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Forum Name: Liver Cancer

Question: Liver Cancer Urgent Advice Needed!


 Anonymous - Wed Jan 29, 2003 9:35 pm

What is your medical advice for my father who is 65 Years old male patient.

Has been suffereing from moderate ascitis with acute onset since 18/12/200

Ultrasound on abdomen then spiral C.T. were done. They revealed focal lesion in the right lobe with other multiple satellites invading portal vein. There is portal vein thombosis most probably malignant Alpha feto protein level is 495,890

Profeeor of hepatologu has revealed that radiofrequency ablasion localized chemotherapy, and liver transplantation have no role.

Professor of Oncology has revealed that systemic chemotherapy has no
role because creatinine is less than 60/ml/minute.

He now is on palliative treatment; lasix for ascitis (lasilactone), liver supplementation, antispasmodics, analgesics, vitamins, diet free from salt or fat.
Dear doctor, do you think there is a cure or treatment available for him anywhere?
 Dr. Jeffrey Gordon - Mon Feb 03, 2003 9:17 pm

Khalefa,

I am sorry to hear about your father's problems. Hepatocellular cancer is a most difficult cancer to treat. When the cancer is localized, one can consider surgery or even liver transplantation. Sometimes, the lesions of the cancer allow for either radiofrequency ablation or cryotherapy. However, in many cases, the cancer cannot be removed by surgery, a liver transplantation cannot be done, and there are too many lesions (or diffuse infiltration throughout the liver) to allow for any other directed treatment. Chemotherapy, either by vein or directly into to liver, is very limited in its benefit. Many different chemotherapy drugs have been, and some reports of benefit have used multiple drugs in combination or combined with interferon-alpha. However, these drug combinations are very toxic and do require good liver and kidney function. As someone gets older, the chemotherapy is tolerated less well than if they were young. The likelihood that chemotherapy drugs used as single agents will be of benefit is low, but can be tried. However, some of the drugs used routinely do require good kidney function, otherwise the chemotherapy drugs accumulate in the body and cause significant problems. Interferon-alpha by itself has limited benefit and carries a lot of toxicities. Unfortunately, there are limited benefits from chemotherapy against hepatocellular cancer. If several specialists have not been able to identify a good and safe treatment in your father's case, then I do not expect that chemotherapy will help him. There is no treatment in this situation that can cure him of the cancer. If the kidneys are a concern in giving chemotherapy, then one could consider using chemotherapy drugs that are cleared from the body by the liver. But one must make certain that his liver is working properly. Some drugs to consider are gemcitabine, vinorelbine, docetaxel, paclitaxel, and adriamycin. However, these drugs do have side effects and are very limited in their usefulness in hepatocellular cancer.Khalefa,

I am sorry to hear about your father's problems. Hepatocellular cancer is a most difficult cancer to treat. When the cancer is localized, one can consider surgery or even liver transplantation. Sometimes, the lesions of the cancer allow for either radiofrequency ablation or cryotherapy. However, in many cases, the cancer cannot be removed by surgery, a liver transplantation cannot be done, and there are too many lesions (or diffuse infiltration throughout the liver) to allow for any other directed treatment. Chemotherapy, either by vein or directly into to liver, is very limited in its benefit. Many different chemotherapy drugs have been, and some reports of benefit have used multiple drugs in combination or combined with interferon-alpha. However, these drug combinations are very toxic and do require good liver and kidney function. As someone gets older, the chemotherapy is tolerated less well than if they were young. The likelihood that chemotherapy drugs used as single agents will be of benefit is low, but can be tried. However, some of the drugs used routinely do require good kidney function, otherwise the chemotherapy drugs accumulate in the body and cause significant problems. Interferon-alpha by itself has limited benefit and carries a lot of toxicities. Unfortunately, there are limited benefits from chemotherapy against hepatocellular cancer. If several specialists have not been able to identify a good and safe treatment in your father's case, then I do not expect that chemotherapy will help him. There is no treatment in this situation that can cure him of the cancer. If the kidneys are a concern in giving chemotherapy, then one could consider using chemotherapy drugs that are cleared from the body by the liver. But one must make certain that his liver is working properly. Some drugs to consider are gemcitabine, vinorelbine, docetaxel, paclitaxel, and adriamycin. However, these drugs do have side effects and are very limited in their usefulness in hepatocellular cancer.

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