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Cirrhosis and Liver Cancer??

painenduser

painenduser

Bluelighter
Joined
Jul 13, 2011
Messages
404
Location
NJ
Hey guys,

For those who may know?? I was at my GI Dr's today and he got me a bit nervous today. They are still trying to figure out exactly what is going on with my liver as normally with cirrhosis they say that the liver normally shrinks, however, mine is not. I do not have hepatitis or any other viral issues with my liver and I am past having a fatty liver yet my liver is highly enlarged as is my s pleen. Today my GI dr told me he wants to step up the tests on me and my liver as he thinks at this point although I do not have any of the markers in my blood work, he wants to have me checked for some form of liver cancer. I shutter at the thought.. :( Does anyone happen to know what the likely hood, chances, percentage of those with cirrhosis actually wind up getting liver cancer? I am 37 and cancer is not something that runs high in my family, infact, as far as I know, just my grandmother had breast / bone cancer, other then that noone else really has had it that I know of. I am just curious if there are any good chances that I could have liver cancer. If I were to have liver cancer, can they still look to do a transplant? From what I understand, if I do have liver cancer, I am pretty much as good as dead, I shutter to think of the thought that my days could be so completely numbered, and to be honest, I scared SHITLESS! Anyway, just wondering if anyone had any thoughts.

Thanks folks!

Pain
 
I recently got out of the hospital for very similar problems and concerns, and I'll just tell you what people told me. It's hard for them to tell you 100% sure whether you have liver cirrhosis unless they do a liver biopsy. With me, they simply decided not to because they were seeing some very minimal improvement. However, they didn't mention cancer to me.

My liver has also been enlarged, as opposed to shrunken. For this and other reasons, some people told me that I probably won't have to worry about cirrhosis. Basically, though, all you can do is get it checked out and hope for the best. Do you have a heavy drinking history?

What you should do now is stay clean, stay healthy, eat right, take vitamins, and drink plenty of water. None of us here can tell you whether or not you have liver cancer, but at the same time, you shouldn't be so sure that it is. It could be a lot of different things. It sounds like in your situation, ruling out cancer is routine so that they can determine the right course of action. Take care of yourself, get your liver checked out, and good luck.
 
Hey Blahman, I hear ya bro, but just so you know, I'm guessing you haven't seen my previous posts. I know I have cirrhosis. I am in end stage liver disease. I had my gall bladder out almost 2 years ago and the surgeon who took out my gall bladder confirmed the cirrhosis. His exact words to me were "You liver looks like someone took glass and sandpaper and rubbed the hell out of your liver" I have also had a CT scan and a different nuclear scan that proved that my liver was fibrous and had vascular abnormalities and I also have portal hypertension. So the cirrhosis is a given. I have been sober since my gall bladder surgery so that almost 2 years ago, however the thing is the Dr's have all agreed with one thing, and that is that my drinking alone should not have caused my cirrhosis as I really had not drank heavily for all that long of a time, although even though it was a shorter amount of time then usual, it was fairly heavy. They ruled out any hepatitis. I have been trying to stay healthy though my immune system has taken a dive since the cirrhosis. I have had MRSA twice since then, a collapsed lung with pneumonia and alot of ascities. Interestingly enough, my blood work continues to get better and my liver does show some although very little signs of regeneration. I also had esophageal varices and they have since cleared. I take my vitamins and lactolous or how ever you spell it and I am following all the Dr's orders. So I am not trying to say I am sure it's cancer, it's just that much of everything else has been rules out and this is where he is looking now. I guess I may be worrying too soon but I also think I have good reason too at this point. I am set to go to the university hospital next week for the last of my tests and a biopsy. I should probably wait until then to worry. I just figured I would see what the likely hood that with all this it could be cancer at this point or if I could get a transplant if it were.

Good luck to yourself man. I hope all turns out well for you too. It's amazing what we wind up doing to ourselves. I just hope if for anything I can come out with some redemption that I didn't do this all to myself. That would be the end kicker. Thanks for the reply!

