Iron? Cause for concern?

Aug 14, 2014 I had Gastric Bypass Surgery. At that time I was told by my Surgeon I had a Fatty Liver. I was told that the Gastric Bypass should help to stop the fatty liver an might even allow it to heal. Then I was prescribed a Vitamin plan by my Gastric Bypass Surgeon. I was told this is because of the Absorptive problems of Gastric Bypass. Multiple Vitamins, Anti Oxidant, and Iron. Since being diagnosed with HCC Liver Cancer Aug 10, 2021 I have been researching all I can about HCC. I find that a primary cause of HCC in People with Fatty Liver cirrhosis is an over abundance of Iron. I think I have killed myself Andrea by following the directions of my Doctor. I have now been seen by all the Doctors and been through all the evaluations. Resection is out. Heat/Cold Ablation is out. Transplant is out. All they offer is the Micro glass ball Y-90. That starts Nov 15, 2021. They will do the three tumors in the right lobe first and then the one in the left lobe. If the first three have no response to the Radiation Micro Glass Balls then it all stops and palliative care takes over. We shall see. With the increase of Liver cancer in the USA in recent years I cannot help but wonder how many people are increasing their Iron supplements. (Age now is 72)

[DancingEyes63 Moderator Caregiver]

Hi. I am so sorry to hear that they aren't giving you many options. Hopefully, the Y 90 will have good results. Something could change to open up a different treatment. In August, my husband was having a terrible reaction to his Lenvima and had decided to stop treatment. His GI referred to palliative care and said thought only a few months Before we could talk to them, his oncologist talked him into trying a lower dose of cancer meds. He's been taking it since and at his visit their month, his labs were stable and his tumor marker had cut in half. Now they've decided he's holding his own and no talk of palliative care. 6 more weeks of Lenvima and then MRI ordered and blood work to see how it looks. Things can change so fast. My husband has always been told to take Iron because tends to be anemic.

Hoping you get better news soon. ❤❤❤

Sharon Dixon

[Curly_Girl Caregiver]

Hi Bill! I'm going to go into detail what Dave's journey was, because so much of it was similar to yours and he also was treated through the VA Community Care program. You can take as much or as little from this as you wish, my only hope is that it helps you make informed decisions and also go forth with some hope.

Dave was diagnosed before he ever had symptoms, because he'd been through treatment for Hep C and they were doing follow-up blood tests and ultrasounds. His AFP began rising and they caught the liver lesion very early in March 2018. It took the VA quite a while to actually do treatment; they sent his info to a tumor board, then they sent him to a liver specialist and then a surgeon. Like you he was told that resection/transplant was out (because of portal vein thrombus) and Y-90 was his only option. Four months after his diagnosis, he finally got his Y-90 in July 2018. It went well, he had very little side effects and it did shrink his tumor.

They did nothing else after the Y-90, just a CT/MRI in October to see if the tumor shrunk, then another in Jan. 2019. The January CT showed that he now had lesions in his lungs. All this time, he felt fine and his liver function was just fine. They put him on palliative care (meaning they can't cure the cancer but try to keep it stable) and sent him to an oncologist, who put him on Nexavar. He was on Nexavar through August 2019, then Stivarga (both are oral chemo pills) which he tolerated much better. He was stable with no progression until April of 2021. He was a little trickier to treat because he couldn't do immunotherapy (he'd had leukemia and a bone marrow transplant in 1993) so not all therapies were available to him.

You can get VERY good quality of life even when you are on so-called palliative care, especially if you have good liver function. So don't let that discourage you! We looked at it like this - stay stable as long as possible, and maybe new treatments will come along that will work even better. Always stay hopeful.

My feeling is that they should have started him on chemo as soon as he finished the Y-90. I think it would have prevented the spread to his lungs. So I would address that with your doctors if you feel it's something that's important to you.

As always, I'm here if you have questions. You got this, Bill!

[Hidden in reply to Curly_Girl]

Thank you. I have sent this idea of chemo immediately after Y90 to my Doctor at UF Health.

[bwpickard Caregiver]

I echo what Wendy and Sharon have shared with combining y90 with an oral targeted med. my husband was immediately started on Lenvima with Y90 after his diagnosis in March 2019 and tolerated it well. He had portal vein thrombus so wasn’t surgical candidate. There is a now a new gold standard treatment that is infusion…Avastin/Tecentriq and he also was on this and tolerated well and had a long period of stability with both these meds. Y90 shrunk his initial tumor and the meds helped with managing the ones too small for Y90. There are so many more med options now than just a few years ago, though not a cure that offer hope of longer stability! And there is hope in some cases that initial treatment response could be good enough to downstage and reconsider someone for transplant. prayers for good results for you!!!!!!

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Thank you very much.