J
I have read a lot of your posts on here and on another Cancer website. You
sure do know a lot
of information but claim you are not a doctor. What gives? How do you know
so much???
You give a lot of great information to the people here.
Jenny
Also to Alayne ~
I forgot me mention how sorry I was to hear of your loss. I guess I was so
wrapped up in my dilemma
that I never thought to mention it until after I hit the "send" key.
Jenny

Glad to hear that you are listening to "good" advice!!  You mention the word
"normal", what's that then?!! Being exhausted will definitely make your more
emotional too.  I think that you have an inner strength that will carry you
far in this battle.  Dealing with cancer is never nice for anyone, yes, I
too went through a tough time (and Tony bless him) but I don't think that
you realise how "tough" it is until it is all over, which is a good thing.
I think that we "carers" just run on adrenalin which is continuous but only
to a point.

I sure hope that you get to spend loads more "normal" time with your Rudy.
Keep optimistic we are all on "limited" time anyway.

Sorry that you were so upset to read my posts about Tony.  I think that I
had reached the end of my personal line and was not quite sure where to turn
to next.  I knew that Tony had been posting to this support group and
because it helped him I thought I would give it a go.  Crying is an
excellent release and shucks why the hell shouldn't we do it!!

My thoughts are with you.

Hugs both to you and Rudy

Alayne

well, you (or someone on your computer) must have entered that information in your newsreader's settings.
I don't know if others are getting the same thing?? (nobody's said anything), but when I click on your posts, your post is one long line about 100 feet long, and I have to scroll way over to read the whole thing.

then when I reply (and this part might be my Netscape) I have to split each sentence by hitting enter or my reply also goes "long"..gad..I wish I was at your end and could have a look at your newsreader settings.

It doesn't just happen with you, by the way, the occasional on other newsgroups too, so I'm trying to figure out commonalites (newsreader settings probably).

It's interesting to me that you are the second Canadian who has someone with this type of liver cancer. The other was out West, haven't heard back, but her husband's was inoperable so they were tyring something different. haven't heard back. I think cogeco is in my area or North North/East of me? (Ontario? - do not name the city please).  I'm in SW Ontario.

So other than the other web site that I posted previously for you, here's the other place I saw mention of this type of liver cancer.  I'm not a doctor but liver surgery always sounds "very tricky" to me and since I think I was told not all parts of the liver can be visualized on scans, sometimes they get surprises once in there (but don't quote me) so hopefully if there are surprises, they aren't negative ones and the surgery goes well, but just in case, other
options and details are mentioned here.

Since your stepson is young and probably doesn't have cirrhosis or hepatitis, he's got a much beter chance if they've got to take out more than a wedge (is my understanding). ..but I'm not an expert.

Do they go in abdominal? or through the back? Either way, it must be a 6 week recovery since they are probably cutting through the muscles ?  I was young when I had the "long cut" for gallbladder so I recovered nicely, but sure wouldn't want that type of surgery now, unless it was really necessary.

so hoping all goes well, keep in touch
J

http://www.cancer.gov/cancerinfo/pdq/treatment/adult-primary-liver/healthprofess
ional/
Patients scheduled for possible resection require preoperative assessment with angiography in conjunction with helical computed tomographic (CT) scan or magnetic resonance imaging (MRI) with magnetic resonance angiography; these scans have obviated the need for angiography in most patients. Information on the arterial anatomy is helpful for the operating surgeon and may eliminate some patients from consideration for resection. The presence of tumor thrombi in
the hepatic veins, the inferior vena cava, or the portal vein can significantly alter treatment approaches. Dynamic CT and MRI scans can document the relationship of the tumor to the hepatic and portal veins (and, on occasion, involvement of these structures), delineating tumors for which the chances for surgical cure are remote.[15] Laparoscopic evaluation may detect metastatic disease, bilobar disease, or inadequate liver remnant, and therefore obviate the
need for open surgical exploration.[16]

Cellular Classification
Malignant tumors of the liver are primarily adenocarcinomas, with 2 major cell types: hepatocellular and cholangiocarcinoma.

