Chemo and Liver disease

Does anyone know if you have fibrosis and fatty liver not due to alcholol but long term medications and dodgy immune system, (LTF's ok ), can you still have chemotherapy?. I have had cancer twice and wondered if the worse happened cd i have chemo again. The second time my chemo was alterned as my liver does not like methotrexate but that was before I was diagnoised with liver disease. I am just concerned that they would not give me chemo if I needed it .

[Bolly]

That's a bummer, cancer twice - well done you coming through both times. I had liver cancer 2 years ago, so not a true 'survivor' yet.

Yes you can have fatty liver and fibrosis caused by long term meds.

To answer, can you have liver disease and still have chemo.. Liver cancer is sometimes treated with chemotherapy, so I guess the answer is yes you can have liver disease and chemotherapy. At the moment in the UK I think the only drug licenced for liver cancer is Sorafenib, but if a patient has metastatic cancer in the liver, then the chemo will be for the primary cancer. I presume in your case the cancer wasnt primary liver cancer.

Its a risk/benefit discussion you need to have with your specialist.

Presumably it was the methotrexate that reduced your wbc/platelets. Are they back to normal now?

[Hidden]

I have had long term severe arthritis and have taken many strong immume suppresent drugs over the years. Then had Breast cancer twice and my liver did not like the Methotrexate side of the chemo after having it for yrs for arthritis. Just bit concerned that if my Breast cancer came back anywhere in the body then would they let me have chemo? LTF's are fine and I am not planning to go the cancer route again if i can help it but can't help but worry given my history. Thanks for replying Bolly and hope you are recovering from your cancer well x

[Bolly]

I think it is safe to say that nearly everyone who has ever been diagnosed with cancer is always worried about one thing, that lingering fear that never really goes away no matter how clean your last scan was or no matter how good your blood counts look - the fear of it coming back.

Also from what I've been told about my own treatment for viral and autoimmune hepatitis on top of the history of HCC, the drugs themselves have a risk of cancer when taken long term.

So its a risk/benefit dilemma - what are the risks of not treating while a disease runs its course versus the benefits of no drug side effects or what are the long term risks of drug side effects while suppressing an illness in order to improve survivability. There is no perfect answer, more a quality of life type debate in ones mind.

Ultimately the final decision whether to do a treatment or not would be down to you, taking into account at decision time lots of different things; i.e your diagnosis and prognosis at the time, your state of health at the time, your mental attitude, your support network, your financial situation etc etc. Its not a decision to be made quickly or when backed into a corner. So my route would be to do what you are doing, asking the hypothetical questions now and doing a bit of my own research.

I guess it would ultimately depend on the health of your liver at the time any further chemo might be needed, so a good idea to keep up regular monitoring with your oncology team or any other specialists you are under.

There seems to be a lot of research/development ongoing for treatments for breast cancer, certainly much higher profile and probably better funded than liver cancer. So hopefully treatment options will have improved/changed again if, god forbid, somewhere in the future you found the breast cancer had come back.

There are a lot of medical journals available on the internet, accessible but not necessarilly understandable, to us lay people. I find them useful for keeping up to date with new developments. The ones I use are on a site called PubMed ncbi.nlm.nih.gov/pubmed

You can search under whatever term you want, however you may find it all far too technical!