Aa
Waiting Impatiently
reading these posts from people who have started treating the C#@p out of there bodys makes me very anxious to get something moving here. I was diagnoised in march and just finally found a GOOD Md. went for NEW blood work and waiting to get a scope done before starting treatment. If I dont hear from them on Tuesday I will call. Waiting for me is always the hardest part or at least this time I HOPE its the hardest part. Fear of the unknown and the anticapation of whats next. Hopefully a long an healthy life is next for all of us. I was thinking the other day I went from being a hippy in the 60's to a heppy in the 20's just gotta shake your head and say Next! and keep moving on. Wishing you all a happy 4th!
Results are in, I don't see the ID folks until July 25th, so still a bit of a wait.
The doctor who did the new report does not say lesion, he calls them irregular enhancements. Liver @ 1.9cm, slight change, kidney @ 2.2cm, again a slight change.
His impressions of both reads "Appearance remains indeterminate" which to me means they just don't really know what they are? Recommendation: Continued CT follow-up to document stability of the hepatic and right renal abnormalities. Alternatively, MRI may be useful to better characterize the liver and right kidney abnormalities.
I feel like I'm still in the same place, they don't know what they are, and they want to continue to watch them. "Appearance remains indeterminate" < again, seems like an easy way to say "I don't know". Oh well, AARRGGHH!!!
The doctor who did the new report does not say lesion, he calls them irregular enhancements. Liver @ 1.9cm, slight change, kidney @ 2.2cm, again a slight change.
His impressions of both reads "Appearance remains indeterminate" which to me means they just don't really know what they are? Recommendation: Continued CT follow-up to document stability of the hepatic and right renal abnormalities. Alternatively, MRI may be useful to better characterize the liver and right kidney abnormalities.
I feel like I'm still in the same place, they don't know what they are, and they want to continue to watch them. "Appearance remains indeterminate" < again, seems like an easy way to say "I don't know". Oh well, AARRGGHH!!!
I understand totally. I am awaiting insurance approval and it is starting to drive me crazy. As the others have said this is just a long process. From the blood tests, to your specialist visit, then the ultrasounds, ct's, liver biopsies etc., etc. etc.. Now the anticipation of what the outcome will be with medical insurance. It is a never ending battle. We must just take it one day at a time. It is easier said then done and I tend to agree with you as my age increases my patience decreases. Hang in there. We can make it!!!!!
I am fine. I appreciate your concern.
You are stage 2 which is good news.
The risk of HCC in patients with chronic hepatitis C is highest among patients who have established cirrhosis, the incidence of HCC is between 2%-8% per year.
In the HALT C study, the 5-year risk of non-cirrhotics developing HCC was 4.8%.
So the risk among non-cirrhotics is much much lower.
What is your AFP? This lesion is so small I would doubt it would affect your AFP.
"a 17 mm lesion along the inferior border of the left lobe of the liver, seen only as a contour abnormality. On the postcontrast imaging, the lesion shows no abnormal arterial enhancement. There is some persistent enhancement on the delayed phase imaging. No other focal hepatic lesions are seen."
Wow, that is a very small lesion.
" no abnormal arterial enhancement" This is the most important finding. HCC is diagnosed by abnormal enhancement of the tumor during the arterial phase.
From the AASLD HCC Practice Guideline for HCC.
http://www.aasld.org/practiceguidelines/Documents/Bookmarked%20practice%20Guidelines/Hccupdate2010.pdf
"In the arterial phase, HCC enhances more intensely than the surrounding liver.
This is because the arterial blood in the liver is diluted by venous blood that does not contain contrast, whereas the HCC contains only arterial blood. In the
venous phase, the HCC enhances less than the surrounding liver. This is because HCC does not have a portal blood supply and the arterial blood flowing through the lesion no longer contains contrast, whereas the portal blood in the liver now contains contrast.
This is known as ‘‘washout’’, although the term does not really describe the sequence of events. In the delayed phase, the presence of ‘‘washout’’ persists, and sometimes ‘‘washout’’ is only present in the delayed phase. The presence of arterial uptake followed by washout is highly specific for HCC.
Thus, to properly document the existence of HCC, a 4-phase study is required: unenhanced, arterial, venous and delayed phases."
AASLD Recommendations
"6. Nodules found on ultrasound surveillance that are smaller than 1 cm should be followed with ultrasound at intervals from 3-6 months. If there has been no growth over a period of up to 2 years, one can revert to routine surveillance.
Don't know much about kidney's except for kidney stones. Ouch!
http://www.ncbi.nlm.nih.gov/pubmed/8008899
"Small hypodense renal lesions with a round shape are frequently detected on CT scans of the upper abdomen after contrast medium administration. In nearly all cases these round hypodensities are simple small cysts with no clinical significance. "
Hang in there!
