Liver blood results

Hi I had a liver resection surgery 14 months ago. My liver enzymes remain very high or out of range still, does anyone know, will they always be like this. Am being monitored, consultant was concerned about bile duct inflammation due to raised alkaline phosphor apse. Says he's not concerned anymore, but its still raised. Reason for surgery was huge tumour, removed 60% of liver

Thanks

10 Replies

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  • I so sorry I can't tell you as I new to all this

  • The best person to answer this question is your clinician and you have had the reassurance that he is no longer concerned. As you are still concerned, I think your best course of action is to ask for another consultation (GP, then consultant) and ask for clarification of the significance of recent results and where they may go from there. If nothing else, it may give you access to new results. It might be a good diea to have a list of questions, rather than try to memorise them.

  • I had a resection 2 1/2 years ago - not as big as you, just a small part of segment 2. My enzymes were pretty much normal before, and have stayed pretty much normal after, so I dont trust them as a guide to whether the cancer has returned. Instead I have an MRI (a CT will suffice) every 6 months which is carefully checked for any sign of recurrance. I also have my AFP tumour marker blood test without fail every 6 months.

  • That's interesting my mris cancer scans blood tests and pre ops showed a large benign tumour. When removed was a mass cancer HCC. So I don't trust any results. AFP marker is always good.never raised. My consultant is giving me a rest from 3 monthly scans. Next scan is nov now. Liver enzymes have been out before and after op!

  • Hi seashell. I'm guessing you are fairly young - younger than the 'typical' HCC patient. In young adults there is a type of HCC called Fibrolamellar hepatocellular carcinoma (FHCC). Sometimes this is the original diagnosis from blood tests/MRI scans etc, but a biopsy post surgery to remove the tumour sometimes contradicts this original diagnosis. I think the result of the surgical biopsy (assuming this was done) is the result you should go on, and probably the result your medical team is going on. However the fact you say your AFP levels are normal makes me ask, do you in fact have FHCC rather than HCC.

    Why are you having to wait 10 months for your next scan, when you are only 14 months post surgery. If it was me, I would be insisting on a minimum of 6 months scans for at least the first 2 years post surgery, as this is the time of highest risk of a recurrance. Is there a health reason for you needing a 'rest' from the scans?

  • No it was surgeons decision he said a year, but am having it done befor insurance runs out. Yes I spose his taking a risk with risk of recurrence . I guess he's not worried. He wants to give me a break from scans etc and pathology. I had biopsy pre op, like screening did nt show cancer. Was told its HCC after the surgery. i assume they thought the mass would turn into cancer. I'm 40. I guess that is young. Am so upset they put me n chemo don't think I needed it, and was told hair wouldn't come out. When it did they said it was stress later found out it was common. It thinned and now it's growing its shedding as well. Which am told is like female pattern baldness thru stress . I had gorgeous curls. And now it's untameable kinky. I didn't stay on chemo long as hated it. And discovered there was little evidence would prevent recurrence.

    Is 40 young? I spose it is.

    I don't have a portal vein in my liver. Caused tumour.

    Thanks for your reply

  • Hi Seashell. Are you in the US that you're treatment/scans etc are paid for by insurance?

    I'm struggling a little to make sense of your diagnosis and treatment. You say you had a biopsy pre surgery? In the UK its not advised to biopsy a mass that may be cancer in the liver, as the risk of seeding the cancer elsewhere is considered high if you stick a needle in it. In my case, the surgeon whipped out the 'mass' straight away and did the biospsy after, which confrmed cancer.

    I'm not surprised you had chemo with such a large tumour. The idea of post surgery chemo (or adjuvant chemo) is to mop up any stray cells, which with such a large resection I would think was worth the extra belt and braces. Sorry to hear your hair fell out, this is a common side effect of chemo.

    With 60% of your liver removed its got quite a bit of work to grow that back, so perhaps thats why some of the inflammatory markers in your LFT results are still high. I would say it took me a good 2 years to feel like I had recovered from a much smaller resection than yours.

    In most cases of primary liver cancer there is an underlying cause of the cancer - hepatitis, iron overload, heavy drinking, fatty liver disease etc. Have you been advised of the underlying cause in your case. Remove the cause, and hopefully the risk of recurrance will go down, have you removed the cause?

  • I still dont understand the surgeons thinking behind giving you a 'break' from the scans. There is a greater risk to your health in the early years after surgery from an undetected recurrance than there is from 6-monthly scans. Is it because of an insurance issue?

  • Here you go, excerpt from report posted on hepatitis FB page: - “Compared with 12-month intervals, 4-month ultrasound surveillance intervals detected more patients with HCC 2 cm or less and in BCLC very-early stage for whom curative therapies might yield the best effects.”

    And from the latest AASLD guidelines for HCC: "The recommended screening interval is 6 months"., so unless there is some other health reason as yet unclear, seems your consultant isnt keeping to the recommended guidelines for scans.

  • Hi bolly, thanks for your thoughtful replies. I'm in the uk. Just had op privately as had private cover. Chemo was private. I don't think I would have had chemo at royal free, I saw oncologist there for 2nd opinion who didn't agree with the adjuvant treatment drug. When I looked into it there was v little proven evidence it would make a difference. I was meant to take for a yr, and chose to come off after 3, half mo.

    my pre op scans were NHs . Showed no cancer. Thus they then diagnosed cause of supposed benign tumour, being due to lack of portal vein in liver, thus causing tumours.at this point I had 3 biopsies in one day. They thought the large tumour was 2 tumours, and they also biopsied healthy site of liver to see if it was healthy enough for surgery. I also had a little tumour on the left side that was ablated during surgery.

    The cancer diagnosis came after the op. all v shocking. Have never has high tumour markers and was v well pre surgery . A scan for previous spinal surgery indicated a liver problem which I chose to get checked out. I was not advised to get it checked.

    Thanks for your advice about scans.

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