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Is One Eligible For Liver Transplant When Breast Cancer Has Metastasized To The Liver Causing Liver Cirrhosis?

Posted on Wed, 24 May 2023

Question: My mom has breast cancer mets to liver. She has undergone chemo for 16 months and now oncologist has stopped chemo due to cirrhosis of liver, advanced stage. My mom has weekly paracenthesis and recently developed swelling in legs as well. Is liver transplant an option since the only organ involved is liver and since her primary life threatening condition is cirrhosis of liver?
If not, is there any options available to her other than waiting for her time to come? We have an appointment with a hephatholist to seek his opinion, what are questions we should ask? thank you.

Answered by Dr. Ramesh Kumar (16 minutes later)

Brief Answer:
Go for PET scan complete body initially.

Detailed Answer:

Hello,

Swelling etc., are all complications of liver failure. End stage cirrhosis means liver failure in lay man's terms. Initially go for a complete body PET scan. If there is no indication of metastasis in any other part then liver transplantation is the only and best option.

Go for PET followed by liver transplant. Overall success rate of liver transplant is good.

Keep your mom motivated.

Question to be asked with the doctor are:
* What is the prognosis of the patient?
* Is it a 5 year survival rate?
* Why not to go for PET before transplant?

Hope I have answered your query. Let me know if I can assist you further.

Thank you.

Regards,
Dr. Ramesh Kumar
Gastroenterologist

Above answer was peer-reviewed by : Dr. Vaishalee Punj

Follow up: Dr. Ramesh Kumar (34 minutes later)

Thank you Dr XXXXXXX for your informative promissing answer.
My mom had a PET scan done a few weeks ago, and as always it showed liver being the main organ involved with breast cancer tumors.
Do doctors allow for liver transplant since it is breast cancer metastatic to liver?
Are there established protocols that prevent doctors from advising transplant to such patients? Are protocols based on the hospital or nationwide?
I much appreciate your advice.

Answered by Dr. Ramesh Kumar (17 minutes later)

Brief Answer:
Follow up.

Detailed Answer:

Hi,

Yes, they should allow and why not, if breast cancer is cured PET scan is normal and liver is the only organ involved then yes, they should go for transplant.

No, there is no such protocol in the medical profession and even if there is a small hope, we should do it if the patient is ready.

However, person protocols may vary from nation to nation and hospital to hospital. If the protocol of the hospital does not allow that, I would give you a suggestion.

In India, the quality of treatment is excellent. Successful liver transplants are done all over the country. You could visit XXXX hospital. Treatment would be cheaper and the best, world class.

Hope I have answered your query. Let me know if I can assist you further.

Thank you.

Regards,
Dr. Ramesh Kumar
Gastroenterologist

Above answer was peer-reviewed by : Dr. Vaishalee Punj

Follow up: Dr. Ramesh Kumar (48 hours later)

Thank you for your response Dr XXXXXXX
What values of Albumin and Bilirubin would basically mean liver complete failure?
I understand there are acceptable ranges but what low Albumin and high Bilirubin values would mean end stage liver functionality?
Thank you

Answered by Dr. Ramesh Kumar (10 hours later)

Brief Answer:
Follow up.

Detailed Answer:

Hello,

As such there are no specific values but bilirubin would be highly elevated more then 20-30 mg/dl while albumin and other proteins would be very low.

Hope I have answered your query.

Thank you.

Regards,
Dr. Ramesh Kumar
Gastroenterologist

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Above answer was peer-reviewed by : Dr. Yogesh D