Hector
You are stage 2 which is good news.
The risk of HCC in patients with chronic hepatitis C is highest among patients who have established cirrhosis, the incidence of HCC is between 2%-8% per year.
In the HALT C study, the 5-year risk of non-cirrhotics developing HCC was 4.8%.
So the risk among non-cirrhotics is much much lower.
What is your AFP? This lesion is so small I would doubt it would affect your AFP.
"a 17 mm lesion along the inferior border of the left lobe of the liver, seen only as a contour abnormality. On the postcontrast imaging, the lesion shows no abnormal arterial enhancement. There is some persistent enhancement on the delayed phase imaging. No other focal hepatic lesions are seen."
Wow, that is a very small lesion.
" no abnormal arterial enhancement" This is the most important finding. HCC is diagnosed by abnormal enhancement of the tumor during the arterial phase.
From the AASLD HCC Practice Guideline for HCC.
http://www.aasld.org/practiceguidelines/Documents/Bookmarked%20practice%20Guidelines/Hccupdate2010.pdf
"In the arterial phase, HCC enhances more intensely than the surrounding liver.
This is because the arterial blood in the liver is diluted by venous blood that does not contain contrast, whereas the HCC contains only arterial blood. In the
venous phase, the HCC enhances less than the surrounding liver. This is because HCC does not have a portal blood supply and the arterial blood flowing through the lesion no longer contains contrast, whereas the portal blood in the liver now contains contrast.
This is known as ‘‘washout’’, although the term does not really describe the sequence of events. In the delayed phase, the presence of ‘‘washout’’ persists, and sometimes ‘‘washout’’ is only present in the delayed phase. The presence of arterial uptake followed by washout is highly specific for HCC.
Thus, to properly document the existence of HCC, a 4-phase study is required: unenhanced, arterial, venous and delayed phases."
AASLD Recommendations
"6. Nodules found on ultrasound surveillance that are smaller than 1 cm should be followed with ultrasound at intervals from 3-6 months. If there has been no growth over a period of up to 2 years, one can revert to routine surveillance.
Don't know much about kidney's except for kidney stones. Ouch!
http://www.ncbi.nlm.nih.gov/pubmed/8008899
"Small hypodense renal lesions with a round shape are frequently detected on CT scans of the upper abdomen after contrast medium administration. In nearly all cases these round hypodensities are simple small cysts with no clinical significance. "
Hang in there!
Hector
truly trying to be patient, a very difficult thing for me, always has been and it seems as I get older its getting worse. Now with this Forget it! Maybe when I see my md. again he can prescribe a "patient pill" I am staying postive only because I do realize how this could easily push you over the edge, especially when treatment starts and god forbid I do have those evil side effects. I have told myself I would not let this get me!!
I know how you feel, but with HepC I have learned the keyword is PATIENCE...its a very long winding road and patience is a must have- otherwise you will drive yourself nuts which you dont need during tx. Many roads, bumps, etc, waiting for PCR's bloodwork etc.
One day at a time, positive attitude-you will need it.
I know its easier said than done however Ive been down HepC road and without patience you will be up the creek without a paddle.
We all know how you feel.
Wish you the best of luck in your journey to get well.
This road isnt easy, but you can and will do it.
There are many people here much more knowledgeable than I, listen to them they know the facts, all I can tell you is what I experienced, tx was hard for me and if I didnt have my wits about me I would have lost it along the way. Lots of patience.
Charm
One day at a time, positive attitude-you will need it.
I know its easier said than done however Ive been down HepC road and without patience you will be up the creek without a paddle.
We all know how you feel.
Wish you the best of luck in your journey to get well.
This road isnt easy, but you can and will do it.
There are many people here much more knowledgeable than I, listen to them they know the facts, all I can tell you is what I experienced, tx was hard for me and if I didnt have my wits about me I would have lost it along the way. Lots of patience.
Charm
Wishing you the best. I wish there was something I could do or say. Hopefully they move you to the top of list.
As for me, the findings were stated as this:
There is a 17 mm lesion along the inferior border of the left lobe of the liver, seen only as a contour abnormality. On the postcontrast imaging, the lesion shows no abnormal arterial enhancement. There is some persistant enhancement on the delayed phase imaging. No other focal hepatic lesions are seen.
The right kidney has a small hypodensity along the posterior cortex of the mid pole measuring approximately 16 mm not accurately characterized due to size. A six month follow up is recommended to assess for stability.
As for my HCV, GT1a, stage 2, grade 2. my VL has increased by 1,574,000 from 23,964,000 (7.380) to 25,538,000 (7.407) over about 5 months.
Take care, Happy 4th!
