Cancer Watch

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cleas001
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if someone has liver cancer- (spread from the bowel) what are their chances of making a fully recovery
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Lush Law
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Well, if its spread from one area [bowel] to another, thats never a good sign, as it's unlikely to be in its first stages. Liver cancer is a difficult one, obviously because the liver is a vital organ for survival.

Helenia or Miles or someone might be able to provide a proper insight.
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Gem
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(Original post by red_roadkill)
Well, if its spread from one area [bowel] to another, thats never a good sign, as it's unlikely to be in its first stages. Liver cancer is a difficult one, obviously because the liver is a vital organ for survival.

Helenia or Miles or someone might be able to provide a proper insight.
Or ask Fluffy as she has a DPhil in Cancer Research I believe, she may be able to help more.
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Jonatan
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(Original post by cleas001)
if someone has liver cancer- (spread from the bowel) what are their chances of making a fully recovery
When it has started to spread the prognosis is usually quite bad Im afraid. My grandmother died from liver cancer, but that was 20 years ago. I think treatments has improved quit a bit now.
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Talya
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(Original post by cleas001)
if someone has liver cancer- (spread from the bowel) what are their chances of making a fully recovery
That exact thing happened to my dad (2.5 years ago).

He's dead now.
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Ataloss
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(Original post by cleas001)
if someone has liver cancer- (spread from the bowel) what are their chances of making a fully recovery

It is impossible to speculate on a prognosis without having access to all the test results and as such any speculation on made is only a generalisation. I honestly believe at this time people on an internet site making speculations as to your loved ones prognosis is not helpful.

I am assuming somebody close to you has just been given this diagnosis and there is little that can be said of comfort at this sort of time.

The best advice I can give you is to speak to one of the doctor's caring for the relative, who can explain the prognosis and treatment options (with your relative's permission) for your loved one. If you are a close family it is always ideal for a couple of you to meet with the Consultant and then explain the situation to other family members. Also, there will always be a more junior member of the team who will be able to speak to you.

I wish you all the best at this time. Take care.
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Talya
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(Original post by Ataloss)

The best advice I can give you is to speak to one of the doctor's caring for the relative, who can explain the prognosis and treatment options (with your relative's permission) for your loved one. If you are a close family it is always ideal for a couple of you to meet with the Consultant and then explain the situation to other family members. Also, there will always be a more junior member of the team who will be able to speak to you.
Don't get your hopes up about actually speaking with a consultant though. Ask and see what they say
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Fluffy
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Agree with Ataloss. I could make comment, but so many things affect prognosis from primary cancer type right the way through to genetic build up of the patient.

I don't think that there is anyone on here, including our new docs, who can give you any *real* advice. Personally, I would hate to give you false hope, but equally I would hate to give a picture of no-hope.

I think you should be talking things over with the healthcare team looking after your friend/relative.
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Snake
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(Original post by Ataloss)
It is impossible to speculate on a prognosis without having access to all the test results and as such any speculation on made is only a generalisation. I honestly believe at this time people on an internet site making speculations as to your loved ones prognosis is not helpful.

I am assuming somebody close to you has just been given this diagnosis and there is little that can be said of comfort at this sort of time.

The best advice I can give you is to speak to one of the doctor's caring for the relative, who can explain the prognosis and treatment options (with your relative's permission) for your loved one. If you are a close family it is always ideal for a couple of you to meet with the Consultant and then explain the situation to other family members. Also, there will always be a more junior member of the team who will be able to speak to you.

I wish you all the best at this time. Take care.
You give this advice alot here, and although its very true to that people here are WOEFULLY under-qualified to give advice or reassurance, and that doctors - no doubt like yourself HATE it when a patient comes in and says 'i read this, i was told that', i still think it might be nice to actually give some information and reassurance once in a while.
RieLouise
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(Original post by Snake)
You give this advice alot here, and although its very true to that people here are WOEFULLY under-qualified to give advice or reassurance, and that doctors - no doubt like yourself HATE it when a patient comes in and says 'i read this, i was told that', i still think it might be nice to actually give some information and reassurance once in a while.
My GP has the opposite view. He encourages people to 'read around' their illnesses.

