Topic: Liver lesion - the disease takes its course

Hello all:

Looking back at this year, I have reasons to feel grateful. At this time last year I was very ill. UCLA made the decision not to do surgery, and I was told I had months to live. A referral to Dr. Selby at USC changed our lives. After a total of 22 hours or surgery, I was rendered "disease free." This relatively healthy time has been a gift.

Of course, this disease is tenacious to say the least. CT scans performed for Dr. Lenz this week revealed a growing lesion in the liver. I will have an MRI next week to provide more imaging information. I will also see Dr. Selby, not because there is a surgical option, but because he best understands my re-engineered liver and can evaluate the lesion and treatment options.

Honestly, it's been a tough couple of days. Of course, we've assumed this day was coming, but one always hopes it would be later rather than sooner. Thursday we were numb. Friday sad. Today, I'm hoping we  begin to turn the corner to take the next positive steps in the journey.

As always, we appreciate the support we've received from all of you through the downs and ups and downs.... For everyone, I hope for a blessed holiday season.

Mark

Re: Liver lesion - the disease takes its course

Dear Mark, I am sorry about your unreasonable, unseasonable and unwanted news. Like my Teddy used to say, now we know what it is, lets fix it! You have a great attitude and what ever you have to do, I know you will get yourself through.  I know today is your day to turn positive and I hope that carries you through a wonderful Holiday with family all around you. I wish for the MRI to guide your great Doctors to a wise decision. Prayers floating your way.

Teddy ~In our hearts forever~ATTITUDE is EVERYTHING
Any suggestion I offer is intended as friendly advice based solely on my own experience. Please consult your doctor for professional guidance.

3 (edited by PCL1029 Sun, 23 Dec 2012 09:46:56)

Re: Liver lesion - the disease takes its course

Hi,Mark,

I am sorry to hear the recurrence; but you and I both know that it will come sooner or later (of course I thought the same like you and hoping that we are the 25% minority that will not get it repeated);apart from that, Mark, don't worry, since  relatively speaking yours lesion at this point is small,that is why they order a MRI to double check it. but if it is <3cm in size and not more than 3 lesions; you have a lot of choices including RFA (if location is allowed); and if so, you can get out of the hospital the same day after the procedure.
My experience told me to seek surgical opinion first after the oncologist told me of my recurrence, RFA on one tumor and resection on the other due to too close to the right hepatic duct.( but if you get an experienced interventional radiologist ,I read reports that some of the skillful radiologists can RFA (or microwave) the tumor even in between  tight and difficult area like near   the portal vein and  hepatic artery area,thus prevent the resection like mine.) but the key is to find out the size and location and vascular involvement  first. Standford is known for radiology treatment.2nd opinion there may be helpful.
You can email me  the CT scan if you don't mind to see what I can do.
Good luck,don't worry and  enjoy the holidays.
God bless.

Please know that my personal opinion is not intended nor implied to be a substitute for professional medical advice. If  provided, information are for educational purposes.Consult doctor is a MUST for changing of treatment plans.

Re: Liver lesion - the disease takes its course

Dear Mark, Let me start by just saying thank you. I cannot tell you how much your posts have meant to us. We are deeply deeply grateful. Your information, guidance and support lead us to Dr. Selby and our best chance against this (explitive deleted) thing. We love you and thank you. You are a light in our lives.

We are so sorry to hear about the bad news.There is never a good time for this, but around holiday season, it's just plain worse.

It is wonderful to see the love and support for you by the other members of our CC family. PCL1029 has some great information and encouragement with a base of first hand experience that may be helpful for you.

We know you are in good hands with Dr. Selby and his team at USC Keck Med Center and that's a great place to start. Obviously, he knows your liver better than anyone. He has actually SEEN it!

Our hope and prayer is for your healing and that your surgeons and doctors will be able to provide the best  treatment plan possible, be it surgery or RFA or whatever.

God Bless You, Mark. Stay strong and positive. Thank you.

Bob & Nancy
Jeff's Mom & Dad

Re: Liver lesion - the disease takes its course

Thank you for your responses. Christmas (and my birthday) were good, spent with our wonderful boys and Jeannemarie's family. Happily, I look a lot pinker in the holiday photos compared to last year when I was sporting a yellow tan. Tomorrow we fly to Bend, Oregon to spend time with my family.

Thanks Percy for your note and the tremendous expertise you share with us. I am seeing Dr. Selby on January 7 to explore my options. I'm hoping RFA might be possible. He has an interventional radiologist on his team that is quite experienced with those procedures.

Thanks Bob and Nancy for your heartfelt note. I sent you a forum email that I hope you received. We continue to think of you daily, and hope that Jeff felt well enough to enjoy the holiday.

Best, Mark

Re: Liver lesion - the disease takes its course

Mark,
We will be praying for you.  I just found out I have a new tumor and will have radiation in the next couple of weeks. One day at a time.
Hugs, Lisa

This Information Is Not Intended Nor Implied To Be A Substitute For Professional Medical Advice. You Should Always Seek The Advice Of Your Physician Or Other Qualified Health Care Provider

7 (edited by mparsons Wed, 02 Jan 2013 14:46:07)

Re: Liver lesion - the disease takes its course

Lisa,

Thank you. I appreciate your message. I'm sure that your multiple recurrences have not been easy. But, it is helpful to know that you have been fairly successful in treating these post-resection tumors. My surgeon had told us after my second resection that it was likely that we'd eventually  be dealing with these sorts of isolated occurences. So we really were sort of prepared for it.

