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Treatment options for LIVER CANCER in biopsy, PET SCAN.

Resolved question:
My dad is 76 yrs old and has been a diabetic & blood pressure patient for 20yrs approx . In the year 2011 he was detected with blockage in heart and has been prescribed to take medicines for the same since then. In the month of Jan 2015 , his Sodium level suddenly went down and he complained of loss of appetite . Also he became anemic and got prostrate problem detected at the same time.

For the prostrate problem , doctors have suggested a laser operation but that can't happen unless he general health improves . We got him admitted to hospital for these issues. Its has been three months now , it took for doctors to identify the root cause of blood loss and loss of appetite

He has become very weak since then and bed ridden . He is on semi solid diet via mouth and liquid via Ryle's tube

Doctors did capsule endoscopy , and found ulcers and small projections in his smaller intestine from where bleeding was happening . Also PET - CT scan and Liver biopsy resulted into LIVER CANCER.

His sodium & potassium levels have now stabilized but sugar levels are above normal level 220~280 . Though the blood loss has stopped but we haven't been able to start the treatment for cancer.

The hospital here in india where it was detected , the oncologist has recommended to start with low dose of Chemo but we are going to meet him next week with blood reports . The blood report is for the urine infection that he caught late and had a medicine course for a week .

I would like to seek an opinion here from the doctors on which procedure should be the best to cure my dad without affecting his health and providing him a better lifestyle at this age

I have uploaded the reports

Submitted: 4 Days
Category: Hematologist

Expert:  Dr. Prasad Eswaran replied 4 Days.

Dear
Thanks for your query at DoctorSpring.com
The liver biopsy is reported as lymphoma. However, bone marrow was normal. Also, the PETct report is not corroborative with the diagnosis of lymphoma, as there is no obvious lymph nodal involvement and uptake in PET scan.
The work up is in lines of lymphoma, though I cannot understand this as isolated liver involvement.
Could you ask for an independent pathology review as the investigations are not correlating?
Are you meaning to benign prostate swelling causing urine obstruction and secondary infection? I do not clearly make out what you mean by laser treatment for prostate. Kindly clarify this aspect.
In addition, if feasible, can u fly to Chennai so that I can arrange for necessary investigations and appropriate therapy as needed?
Kind regards

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Patient replied :

As per doctor there is swelling in prostrate which is causing urine infection. They advised for TURP, however it could not be done due to his health condition. Now he has been diagnosed with liver cancer. As this is not correlating to pet ct pls advise what else I need to do to start the correct treatment. I am attaching his latest blood and urine reports


Expert:  Dr. Prasad Eswaran replied 3 Days.

As I suggested earlier, it is a benign prostatic hyperplasia, probably if surgery is not feasible, consult an Urologist to consider tab. Finasteride for reducing the symptoms.
Regarding the liver, ask for a pathology review for confirmation of the diagnosis.
Regards.

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