As for me, the findings were stated as this:
There is a 17 mm lesion along the inferior border of the left lobe of the liver, seen only as a contour abnormality. On the postcontrast imaging, the lesion shows no abnormal arterial enhancement. There is some persistant enhancement on the delayed phase imaging. No other focal hepatic lesions are seen.
The right kidney has a small hypodensity along the posterior cortex of the mid pole measuring approximately 16 mm not accurately characterized due to size. A six month follow up is recommended to assess for stability.
As for my HCV, GT1a, stage 2, grade 2. my VL has increased by 1,574,000 from 23,964,000 (7.380) to 25,538,000 (7.407) over about 5 months.
Take care, Happy 4th!
Sorry about your waiting. If it was thought that the liver lesion was HCC they would have put you on a 3 month schedule instead of the usual 6 month surveillance. So that is a good sign. I am waiting until August to see what is happening with my 1.5 cm HCC tumor. My treatment is off for good now, as once you developed HCC
a transplant is the only cure.
Usually it takes between 3-6 month for a tumor to double in size. But that is no consultation when it is us. There are more aggressive cancers, and basically as in everything else with the liver it all depends on the individual. Unfortunately we have to give the lesions time to grow which is very nerve wracking. I don't like the idea of letting cancer grow inside of me for any length of time but because of the shortage of organs it is my only chance for getting a transplant.
I hope you get good news soon and it is not HCC.
Sorry I don't recall...Do you have cirrhosis? If not, the chances of developing HCC is very low.
Hang in there. Enjoy your life and try not to dwell on the worst case scenarios. I know it is hard but what can we do. And keep in mind there are a lot worst things that can happen so try to appreciate all that you do have.
Let us know what happens with your next imaging.
Cheers!
Hector
a transplant is the only cure.
Usually it takes between 3-6 month for a tumor to double in size. But that is no consultation when it is us. There are more aggressive cancers, and basically as in everything else with the liver it all depends on the individual. Unfortunately we have to give the lesions time to grow which is very nerve wracking. I don't like the idea of letting cancer grow inside of me for any length of time but because of the shortage of organs it is my only chance for getting a transplant.
I hope you get good news soon and it is not HCC.
Sorry I don't recall...Do you have cirrhosis? If not, the chances of developing HCC is very low.
Hang in there. Enjoy your life and try not to dwell on the worst case scenarios. I know it is hard but what can we do. And keep in mind there are a lot worst things that can happen so try to appreciate all that you do have.
Let us know what happens with your next imaging.
Cheers!
Hector
I understand the waiting/worrying all too well. I've waited over 5 months now for my next CT scan at 6 months to check the "stability" of my lesions (liver/kidney, 1 each). I'm not sure what worries me most, starting treatment or the CT results, but I think the lesions cause the most concern. If they have enlarged, then what, more worry and concern. My treatment has been delayed due to the lesions, I just want to have the CT and know the results, good or bad, not knowing is just as bad. Hang in there, Happy 4th!
mykids -
seriously, I do know what you mean. I have been waiting 3 weeks for biospy orders and it is driving me crazy. Seems like this hospital is just one big big machine with too many specific departments. My orders are in the "scheduling department" awaiting my turn. LOL - this drives me crazy
seriously, I do know what you mean. I have been waiting 3 weeks for biospy orders and it is driving me crazy. Seems like this hospital is just one big big machine with too many specific departments. My orders are in the "scheduling department" awaiting my turn. LOL - this drives me crazy
There is no need to get yourself upset over the waiting. The wheels turn slow and there is nothing you can do about it. We all went through it. I know it is easier said than done but try to think positive. Worrying is only going to make it seem longer. If you are just starting with a new Dr., it is going to be awhile before treatment actually starts.
Beginning trt for me was like stepping on a path that led down a very dark tunnel. Lots of anxiety of the unknowns that can come from any direction. Each time a member of this forum responds to a question, its like they're lighting the path with a candle, making things easier to understand, helping to guide the way. Once you begin you will have lots of questions.
Best of luck as you begin your trt. There are many here with you.
Best of luck as you begin your trt. There are many here with you.
Have an Answer?
You are reading content posted in the Hepatitis C Community
Learn about this treatable virus.
Getting tested for this viral infection.
3 key steps to getting on treatment.
4 steps to getting on therapy.
What you need to know about Hep C drugs.
How the drugs might affect you.
These tips may up your chances of a cure.
A list of national and international resources and hotlines to help connect you to needed health and medical services.
Herpes sores blister, then burst, scab and heal.
Herpes spreads by oral, vaginal and anal sex.
STIs are the most common cause of genital sores.
Condoms are the most effective way to prevent HIV and STDs.
PrEP is used by people with high risk to prevent HIV infection.