We'll pray that you have successful treatment.

Best, Mark

Re: Liver lesion - the disease takes its course

Mark and Lisa...so many reasons for us to think of this as a chronic disease and a roller coaster ride.  May the upswing begin.
Hugs,
Marion

THIS INFORMATION IS NOT INTENDED NOR IMPLIED TO BE A SUBSTITUTE FOR PROFESSIONAL MEDICAL ADVICE. YOU SHOULD ALWAYS SEEK THE ADVICE OF YOUR PHYSICIAN OR OTHER QUALIFIED HEALTH CARE PROVIDER

9 (edited by mparsons Sat, 19 Jan 2013 09:39:01)

Re: Liver lesion - the disease takes its course

Hi all:

I'm moving forward with the new normal - treating this as a chronic disease, as Marion says. Or, as Lainy's Teddy always said, now we know what it is, so let's fix it.

Further study of a follow-up MRI by Dr. Selby's team revealed a second lesion in the caudate lobe. So, he's taking a two-pronged approach over the next couple of weeks. They will do a percutaneous RFA procedure on the "original" lesion on right lobe of the remnant liver. It is posterior near the spine and high near the diaphragm, so in a tricky spot. For the caudate lobe lesion they will attempt an endoscopic procedure to do an ethanol injection (ablation). If any of this fails, Dr. Selby will do an open abdominal surgery so he can flip the liver over for access; obviously that's what we're trying to avoid.

As far as adjuvant therapy, my oncologist thinks my liver can't withstand chemo, my hepatologist does...but that's next month's battle!

As always, thank you for your continuing thoughts and prayers. Jeannemarie and I are grateful to all of you.

Mark

Re: Liver lesion - the disease takes its course

Dear Mark, this is all Greek to me but I just want to wish you the very best and am praying that they are highly successful on the first procedure. You are some kind of warrior! You never know how strong you are until "strong" is the only choice you have! Good luck and we will be anxiously awaiting your news.

Teddy ~In our hearts forever~ATTITUDE is EVERYTHING
Any suggestion I offer is intended as friendly advice based solely on my own experience. Please consult your doctor for professional guidance.

11 (edited by PCL1029 Sat, 19 Jan 2013 10:42:32)

Re: Liver lesion - the disease takes its course

Hi, Mark,

Your posterior spot in the liver near the diaphragm on the right lobe is pretty like my spot before I had my second resection; After they wheeled me in the room for RFA, finally after an hour, they decided not to do RFA due to the leison ,which is 2-3cm in size ; they were worry they could not get it all and there was a high possibility that the procedure could  puncture the diaphragm and that was the main reason they stopped the RFA on that part.
Your interventional radiologist may be better and more confident,but make sure you ask the possibility of puncture the diaphragm and what will be the result of it.
Just a suggestion, since you also have a lesion in the caudate lobe too,and the other lesion is ,as you describe posterior near the spine and high near the diaphragm, so in a tricky spot. . Therefore ask the doctors if is it better and safer  to have the resection to remove the tricky lesion  by wedge resection and completely resect and take out the caudate lobe all at once and at the same time?  Ask Dr. Selby do a mob up exam to remove the other suspicious lesions is not a bad idea too.  My suggestion may sound a lot more than you ask for;but if you are looking for long term survival;you know ethanol ablation and RFA ablation are not as good as resection;and what if they puncture your diaphragm and spine . I forgot about your age, but if you are under 65 like me and have no other chronic health problems, I think you should talk to the  doctors  and discuss about it. Ask how confidant the radiologist is to do that upper right RFA near the diaphragm and posterior near the spine face to face and how many he has done on such  tough location in order to provide you decision info. not only thru the words of his mouth but the body language too of how confident he is in doing the tricky location RFA.
One more note ,the liver surgeon that treated me told me I can have up to FIVE resections in my case ,since I am relative young and no other health issue involved;but of course who wish for that ceiling of limitation.Good luck
and God bless.

Please know that my personal opinion is not intended nor implied to be a substitute for professional medical advice. If  provided, information are for educational purposes.Consult doctor is a MUST for changing of treatment plans.

Re: Liver lesion - the disease takes its course

Thank you for your kind words Lainy.

Percy, interesting that we apparently had lesions in a similar spot. I am 53 and in otherwise very good health. At this point, I guess I'm trusting Dr. Selby's judgment in wanting to explore these options first. In first viewing the imaging with me, he pondered for a long time about accessibility by IR and/or GI procedure, which is why he consulted with them before getting back to me. They "think" they can do it (it's the "think" part that bugs the hell out of my wife...and me a bit too). I will certainly talk to each physician before they do the procedure, making it clear that I want to tend toward caution since resection is a possibility. Thank you as always, Percy, for sharing your experience and expertise...and helping me to be all the more cautious!

Best, Mark