But fora such as this are more for mutual support than 'diagnoses'. (Rather like Anonymous Fellowships or self-help groups). Most docs wouldn't give diagnoses over the net anyway. When I was a member of a support group there was a member who was a newly qualified doctor. She said 'while I am here, I am here as someone with an eating disorder not as a medical professional. Please treat me in this way.'
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Elles
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(Original post by Snake)
although its very true to that people here are WOEFULLY under-qualified to give advice or reassurance...i still think it might be nice to actually give some information and reassurance once in a while.
& no doubt the people who are in a reasonably qualified academic position to ponder on the general topic are aware of the woeful inappropriate-ness of it in this context for all the reasons Ataloss & Fluffy have already mentioned.

& that's why they don't think they can comment - as well as not being in a position to do so (would you go to an internet doctor who had never seen you before & didn't have access to any notes/test results?) the potential ramifications of the information/misinformation are unfortunately far greater than the "diet tip information" or "relationship reassurance" often dished out in here.

that said, for general information on liver cancer specifically & health issues, the NHS website might be a decent "official" start, if you haven't already found it? http://www.nhsdirect.nhs.uk/en.asp?t...23&LinkID=2698


again, i wish you all the best cleas001.
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AT82
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My grandad had bowel cancer they sucessful removed his bowels but it had spread to the liver, he died a month ago.

I some times get the impression that doctors don't tell you the full truth and try and hide things from you, so its always best to get a second opinion. Certainyl with my grandad what they told him didn't make a word of sense.
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Talya
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(Original post by AT82)
My grandad had bowel cancer they sucessful removed his bowels but it had spread to the liver, he died a month ago.

I some times get the impression that doctors don't tell you the full truth and try and hide things from you, so its always best to get a second opinion. Certainyl with my grandad what they told him didn't make a word of sense.
I agree. My dad thought he was going to get 6 months of chemo and then live! He thought his second operation (first was to remove colon) was to get a liver biopsy, then he ended up dying from it. Someone didn't tell us everything, surely?
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Fluffy
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OK - and I'm sorry for the original poster, as this will be fairly blunt, but isn't aimed at his post.

The prognosis from liver cancer isn't great, especially if it's a secondary cancer. The symptoms of liver cancer often do not show until the cancer is at a late stage, so treatments like hemi-hepatectomy or segmental resection which have great success if the tumour is caught eraly enough are pointless.

A lot of doctors feel ***** that they can't cure someone, as if it's a failing on their part. Some think that if they try their all may be they can do something. They're human - how would you feel about telling someone they're going to die, or do not have long left? Just because someone is a medic, doesn't make them immune to the effects of death and disease. Modern medical education tends to consider this, but many older peeps 'slipped through the net'...

Most people go into medicine to save lives, and IMHO not enough time is spent by medicial students contemplating that medicine is more than this. At the med school I attend we have compulsary 'breaking bad news' courses and modules, however from talking to other peeps at other schools not everyone gets this provision.

Bad news, terminal illness and death is a real melting pot. I read an artical a few months back on how a doctor was being sued for being 100% honest with the family of a terminally ill woman, saying that the doctor had no 'people skills' and had caused them great upset at a time where they should have been spending time with their mum.

His prognosis etc. was spot on, but it just goes to show how difficult it is getting the balance between hope and dispair right, and trying to work out how much information a person is capable of taking on in what can be a very dark and upsetting time. I'm not saying that that is an excuse, but it's not a black and white subject - everyone has their own individual colour of grey, and the doctors job is to try to come up with the exact shade...
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AT82
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Its better to be honest than not on honest though, the doctor my grandad saw was very nice, he said if I thought you would be dead in 5 years I wouldn't advise the operation but I don't think that will be case. He was 79 so even he didn't have the cancer he was likely to be dead anyway. Exactly six weeks after that doctor said that I was at my grandads funeral.

My grandad had to go through a range of emotions from "its nothing" to "you have terminal cancer" to "its nothing again"

His hopes were falsey raised as the doctor wouldn't tell him the complete truth.

I do understand that the doctors find it hard I just wish they were blunt but human at the same time.

The problem with my grandads secondary liver cancer as well seemed to be that the surgions had no idea how bad it was until they operated, by then it was too late.
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Fluffy
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(Original post by AT82)
Its better to be honest than not on honest though, the doctor my grandad saw was very nice, he said if I thought you would be dead in 5 years I wouldn't advise the operation but I don't think that will be case. He was 79 so even he didn't have the cancer he was likely to be dead anyway. Exactly six weeks after that doctor said that I was at my grandads funeral.

My grandad had to go through a range of emotions from "its nothing" to "you have terminal cancer" to "its nothing again"

His hopes were falsey raised as the doctor wouldn't tell him the complete truth.

