liver Cander

Hi Pinkgrandma  I'm trying to educate myself on some things that could come next.  I know there is going to be a curve ball coming and I don't want any more surprises.  Those surprises seem to come a lot with this horrible disease!  Can you tell me what some symtpoms are of Liver Cancer.  Jerry has had side pain also goes to his back.  That is all as far as symptoms.  What blood test should I look for?  I can only think of one other thing he hasn't had and that is bleeding.  Even though he has a transfusion a few days ago the Gastro Dr. told me it was because his bone marrow is not producing enough blood it is not that he is loosing blood anywhere.  Thanks for the help.

JoAnn

Hi JoAnn, I feel so bad for Jerry right now. As you know my mom had liver cancer. She had severe back pain and was on Oxycontin for it. The side pain came later on. The liver gets scarred as you know with the chirrosis and scars are hardened. When the liver swells it is painful enough but add the scarring of the tissue and it hurts even worse as you can imagine. The most common blood tests for liver cancer that I know of is a CEA and AFP which are tumor markers. For the blood problems with his bone marrow they usually do a CBC with differential, H&H, and blood coagulation tests. This tells them the number of blood cells both red and white. In Jerry's case they are looking at several things when they do this test. They are looking especially for the number of  "blasts" (immature white blood cells). They also check his plateltte count. When the percentages and numbers are low for mature cells this tells them that the bone marrow isn't producung what it should. In some cases they do a Bone Marrow Aspiration. This test is done under sterile technique and the use a large bore needle to aspirate (or suction) about a teaspoon full of bone marrow. They do various tests on the marrow. I doubt that they will do the bone marrow on Jerry however. With the problems he is having you can expect severe or extreme fatigue, bruising very easily, poor appetite, weight loss, lack of interest, abnormal bleeding etc. This is due to the blood problems and unrelated to the ammonia issue. I hope this helps a little. Just remember that not everyone has all the symptoms that occur. I listed the most likely ones. I am proud of you for educating yourself. Have they actually diagnosed Jerry with liver cancer? If not then that requires other tests as well. Usually theyare pretty sure when they do the CEA and AFP blood tests and will follow up with other testing as I said. GOD Bless.

JoAnn, You know I will always try to answer your questions if I can. I would ask you not to worry so much tho. Just take each day as it comes and deal with what you can do to improve what ever it is thas going on at the time. I fully understand what your fears are and I would do the same I'm sure but I also know that you can drive yourself crazy with worry. Sometimes the worry is unfounded and fear is driving you. Please JoAnn, I want you to be educated so that you know what's going on with Jerry but I don't want you getting sick with issues that haven't even occured and may not occur. You can ask the Dr to do the tumor markers when he goes in for blood work if it will help you to cope better. It sounds like they are more concerned with his low H&H right now. They will probably follow that pretty often as he may need another transfusion if they are low. I just don't want you getting sick as a result of your anxiety. Then you are not able to do what you have to do for Jerry and yourself. This is the Rx I am giving you OK? Take a really deep breath in thru your mouth and then slowly breath out thru your nose. This is an old technique that the medical field uses to help you relax and it significantly lowers your anxiety level. Do this three times in a row-slow and even. You will see that it does help a lot. I do it myself at least 2-3 times a day. Whenever you feel your stress levels going up just stop what you're doing and do the deep breathing. You will make better decisions on a day to day basis and it energizes you a little too. If you wonder why it helps so much it's because it fills the brain with oxygen!!!!!!!!!!!!

JoAnn. I am such a dork ..................it is thru your nose and out of your mouth. I said it completely backwards. So sorry honey. I was in a hurry (naturally) and gave you the wrong RX. So just reverse what I said before and again I'm sorry.  Can you imagine that I was even doing it as I wrote it and still said it backwards? That's what I get for posting in a hurry...just make sure they are really really deep breaths then blow slowly out of pursed lips OK? It will work I promise. Make it a habit and you will notice that after awhile it becomes second nature when you are stressed. As for what I think about the bone marrow...it needs further investigation for sure. I would pursue it with the Dr. Several chronic illnesses can cause the decrease in bone marrow production. The most common are leukemia and kidney disease. Now don't freak out. That doesn't mean he has either one but the fact remains that Jerry is anemic. What needs to be discussed is will this be an ongoing problem for him or not and what is causing it. Blood dyscrasias are not uncommon with liver disease and this may be something that they see and I just am not aware of it. So PLEASE don't get yourself upset and see what the Dr has to say first OK?

JoAnn what's even funnier it's working for me too!

Hope you have a good evening .......Good night....

JoAnn, I just wanted to give a quick reply because, as you know, I had liver cancer.  I had a HUGE tumor that took up most of the right lobe and spread into the inferior vena cava.  It first became apparent on a routine sonogram, which I was having on a yearly basis.  From the size of the thing, I think it must have been overlooked the previous year.  After diagnosis, it did not grow much more in the next 1 1/2 yrs. before I finally had surgery.  What confirmed the diagnosis was a CT scan with 2 types of contrast--one I drank and the other was IV.  I now have this done regularly, and before any surgery.  My alpha-fetoprotein (AFP)...remember we talked about this recently--was never sky-high, not even when I developed cancer.  Also, I never had a lot of pain.  Just prior to surgery, I started having some "twinges" in my upper right quadrant, but I was MUCH more fatigued than I am now, even though I still have untreated hep C.

I agree with Shelly--don't worry about things that have not yet happened.  Have they done any CT scans of Jerry's abdomen?  Aside from a biopsy, a CT or MRI would be the surest way to know what's going on with his liver.  Blood work does not always show the whole story.  It didn't with me.  I was diagnosed and treated for the cancer and never did have to have a biopsy...though one was done of the left lobe while I was under anesthesia during the cancer surgery.

Hugs,

Connie

Connie, I agree with you a CT scan is definative as is an MRI. You overcame such tremendous obsticles with your cancer. It couldn't have been easy for you yet you refused to give up. I think that is so commendable and shows me that miracles do happen in this day and age. Isn't it amazing what our bodies can do?

JoAnn, that is great!  That's about what mine is, or a little lower.  I was told that it never did get really out of range.

Shelly (and JoAnn and all), when an MRI is done to look at the liver, the specific IV contrast material used is Gadolinium.  This has to be given at a fairly rapid rate.  The first time I had it (at Shands), the vein blew w/o the tech being aware of it.  Nobody was in the room with me, but I started hollering and crying and was ignored.  I didn't know what was happening except that I was in excruciating pain.  I felt like my arm was coming off.  Well, when they got me out of the machine, I had a huge blister on my forearm.  I had suffered a chemical burn from under the skin.  I now have a large white scar as a "souvenir."  This really was a fluke, but it wasn't handled very well...to say the least.  At Mayo, I've had no problems at all with the Gadolinium...always make sure they know what happened previously, and they have someone stay right by my side while the Gadolinium is infusing.

Connie