Liver Cancer. What Are Options When Patient Too Weak For Treatment

Posted by gci @gci, Aug 4 1:53pm

My wife diagnosed with Intrahepatic cholangiocarcinoma one month at John H Stroger Cook County hospital in Chicago. She was complaining of tiredness and sleeping long hours, and went for check-up. Was going to work until one a few days earlier. After the diagnosis and 10 days in hospital during which they ran various tests and carried out a biopsy, she become so weak that she can hardly talk or walk around without great difficulty. Oncology says she is too weak and therefore too risky to commence for chemotherapy and that even immunotherapy cannot given because of her weakness due to side-effects. Part of the concern is lack of appetite which is causing weakness. We are doing everything as suggested to help her eat more. Any suggestions here would be appreciated.

If a patient is too weak for chemotherapy and immunotherapy to be administered, are there no other options available to start liver cancer or bile cancer treatment? What are they? Not starting treatment allows the cancer to keep expanding and weakening patient. Family is in great distress and not knowing what to do is killing me inside. It is very traumatic and painful to watch my wife dying slowly and not being able to do something. Does anyone have experience any suggestions? Despite the risk, starting treatment will at least give a fighting a chance of extending patient life and/or managing illness.

Interested in more discussions like this? Go to the Liver Cancer Support Group.

craigcraig | @craigcraig | Aug 4 5:08pm

So sorry for your situation. Sorry I personally can't think of a silver bullet. It sounds like you are doing all you can. You are probably right her long term prognosis has to be better if she can have treatment. But if the doctors say no because of her weakness ? Good move to try to get he to eat more to gain strength. She does seam so very weak from your description. It is usually not possible because of insurance but any chance of changing away from Cook County hospital ? I have three relatives who live in Cook County Ill. and they always choose other providers. Wishing you and your wife the very best. Prayers up.

Turkey, Volunteer Mentor | @tomrennie | Aug 4 5:59pm

@gci Hi and welcome to Mayo Connect. I am really sorry to hear about everything. You and your wife are in an incredibly difficult situation. Since oncology at her current hospital says that your wife is too weak for treatment, she needs some additional help now. I suggest seeking out palliative care for your wife. A Mayo Palliative Care doctor said that it is his job to get people healthy enough for treatment. I have never heard anyone put it that way before, but it makes sense especially in your wife's case. Palliative care can help with things like pain, nutrition, loss of appetite, and overall quality of life while getting your wife as prepared as possible for treatment. Second, get a second opinion. Because I personally get treated at Mayo for pancreatic cancer with liver metastasis, I only know how to get a second opinion started there. Here is a link to get it going: http://mayocl.in/1mtmR63 I think getting her as healthy as possible while you folks find the best place to get her treatment is a good way to start. What are your thoughts?

scottmcf1431 | @scottmcf1431 | Aug 5 7:16am

She may need tube feeds to get her strength back.

hopefulpapaya | @hopefulpapaya | Aug 6 7:06am

I’m so sorry you’re experiencing this. My dad is in the exact same situation. Advanced liver cancer. Very negligible food intake and so weak. He’s only had one immunotherapy treatment and I don’t think he’s strong enough for another. We are hoping he gets a feeding tube inserted even though his care team said that could bring complications. It’s hard to feel so helpless in helping them.

I’m sorry I couldn’t be more help, but I’m sending you and your wife lots of strength to get through this.

gently | @gently | Aug 6 9:31am

scottmcf1431's idea is perfect isn't extreme. A j-tube would allow her to regain strength and would be removed at some later point. This is a great brand https://www.realfoodblends.com/ I'd avoid the canned ones made of soy, or the one made with corn syrup.
She would be able to continue to eat whatever she pleased in addition. Some of the pegs are large and get caught on clothing, but you can ask for the smaller retractable peg.
While she is getting stronger get those second opinions in video conferences at your kitchen table. It is good to record the conferences by setting your phone because it is hard to keep everything straight when you are under stress.
You may be able to treat her liver cancer with radiation only. Have at least one conference with City of Hope.
It might surprise you how quickly she gets stronger.
Praying.

Turkey, Volunteer Mentor | @tomrennie | Aug 7 8:00am

In reply to @hopefulpapaya "I’m so sorry you’re experiencing this. My dad is in the exact same situation. Advanced liver..." + (show)

@hopefulpapaya Hi and welcome to Mayo Connect. Sorry to hear about your dad. Is there any game plan for moving forward?

Colleen Young, Connect Director | @colleenyoung | 1 day ago

@gci, checking in. How is your wife doing? Has her team been able to improve her appetite and health status so that she can start treatment? How are YOU doing?