I do understand that the doctors find it hard I just wish they were blunt but human at the same time.

The problem with my grandads secondary liver cancer as well seemed to be that the surgions had no idea how bad it was until they operated, by then it was too late.
I'm not saying that it's right - it's a very complex area, people do things in different ways.

I'm quite interested in all this as I want to move in cancer circles, but someone who doesn't might not have the same 'enthusiasm' for getting it right - especially if breaking bad news is smaller part of what they ususally do.

The problem with getting it right is that there's no one consensus on how to do it - what works for one person might not work for another. Unfortunately the limits on a doctors time are great, and there isn't much time for trying to find what is right for any one patient. Loads of studies have been conducted (I can post some refs when I got home from work) to try to find a generic method for breaking news, but most have concluded it's impossible, or come up with something so generic that it is not of much use.

I would be dissapointed though, if a doctor 'actively' misinformed/skirted the issue if directly asked the question by a patient. However, also bear in mind that the doctors duty of care is not to the patients family and friends, but to the patient themselves - data protection and patient confidentiality well as protecting a patients privacy and dignity are the key factors.

I've copied over the GMCs 'Duties of a Doctor' - the modern hypocratic oath I guess...

http://www.gmc-uk.org/standards/doad.htm

The duties of a doctor registered with the General Medical Council

Patients must be able to trust doctors with their lives and well-being. To justify that trust, we as a profession have a duty to maintain a good standard of practice and care and to show respect for human life. In particular as a doctor you must:

- make the care of your patient your first concern;
- treat every patient politely and considerately;
- respect patients' dignity and privacy;
l- isten to patients and respect their views;
- give patients information in a way they can understand;
- respect the rights of patients to be fully involved in decisions about their
care;
- keep your professional knowledge and skills up to date;
- recognise the limits of your professional competence;
- be honest and trustworthy;
- respect and protect confidential information;
- make sure that your personal beliefs do not prejudice your patients' care;
- act quickly to protect patients from risk if you have good reason to believe
that you or a colleague may not be fit to practise;
- avoid abusing your position as a doctor; and
- work with colleagues in the ways that best serve patients' interests.

In all these matters you must never discriminate unfairly against your patients or colleagues. And you must always be prepared to justify your actions to them.
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Snake
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(Original post by Kavanne)
I agree. My dad thought he was going to get 6 months of chemo and then live! He thought his second operation (first was to remove colon) was to get a liver biopsy, then he ended up dying from it. Someone didn't tell us everything, surely?
liver biopsies have a complication rate - especially if you have a serious disease. He (and yourselves) would certainly have been informed of that - you have to before you sign the consent form after all.
Talya
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(Original post by Snake)
liver biopsies have a complication rate - especially if you have a serious disease. He (and yourselves) would certainly have been informed of that - you have to before you sign the consent form after all.
Er, no one told me. I would have liked to know if my father had a chance of dying instead of being told he'd be back in work in a month or so.

Yes, so I was 14, but I sat in his room and outside ICU long enough for a goddamn doctor to take 5 mins to come and talk to me. Expecting my father to live, then getting a call 'oh, he's dead' is much freaking worse than expecting he may die and then him dying.
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rainjan_4now
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(Original post by cleas001)
if someone has liver cancer- (spread from the bowel) what are their chances of making a fully recovery
My uncle died an unexpected death from that exact form of cancer. He found out in october 03 and died in february 04. It was a shock to everyone, and kind of affected my exam results (jan). But i wasn't so much worried about my feelings, my main concerns were of my cousins around the same age as me who were about to lose a father very early on in life. When his chemo didn't work, he was told by the doctor to go home as opposed to staying in the hospital...reducing the quality of life he would have had if he stayed in the hospital.

My gran died of cancer of the pancreas this year around the same time my uncle died last year, and she also tried chemotherapy and natural remedies. Cancer has affected my family immensely over the past 2-3 years, but i suppose you have to deal with what life can throw at you. My cousins have learnt to love their father even more as they realised how many lives their father had touched at his HUGE funeral!
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AT82
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I think the reason for sudden liver deaths is that the body can function normaly with a lot of it in very poor condition I think its like a big sponge which absorbs bad chemicals and substances, if these substances get into other organs it can cause multiple organ failure which happened with my grandad.

Fluffy I understand its difficult for the doctors, I just some times think there needs to be better communication with the doctors form different departments dealing with the same patient as they all say different things.
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