some of them worsened and did not live long afterwards even though their operations had been successful.

My doctor did not attempt to convince me one way or the other as to whether I should elect to have the biopsy or not. He simply replied that he believed it was a "sane decision." This was in October and he suggested I have another CT-Scan this month, February.

Ironically when I appeared for my appointment Thursday he still had not returned to work as a result of surgery. I was seen by another doctor and he also asked me about the biopsy. I again said no.

But unlike my regular doctor this one said something like "Well, I'm pretty sure you have liver cancer. And if you decline treatment you are going to die." Because I declined the biopsy he saw no need for the second CT-Scan and it was not scheduled.

He said they would continue to treat me "clinically" and that would be that.

I have been taking several medications daily since the cirhosis was diagnosed years ago. I feel absolutely fine and have exhibited none of the symptoms associated with liver cancer so far.

Although I am not dwelling upon it, I am curious to know what I can expect if this is cancer and what will I feel when it begins to take its toll. Will I simply waste away gradually over days and weeks, will I suffer excruciating pain? Will I just drop dead suddenly?

I have been divorced for 18 years and all my children are grown and successful. I have not mentioned anything to them and I do not intend to.

When my doctor presented me with the news in October and I told him I would not have the biopsy, for some reason when I left his office I felt somewhat elated. It was as if this new information was adventureous. Knowing the end might very well be not far off at all. Yet I was feeling absolutely healthy! Smile

hhmv73a · Experienced user Joined: 16 Jan 2005 Posts: 95

I think the biopsy was suggested to rule out liver cancer (hepatoma). Although tumor marker cannot be used for cancer diagnosis, but under certain circumstanced they can be helpful. Have you talk to your physician about an alpha fetoprotein test?

Regards,

J. Jay Lu, MD

jackwebb · New User Joined: 27 Feb 2005 Posts: 3

If the test you refer to is the one I believe it is, yes all the tests the doctor requested in bloodwork over the past several years included the "alpha protein" one.

At the time he discussed the results of the CT-Scan with me he mentioned it and said the results indicated I might have cancer but that it was not totally conclusive and the only way to know would be to have a liver biopsy.

Last week his temporary replacement placed much more confidence in the "Alpha Protein" test than my regular doctor and he said he believed the spots were cancerous.

I still feel very well comparitively speaking for my age and I see no reason to proceed any further with something like the biopsy, chemotherapy etc. and I am satisfied with just continuing my medication.

My regular doctor said quote: "That is a sane decision."

leo · Site Admin Joined: 23 Sep 2004 Posts: 1574

Dear Sir,

I am sorry to hear about these problems. It seems that you are doing well, though.

On your question about what to expect if this is indeed cancer, there are so many things that can happen, such as infections, blood clots, liver failure and such. It is impossible to know how this will or will not go. Even if you choose not to have any treatment or biopsy, I encourage you to stay in touch with your physicians, as there are many things that can be done to make you comfortable, in case you have pain, shortness of breath, and such. Not having treatment does not mean not having "care". I strongly believe in palliative medicine, and if you made a decision about not treating or pursuing this, you are obviously entitled to treatments aimed at making you comfortable.

best regards,
Leo
_________________
Leonardo F - Webmaster Cancer Forums
Disclaimer: this information is for informational purposes only. It is not medical advice.

jackwebb · New User Joined: 27 Feb 2005 Posts: 3

Thank you Leo. Take care. Smile

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