Histologic classification is as follows:

Hepatocellular carcinoma (liver cell carcinoma).
Hepatocellular carcinoma (fibrolamellar variant).  [Note: The fibrolamellar variant is important because an increased proportion of these patients may be cured if the tumor can be resected. It is more frequent in young women. It also generally exhibits a slower clinical course than the more common hepatocellular carcinoma.]
Cholangiocarcinoma (intrahepatic bile duct carcinoma).
Mixed hepatocellular cholangiocarcinoma.
Undifferentiated.
Hepatoblastoma rarely occurs in adults.

Localized resectable disease
(T1, T2, T3, and selected T4; N0; M0)

This type of liver cancer is confined to a solitary mass in a portion of the liver that allows the possibility of complete surgical removal of the tumor with a margin of normal liver. Liver function tests are usually normal or minimally abnormal, and there should be no evidence of cirrhosis beyond Child class A or chronic hepatitis. Only a small percentage of liver cancer patients will prove to have such localized resectable disease. Preoperative assessment
that includes helical computed tomography and/or MR scanning should be directed toward determining the presence of extension of tumor across interlobar planes, involvement of the hepatic hilus, or encroachment on the vena cava. A resected specimen should contain a 1- to 2-centimeter margin of normal liver. Patients with chronic hepatitis and cirrhosis are at high risk when surgical resection is performed.

Localized unresectable disease
(Selected T2, T3, and T4; N0; M0)

This type of cancer appears to be confined to the liver, but surgical resection of the entire tumor is not possible despite a localized mass because of location within the liver or concomitant medical conditions (such as cirrhosis). Patients with locally unresectable fibrolamellar variant hepatomas may be considered for liver transplantation.[2-5] For other patients, chemoembolization, percutaneous ethanol injection, or radiofrequency ablation (when fewer than
4 lesions are present) may be options.[6]

Advanced disease
(Any T, N1 or M1)

Advanced liver cancer is cancer that is present in both lobes of the liver or has metastasized to distant sites. Median survival is usually 2 to 4 months. The most common metastatic sites of hepatocellular cancer are the lungs and bone. Multifocal disease in the liver is common, particularly when cirrhosis or chronic hepatitis is present. Chemoembolization has been beneficial in selected patients who have no extrahepatic metastases.[6]

Treatment Option Overview
The designations in PDQ that treatments are “standard” or “under clinical evaluation” are not to be used as a basis for reimbursement determinations.

Hepatocellular carcinoma (fibrolamellar variant).  [Note: The fibrolamellar variant is important because an increased proportion of these patients may be cured if the tumor can be resected. It is more frequent in young women. It also generally exhibits a slower clinical course than the more common hepatocellular carcinoma.]

Localized Resectable Adult Primary Liver Cancer
Note: Some citations in the text of this section are followed by a level of evidence. The PDQ editorial boards use a formal ranking system to help the reader judge the strength of evidence linked to the reported results of a therapeutic strategy. (Refer to the PDQ summary on Levels of Evidence for more information.)

T1, T2, T3, and selected T4; N0; M0
Standard treatment options:

Surgery: Resection of the localized liver cancer varies from segmental resection to trisegmental (80%) resection. In series of carefully selected patients, partial hepatectomy has resulted in a 5-year survival of 30% to 40%, with median survivals approaching 3 years.[1] Hepatic carcinoma is frequently multifocal and may involve multiple sites throughout the liver at the time of exploration, even when a dominant mass is found on preoperative assessment.
Preoperative assessment should also include a search for extrahepatic metastases, since this condition will also preclude the planned hepatic resection. Intraoperative ultrasound assessment of the liver often finds satellite or second lesions.[2] Resection that involves more than a wedge of liver is poorly tolerated (high mortality rate) in patients with cirrhosis or chronic active hepatitis. These are generally contraindications to major hepatic resection but
may not contraindicate hepatic transplantation.[3-6] Hepatic transplantation for hemangioendothelioma, fibrolamellar hepatocellular carcinoma, and small (<5 cm) hepatocellular carcinoma in patients with or without cirrhosis has been associated with 5-year survivals of 20% to 30%.[7][Level of evidence

Thanks,
I just figured that out!
Jenny