Should I get a biopsy?

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Sable43
Sable43 Member Posts: 91
edited June 2014 in Not Diagnosed With a Recurrence or Metastases but Concerned

I apologize for being off of the site for a while although I have been trolling the topics.

Was told after my most recent PET scan and MRIs that a liver tumor was found. Radiologist states it's nodular hyperplasia based on its shape and that a biopsy isn't needed.

I'm concerned for the tumor is new. To be told that a biopsy isn't necessary doesn't sit well with me although my oncologist has faith in the radiologist who read my results.

Am I wrong for feeling concerned? Should I demand a biopsy just to be certain?

Any feedback would be appreciated.

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  • barbe1958
    barbe1958 Member Posts: 19,757
    edited March 2012

    The liver is weird. I was told once that I had tumours on my liver (pre bc) and it almost ruined my wedding day  (we were sobbing by the "death till you part" part)!! Then I found out that the tech was wrong (should NEVER have told me that I had hepatitis too!!) and in fact, I just have a fatty liver!!

    Having said that, I am concerned about my liver right now, but all bloodwork is okay. Yet, I've heard from liver mets ladies here that their bloodwork was normal as well. 

    A liver biopsy isn't a walk in the park. I don't think I'd want to compromise my already annoyed liver by sticking needles in it. I'd go for a watch-and-wait approach. No more than 3 months, though. Any changes and SCAN me!!!! That is just me...how are you feeling today?

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  • kathleen1966
    kathleen1966 Member Posts: 793
    edited March 2012

    Maybe you should just have them watch it and re-scan in three months? I see why you want the security of knowing it is NOT cancer. Perhaps you also should get a second opinion from another radiologist.

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  • Sable43
    Sable43 Member Posts: 91
    edited March 2012

    Hello barbe1958,

    Thanks so much for your insight. From everything I've read on nodular hyperplasia, a biopsy isn't considered unless there appears to be increased growth in the size. Even then surgery to remove the tumor would be more likely.

    I've been dealing with fatigue and joint pain for the past 2 1/2 years; so that's nothing new. Chemo ended in Dec. 2009. There are days that my stomach blows up as big as a beach ball; which by the way I'm dealing with right now. Blaming that on the amount and kind of meds. that I'm taking. Neurontin 1800 mg daily, Cymbalta 60 mg daily, Tramadol 100 mg twice daily, Flexeril 10 mg nightly. Miralax doesn't seem to do it for me; although I don't take it as often as I probably should.

    Your advice is sound. I'm scheduled for a meeting with my oncologist in June. A good friend of mine suggested that I keep a journal of everything that's being told to me, just in case, as well as obtaining copies of my test results. I intend to do that as well.

    Thanks again for your insight.

    Take care!

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  • barbe1958
    barbe1958 Member Posts: 19,757
    edited March 2012

    Sable, hmmm, I may be wrong, but I don't think you should be on Neurontin AND Cymbalta!!! That could be knocking you down!! They are similar drugs and you may be overloading and taxing your liver. Please confirm that sooner rather than later. Your pharmacist may even be able to help you.

    Do you have Fibromyalgia? That is what Cymbalta is normally prescribed for. And the neurontin is for peripheral neuropathy in diabetics, but has been found to work for some people with Fibro. CAUTION, Neurontin can cause weight gain as much as a pound a WEEK.

    Tramadol can be effective for medium pain management, but the Cymbalta you are on is the lowest dose. Maybe raising the Cymbalta and ditching the Tramadol (do you find it constipates you?) may ease your system somewhat.

    Please let me know what the professionals say about Cymbalta AND Neurontin at the same time.

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  • Sable43
    Sable43 Member Posts: 91
    edited March 2012

    Hello barbe1958 and kathleen1966,

    As a matter of fact it was a neurologist who prescribed both. I suffer from chemo induced neuropathy after having finished chemo 2 years ago. I was on Ixempra and it left me with terrible joint pain as well as neuropathy; particularly in my feet.Both the Neurontin and the Cymbalta were prescribed by my neurologist for my condition. 

    As well as still seeing a neurologist, I'm also now under the care of a pain management specialist who increased my Neurontin dose from 600mg to 1800mg. They are aware of what meds I'm currently taking. I do meet with them tomorrow, for as you mentioned, I've read that Neurontin can cause substantial weight gain. Something that I'm having a terrible time getting rid of. The Tramadol doesn't seem to be helping at all.

     I'm guessing that a mix of all of these meds, taking the majority of them together at night, is what's constipating me.

    I'm more on board with waiting until June as suggested. The thought of getting another radiologist has crossed my mind; but my oncologist swears by this man's reputation. And I have a great deal of faith in her.

    I will bring up my concerns tomorrow.

    Thanks again for the advice.

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  • barbe1958
    barbe1958 Member Posts: 19,757
    edited March 2012

    Sable, good luck for tomorrow and please let us know how it goes! Do note that Lyrica and Gabapentin (real name for Neurontin) is the same drug and will give the same weight gain issues. I am very interested to see what they say. My docs deny that's why I can't lose weight!!

    My brother and I went on a diet together (I had just happened to start Lyrica). He lost 75 POUNDS and I lost NOTHING!! It was over a 5 month period and I was pretty upset!! Then I realized that if I hadn't been on that diet I would have GAINED!!! Very, very scary.

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  • Sable43
    Sable43 Member Posts: 91
    edited March 2012

    Hi barbe1958,

    Was told that Neurontin and Cymbalta aren't similar; acting on different pathways. Cymbalta has also been approved for neuropathy, so both my neurologist and pain management docs are in agreement. I've decided to cut down on the carbs. in my diet. I noticed that since I started taking Neurontin my carb cravings seems to have increased substantially. I'm thinking that's why the weight won't budge.

    I'm hoping to see some of the weight go as I increase my activity level.

    Thanks for your concern. I do go back in June for more testing. I'm hoping that the liver tumor hasn't increased in size by then.

    Take care.

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  • CoolBreeze
    CoolBreeze Member Posts: 4,668
    edited March 2012

    I wouldn't biopsy but I would watch it.

    The liver has lots of benign nodules and things that only we cancer patients get to see. :)   Your symptoms are likely, as you said, from your meds and not liver mets, especially just one met.  Most of us with liver mets are asymptomatic until end stages.  The liver doesn't need much to function.

    I had a liver biopsy and they are not exactly pain-free.  In fact, I felt like I was being stabbed in the liver, it was quite awful for me. (Not everybody has that pain but some do). I don't know that there would be any benefit to finding out now as opposed to three months from now even if it was cancer, so Dr. CoolBreeze recommends a rescan in a reasonable amount of time, especially since you seem to have a good radiologist. 

    Here's hoping there are no changes!  

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  • Sable43
    Sable43 Member Posts: 91
    edited March 2012

    Thanks so much for your input ladies!  So grateful for the response.

    CoolBreeze; Thanks for the info. regarding the liver biopsy. Was told that it was no walk in the park and that one would only be performed if need be.

    God Bless.

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