Pain
 
Hepatomegaly can be caused by a number of diseases. It is useful to break the differentials down into categories, including: 1. inflammatory (active viral hepatitis, HIV, sepsis, abscess, parasitoses, bacterial hepatitis), 2. chronic ( hepatogranulomas, chronic active hepatitis), 3. metabolic/toxic (fatty liver syndrome, amyloidosis, copper storage disease), 4. biliary (biliary tract obstruction, cholangitis) 5. vascular (portal hypertension, venous occlusion, right-sided heart failure), 6. tumors (hepatomas, hepatocarcinomas, metastatic lesions), 7. cystic, 8. congenital, and 8. systemic hematological disorders (certain leukemias, lymphomas).

Cirrhotic livers can be variable in size, especially if any of these diseases coexist, such as portal hypertension and biliary obstruction. WRT to your question about hepatic carcinoma and cirrhosis, cirrhosis is certainly a risk factor for liver cancer. Part of a work-up for liver cancer involves measuring alpha-fetoprotein, and the higher the serum value of this protein, the greater the risk for liver cancer. Individuals with cirrhosis have higher serum levels of this protein. Additional diagnostics include diagnostic imaging (ultrasound/CT/MRI) and a liver biopsy.

You didn't mention if you are experiencing any pain, nausea, weight, or any other signs of systemic illness. It's worth repeating that following a low-fat diet lean meat, dairy, and fresh fruits and vegetable, fresh air and exercise is very important. An individual with cirrhosis should abstain from alcohol and drugs.
 
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Hya Missykins,

Looks like you tore a page out of the books I have been reading lol. You are correct however in what you said, infact the tests for measuring the alpha-fetoprotein, doing further diagnostic imaging, and biopsy, those are all scheduled for next week. I have aready had them run once, but my GI Dr's is calling for more indepth tests to see if they missed something first time around and I will be getting the biopsy done for the first time next week as well. As for the other stuff for the pain, I have the air and excersise covered, however the diet is a different story because I have always had a limited menu, meaning that I don't like the taste of anything lol. I find it hard to find food that I will eat that fall under those restrictions.

As for the alcohol and drugs, yeah thats a given. I have been clean for over 2 years now. ;)

It's just one of those things you never want to hear.... The C word is not one I expected to hear from my Dr since I know/knew already the extent of the cirrhosis, they are trying to figure out however why when I test negative for everything but the cirrhosis, why my liver and spleen are so enlarged and why I have such serious pain. It's out side the standards for just a diet change especially since my upper right quadrant has point tenderness when palpated. The pain should not be that severe unless there is something more then the cirrhosis. This is why he wants a whole new set of images, blood work, and biopsy. They are not sure what to do at this point until we get those done. Infact he is sending me to UMDNJ which is the leading hospital in NJ for liver related issues. So next week I will be spending about a week there under going tests and the biopsy which they better knock me out for as I REFUSE to have them jam a needle into my belly and into my liver whilst awake. I have had ascities drained before and it's very similar, they stick a long needle in your belly to drain the ascities and that freakin hurts!

Anyway, I appreciate everyones responses.. Even though we are discussing it, it's actually keeping me from dwelling on the C word and making me re-evaluate what the tests and results have been that I have already had done.

Thanks!!

-Pain
 
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MDs are obligated to discuss cancer as a differential. When you say that you have ruled out hepatitis, I assume that you are referring to the infectious viral types of hepatitis. There are immune-mediated forms of hepatitis where antigen complexes form within the liver, leading to fibrosis ("chronic active hepatitis"). This is a diagnosis that is made with a biopsy/fine needle aspirate. An enlarged spleen with an enlarged liver goes along a blood disorder (leukemia, lymphoma), but you don't mention any enlarged lymph nodes or abnormalities in a complete blood count. Hepatosplenomegaly still can accompany cirrhosis, so it may still turn out to be that.

