dad was diagnose with hcc

gotendbz1 · New User Joined: 27 Mar 2009 Posts: 8

found out this wednesday that he has hcc in the right lobe of the liver. doc wants to use chemoembolism, then block the vien which supplies blood to the right side of the liver.

he said that then the left side would grow and then he can do a resection of the entire right lobe.

dad has hep B., which is what mostly likely caused the cancer. but my question is we have to wait until april 6 to do the chemoembolism(spelling). Is this 2 long of a wait? we are currently at mount sinai in nyc which i hear is a good facility.

So is the wait 2 long, and should we be looking into other hospital to see if we can get soemthing done early? My dad is really worry and wants this done as quickly as possible.

Are there any other good hospital in nyc we can try to go to. But i think the delay can cause the cancer to spread more and cause more problems. Not sure how this is gonna work out, but I'm hoping for the best and praying that we make it thru this ok.

thanks for listening to this rant. any advice would be helpful. Anyone who is in NYC and can help it would be great

hummelja · Regular Joined: 04 Feb 2009 Posts: 11

I've had two chemoembolizations and, assuming your dad was diagnosed withint the past couple of weeks, dong the procedure by April 6 seems pretty quick to me. There's quite a bit of pre-work they will have to do including labs, perhaps some imaging work, etc.
_________________
Andy Hummel

gotendbz1 · New User Joined: 27 Mar 2009 Posts: 8

[quote="hummelja"]I've had two chemoembolizations and, assuming your dad was diagnosed withint the past couple of weeks, dong the procedure by April 6 seems pretty quick to me. There's quite a bit of pre-work they will have to do including labs, perhaps some imaging work, etc.[/quote]

Yea he was diagnose last wednesday. the appointment in the 6 is for a "consult" or soemthing liek that. He has a ct and bllod works done at the hospital already. What can i expect when we get there?

hummelja · Regular Joined: 04 Feb 2009 Posts: 11

This is how they do it at Baylor in Dallas:
Check in, get admitted, go to day surgery room.
Change, give blood for labs, get IV started, vitals, etc.
Wheel down to interventional radiology and put on table.
Get draped, shaved, and phenergan or something similar through your IV to relax.
Procedure lasts a couple of hours.
To recovery area, clamp installed on groin to stop bleeding from femoral artery. Pain starts. This is due to tissue dying from the chemo and the blood supply being cut off, which is the whole point. Kills the tumor hopefully. Can be bad. They give you IV morphine.
After an hour clamp comes off and they take you to a regular room. The ones at Baylor are big and nice.
Nausea starts. Pain continues. Tell them about it! They'll give you medication.
They check vitals and for bleeding every 15 minutes or so.
They'll probably keep you overnight. They worry about the bleeding thing a lot.
To go home you have to get off the IV pain meds, eat a meal, and use the restroom.
I went home about noon the next day.
Will probably be in bed a couple of days taking pain and nausea meds.
Pain and nausea go away after a couple of days.
Will be depressed, not real sharp, and fairly tired for a few weeks.
Go back for imaging after about 8-10 weeks.
_________________
Andy Hummel

gotendbz1 · New User Joined: 27 Mar 2009 Posts: 8

[quote="hummelja"]This is how they do it at Baylor in Dallas:
Check in, get admitted, go to day surgery room.
Change, give blood for labs, get IV started, vitals, etc.
Wheel down to interventional radiology and put on table.
Get draped, shaved, and phenergan or something similar through your IV to relax.
Procedure lasts a couple of hours.
To recovery area, clamp installed on groin to stop bleeding from femoral artery. Pain starts. This is due to tissue dying from the chemo and the blood supply being cut off, which is the whole point. Kills the tumor hopefully. Can be bad. They give you IV morphine.
After an hour clamp comes off and they take you to a regular room. The ones at Baylor are big and nice.
Nausea starts. Pain continues. Tell them about it! They'll give you medication.
They check vitals and for bleeding every 15 minutes or so.
They'll probably keep you overnight. They worry about the bleeding thing a lot.
To go home you have to get off the IV pain meds, eat a meal, and use the restroom.
I went home about noon the next day.
Will probably be in bed a couple of days taking pain and nausea meds.
Pain and nausea go away after a couple of days.
Will be depressed, not real sharp, and fairly tired for a few weeks.
Go back for imaging after about 8-10 weeks.[/quote]

wow thats alot of good info. is the 8-10 weeks mandantory? doctors about a month after the chemo, if the left liver has grown enough to compensate for the right, we will have surgery to remove the cancerous right lobe. we're at Mount Sinai in NYC.

