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Ken
Ken, Postgraduate doctor
Category: Medical
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Experience:  Working as a Doctor who Cares since 2001.
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What is approx the number of liver metastatses in the liver

Customer Question

What is approx the number of liver metastatses in the liver needed to
Fail the liver in a cancer pt ?
Submitted: 1 year ago.
Category: Medical
Expert:  Ken replied 1 year ago.
Hello I am Dr Ken and I will be helping you today. It does not only depen on the number but other factors like - size of each metastatic deposit/ the primary cancer type/ the pressure over the vessels like - hepatic artery, vein, portal vein and bile ducts. Let me know if you want me to describe any point in more details.
Customer: replied 1 year ago.

Well primary removed in march 2014. Was a stage 3 but then developed mets , liver and some small in peritoneal .

liver has approx 9, with 2 being atleast 8 cm each.

peri ones are 7mm.

he also had "simple liver cysts" but no mention of

these on scan . Would this disappear themselves ?

Expert:  Ken replied 1 year ago.
I assume a CT scan done to see for the size of metastasis. Cysts may collapse over time and thus can be missed on scan. Was there any mention of dilatation of IHBR, CBD or portal vein thrombosis?
Customer: replied 1 year ago.

No mention of all that . in march:

2 liver mets x 7 cm

about 5/6 were 2 cm

perioneal nodules x4 yof 7mm each

Expert:  Ken replied 1 year ago.
Metastasis may reduce in size with chemotherapy or radiotherapy {depends on primary} so do peritoneal metastasis. I am happy that there is no mass effect over the vessels or bile ducts. This makes prognosis better.
Customer: replied 1 year ago.

It was colon cancer and primary was removed back in march 2014 as a stage 3.

what does that mass mean .

prob is that both xeloda and irinotecan have not worked . Now he's just starred oxyplatin and raltitrexed . But after first round , cea went from 65 to 80!

so it's not again working right . Plus ALP blood test is now 175 n was 75 in march

Expert:  Ken replied 1 year ago.
Mass means the lesion {metastasis}. The levels show that the size or activity of the lesion is not reducing. This is concerning.
Customer: replied 1 year ago.

Yes there are metastases

so cea should be reducing right ?

Expert:  Ken replied 1 year ago.
CEA stands for carcinoembryonic antigen. Many tumors never cause an abnormal blood level, even in advanced disease. I would not go with the levels alone. As primary was diagnosed and metastasis are of large in size CEA level is not of much importance. Raised CEA level indicates carcinogenic activity - either recurrence or metastasis.
Customer: replied 1 year ago.

But can it b that no chemo

may work as xeloda and irinotecan failed already

Expert:  Ken replied 1 year ago.
Yes it can be however varied medicines need to be tried as it is difficult to predict which medicine can help.
Customer: replied 1 year ago.

Any option if chemotherapy fails?

Expert:  Ken replied 1 year ago.
Chemotherapy is the best and the only way {sorry to be frank} to reduce the size of metastasis and improve prognosis.
Customer: replied 1 year ago.

Wouls chemoembolization etc be beneficial?

Expert:  Ken replied 1 year ago.
Chemoembolization works if vessel to the lesion is appreciated on angiogram and the lesion is vascular. This needs to be confirmed with doppler study and angiogram.

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