Tofu, low-fat dairy, or a vegan diet would be good (a peanut butter and jelly sandwich is vegan, use the natural peanut butter that does not have any added oils). Try fruit smoothies with protein powder and yogurt. Lactulose is used to decrease levels of nitrogen that your liver used to do.
 
Missykins said:
MDs are obligated to discuss cancer as a differential. When you say that you have ruled out hepatitis, I assume that you are referring to the infectious viral types of hepatitis. There are immune-mediated forms of hepatitis where antigen complexes form within the liver, leading to fibrosis ("chronic active hepatitis"). This is a diagnosis that is made with a biopsy/fine needle aspirate. An enlarged spleen with an enlarged liver goes along a blood disorder (leukemia, lymphoma), but you don't mention any enlarged lymph nodes or abnormalities in a complete blood count. Hepatosplenomegaly still can accompany cirrhosis, so it may still turn out to be that.

Tofu, low-fat dairy, or a vegan diet would be good (a peanut butter and jelly sandwich is vegan, use the natural peanut butter that does not have any added oils). Try fruit smoothies with protein powder and yogurt. Lactulose is used to decrease levels of nitrogen that your liver used to do.
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Yes I am aware of the MD's responsibility, and I am not questioning his reasoning, after all that's why he is the Dr making the big bucks and I am not.. As for hepatitis, I am only referring to the viral kind not the immune hepatitis. Again, I am going next week to have the further tests done and this will include a biopsy. I don't mention any enlarged Lymph nodes nor problems in my blood count because there aren't any currently. 2 years ago when I first got diagnosed with the cirrhosis I had these problems but they have since cleared up. I am confirmed to have Hepatosplenomegaly but it is secondary in nature to the cirrhosis according to my last set of images.

Tofu is nasty lol and I would rather let my liver kill me then eat vegan food. No offense to those that do, I just could not do it. I currently do make smoothies with fresh fruits and yogurts. As for the Lactulose I am only to take it PRN constipation (Go Opiates, clog up the garbage disposal!!) and hepatic encephalopathy used to lower my ammonia level, which all ties into the nitrogen levels as well. I am only to take it now when and if I need it, but not regularly.

Again, I am not questioning the diagnosis and the steps in which we are going to determine what is absolutely going on and other possible issues primary or secondary to the cirrhosis. All I am questioning is how common is it to actually be diagnosed with Liver cancer from my liver disease, and whether if it is cancer can I still be offered a transplant. Trust me when I tell you, I am quite intune to my current diagnosis. I am aware of all the other possibilities and again, thats why I am going to the university hospital who specializes in liver disease. I know what it could be, what is there (for the most part) and just wondering how likely it would be that I could infact have liver cancer. Perhaps this is not a question that can be answered by anyone other then those who will be reading the results of my tests, but like they say, "It never hurts to ask".

So I get what your saying Missy, but I am not looking for anyone to diagnose me here, I am merely asking about the likely hood of cancer as a secondary or even primary diagnosis. Thats all. It was just unsettling to hear that my Dr has run all the tests he can run and he's referring me out to the specialists to see the cause of my pain is due to cancer and somehow has been overlooked.

Thanks!

-Pain
 
painenduser said:
So I get what your saying Missy, but I am not looking for anyone to diagnose me here, I am merely asking about the likely hood of cancer as a secondary or even primary diagnosis. Thats all. It was just unsettling to hear that my Dr has run all the tests he can run and he's referring me out to the specialists to see the cause of my pain is due to cancer and somehow has been overlooked.

Thanks!



-Pain
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Carcinoma could certainly be a diagnosis, I'm afraid. You have the primary risk factor for liver cancer and that is cirrhosis. But the biopsy will be the Holy Grail of all tests. I, too, would ask for some midazolam or propofol.