also does this procedure also cut off blood flow to the cancer?

thanks agian for your great info. How are you doing with your own health situation? if you don't mind me asking.

hummelja · Regular Joined: 04 Feb 2009 Posts: 11

Please don't think of me as an expert on all this. Only your oncologist is qualified to provide accurate information about your specific situation. So much depends on the specifics of the individual case. I do know this, TACE takes a while to have its effect. It doesn't happen overnight. I've heard them mention 6 weeks as the minimum for reassessment but I'm sure different oncologists have different standards. I wasn't a candidate for surgery so my follow-up may not have been as urgent as your husband's.

I have not previously heard of removing an entire lobe to get rid of the cancer, but if it's confined to that lobe it would seem to make sense. I know the liver does have amazing regenerative capabilities if it is otherwise disease free (i.e. no active hepatitis or extensive cirrohsis).

Yes, the intent of TACE, as I understand it, is to kill the tumor by a combination of chemo plus cutting off the blood supply via embolization.

In my case TACE wasn't entirely successful. They don't really know why but it probably has something to do with the fact that the cancer has invaded my portal vein and is getting some of its blood supply from somewhere other than the hepatic artery, which is what they embolize and how the chemo is introduced. So I had radiosurgery in January using the CyberKnife. Hopefully this killed the rest of the tumor. I go back for imaging in a couple of weeks so we'll see. Also I'm taking Nexavar which is hopefully keeping the cancer from growing.
_________________
Andy Hummel

gotendbz1 · New User Joined: 27 Mar 2009 Posts: 8

just a quick update, had the consult today, they told us all the risk and what was needed to be done. so the chemoembolostion is gonna be april 20. hopefully this is not too late, no other dates avilaible.

orignal diagnose date is march 17.

gotendbz1 · New User Joined: 27 Mar 2009 Posts: 8

just an update, he had the TACE on monday, came home on tuesday and when he was eating he had i guess what the hospital called a hematoma. they did a few ct scan and ultrasoudn and found no active bleeding.

we cam home last night and he is resting, he doesnt have any real side effect from the chemo, only thing we worried about is the hematoma. is this normal?

gotendbz1 · New User Joined: 27 Mar 2009 Posts: 8

another update, dad had PVE and everything went well. he will have a ct in about 3 weeks and if all goes well liver resection will follow.

He has also started losing hair from the chemoembolization and he also snoozes now when he sleeps. Thanks everyone for your support, hope all goes well.

gotendbz1 · New User Joined: 27 Mar 2009 Posts: 8

Dad had whole right lobe and a few wedges on left and gallbladder removed on monday. He is on a liquid diet right now and still hasn't had any bowel movement yet.

He is able to urinate and walk. does anyone know how long the recovery process is? I seen the incision and it is pretty big. He also as a drain for i guess bile, but everytime we drain it more seems to come out.

hopefully he can get out of the hospital soon and we are hoping for no more cancer.

gotendbz1 · New User Joined: 27 Mar 2009 Posts: 8

Well its been 4 weeks since the liver resection and my dad is finally getting his energy back it seems.
He couldn't sleep at all durign the 2 weeks after the surgery, but it getting better now. He still take some painkiller to deal with the pain. the day for the ct scan is oct 14, so we hoping for the best.

The question i wanted to ask before calling the doctor was his feet are kind of swollen, they don't hurt him or anything just swollen. He doesn't walk around much just basically from bed to couch to bathroom to get food, but most of the time he is on the couch.

It seems to be less swollen when he first get up from bed, but as the day wears on it get bigger. Anyone with any experience with this after a resection?

thanks everyone

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