ASCITES

my wife has liver mets with ascites and few peritoneal nodes seen on PET SCAN ,Now the MO Has put her on IBRANCE + FEMERA since last 2 days ,the fluid builds up every -4 days to about 2to2.5 litres and is drained -4 times in last 15 days .I am confused as the fluid buildup is not stopping and MO says that it needs to be drained till IBRANCE starts to work ,you all may please provide your input

My wife also had ascites that stemmed from her liver mets. In her case, the liver mets were causing obstruction of the blood flow through her liver, and the obstruction resulted in what they call hepatic hypertension (high blood pressure in a specific part of her system). The high blood pressure caused her to develop varisces (swollen veins) in her belly and esophagus, and also caused the ascites. The put her in both blood thinners and diuretics as part of the treatment of ascites and its cause. They drained her many times, as much as 5 liters in a week. They eventually installed a line so we could drain her at home. As the xeloda (an oral anti cancer drug) worked, but it took many months, the ascites eventually tapered off and and stopped. The line has now been removed, and she isn't accumulating fluid any more.

Hopefully the treatment your wife receives will reverse her condition as well. Ask your Doc if its caused by hepatic hypertension. If so, you will want to keep an eye out for signs of internal bleeding as esophageal veins can bleed under increased pressure. They can do a scoping of her espophagus to look at them. The can also do an utrasound of her belly to see of veins are distended and measure blood flow rate.

Not sure if the diuretics helped my wife, but that was something they tried. They are keeping her on blood thinners to prevent the clots from reoccuring, although that isn't an exact diagnosis of the cause, just an attempt at preventing it from coming back or getting worse as she has near total blockage of one of her hepatic arteries.