It's tricky to do a transplant when you have cancer because of the immunosuppressive drugs one is placed on following the transplant to prevent organ rejection. The surveillance provided by your immune system plays an important role in recognizing and destroying neoplastic cells. Certain types of cancers (myeloproliferative), such as leukemias and lymphomas, are known to develop in response to the immunosuppressive agents used after organ transplants. It's comes down to the devil you know versus the devil you don't.
 
blahman8000 said:
Did some research for you, regarding a transplant for liver cancer:
http://www.hopkinsmedicine.org/Press_releases/2003/10_30_03.html
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Missykins said:
Carcinoma could certainly be a diagnosis, I'm a
Thanks Blah, I have been researching so much over the last few weeks, my head is ready to explode... I will be reading the link in a moment....
fraid. You
have the primary risk factor for liver cancer and that is cirrhosis. But the biopsy will be the Holy Grail of all tests. I, too, would ask for some midazolam or propofol.

It's tricky to do a transplant when you have cancer because of the immunosuppressive drugs one is placed on following the transplant to prevent organ rejection. The surveillance provided by your immune system plays an important role in recognizing and destroying neoplastic cells. Certain types of cancers (myeloproliferative), such as leukemias and lymphomas, are known to develop in response to the immunosuppressive agents used after organ transplants. It's comes down to the devil you know versus the devil you don't.
Click to expand...

Some how I got to figuring that the incidence of cancer in my current place in time was probably the most likely cause. Thinking back now, thanks missy for making me remember this, on my blood work the only thing out of place was the Lymph Percentage was low, but that was the only one. The absolute was normal. I don't know if that means anything but what I have read seems to indicate that one should be more concerned of the Lymph Absolute and that's perfect. Maybe I am just bugging out to early on this, but I'm still young, and I have a lot of living left to do, or maybe not :( . I suppose it really doesn't matter at this point, whatever it is it is. Thanks guys
 
Missykins said:
That's very encouraging. Pain, aren't you already on the transplant list or am I wrong?
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No not yet because the GI Dr that I see wants me to get the biopsy from UMDNJ first. Once the results of that come in, then he will be more in a position to decide if a transplant is even an option. I kinda jumped the gun earlier when I was asking if you could get a transplant if you had liver cancer. I should probably wait until all my tests are done before I delve deeper into the questions. Like I mentioned earlier, I may have asked these questions a little to early, but I thought we were further along with my diagnosis and prognosis, but really I should wait until I get all the tests completed, which after speaking to my family, we can not get them done next week, so it will have to be in 2 weeks. I don't think (I hope) things don't suddenly take a dive for the worse in between then, however, all my other tests were good other then the scans and imaging stuff. And thanks for reminding me. I got so caught up in things tonight I forgot to check out Blahmans link, going to check it out now.
 
Blahman, that was a great read, very encouraging! Thanks for finding that for me.
 
painenduser said:
No not yet because the GI Dr that I see wants me to get the biopsy from UMDNJ first. Once the results of that come in, then he will be more in a position to decide if a transplant is even an option. I kinda jumped the gun earlier when I was asking if you could get a transplant if you had liver cancer. I should probably wait until all my tests are done before I delve deeper into the questions. Like I mentioned earlier, I may have asked these questions a little to early, but I thought we were further along with my diagnosis and prognosis, but really I should wait until I get all the tests completed, which after speaking to my family, we can not get them done next week, so it will have to be in 2 weeks. I don't think (I hope) things don't suddenly take a dive for the worse in between then, however, all my other tests were good other then the scans and imaging stuff. And thanks for reminding me. I got so caught up in things tonight I forgot to check out Blahmans link, going to check it out now.
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I mistakenly thought that you had reached end-staged liver disease for reasons other than cancer and were already a candidate for a transplant.
 
Missykins said:
I mistakenly thought that you had reached end-staged liver disease for reasons other than cancer and were already a candidate for a transplant.
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I am diagnosed currently with End Stage Liver disease from the cirrhosis, however, I am not on the transplant list yet as there are other aspects of my illness my Dr is trying to understand. Once that is all done, I imagine I will be placed on it. That's why I was curious if one can be put on the list if you had liver cancer. From the looks of the document Blahman pasted in, it would seem that one can be on the list with liver cancer.
 
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