Ethanol Alcohol Ablation for HCC
I get these hunches. Call it intuition, inkling, or whatever you want. I knew that the tumor was growing again. For several weeks my snooze alarm was getting tapped more frequently. Not even Matt Bellamy motivated me to get up. After changing the ring tone to Muse’s Super Massive Black Hole at full volume, I still went back to sleep. I spent a lot of time on my meditation cushion in stillness calling on my inner reserve and the Spirit of God to renew my mind and heal my body. So much peace surrounded me. But there was a sense that I was preparing for something.
Then I went in for my 3 months screening and sure enough, the tumor was back. It’s the same one that I had the Transcatheter Arterial Chemoembolization (TACE) for. It worked and knocked that sucker out for a while. But I understood that it could grow again. They call it a recurrent or residual tumor. My medical team swung into action. I met with my interventional radiologist, Dr. Malloy at Integris, and we’ve got a plan.
Dr. Malloy is a bridge builder. See, treating Hepatocellular Carcinoma (HCC) is like trying to plug a dam with your finger. It’s not a permanent fix because once those tumors start growing, they are persistent and pop up again and again.
Interventional Radiologists build a bridge to transplant. Keeping the tumors small enough to stay within the Milan Criteria is their job. That is really our best option with HCC. Treating those tumors means he has to have a lot of tricks up his sleeve. Well, he calls them options.
Options! Yes, there are always glorious life saving options! Maybe one of the reasons I like that word is because it reminds me of optimism. I outlined some of those options in my TACE blog. For this round, we’ve eliminated a few procedures that won’t work for my situation.
I’m changing my tune now. Shift from Matt Bellamy to Paul Simon. I was 13 when Bridge Over Trouble Water was released. My dad and I sang harmony to every song on that album. It’s good for me to pull the title song up on youtube and sing along. I can hear Daddy’s voice now.
Aren’t the teen years just hard? I remember being the last one of my friends to need a bra. I was the last one to get kissed. My arms hung down to my knees. Daddy drank too much and mama cried a lot. I took on more and more responsibility. But at night, when the fighting died down and the house was quiet, I lifted the arm on the turntable next to my bed.
“When you’re weary, feeling small, when tears are in your eyes, I will dry them all;
I’m on your side. When times get rough and friend’s just can’t be found.
Like a bridge over troubled water I will lay me down.”
Interventional Radiologists build a bridge over the troubled water of cancer for us. I love that thought. Here’s what is left to build my bridge with.
Cyrotherapeutic ablation or freezing the tumor won’t work because it’s too close to the important artery in my liver. Dr. Malloy says the risk of bleeding is too great with my messy end stage liver.
Percutaneous radio frequency ablation (RFA) is out too. They insert a needle and deliver waves that produces heat. The problem again is location to the arteries and gall bladder.
Microwave ablation heats up and burns the tumor out. But, you guessed it: the location and size is not good for that either.
Percutaneous Ethanol Injection. is what we’re going with. Like the TACE and other ablation procedures, an ultrasound or cat scan used to guide the needle. I will be under general anesthesia so it will be an overnight stay. Now that I think about it, surgical radiology is a better term for what Dr. Malloy is doing. He uses little teeny tiny miniature surgical instruments.
So I go in to the hospital a few weeks ago and he welcomes me like I’m at his house. I half way expected his wife to bring out some cookies.
“When you’re down and out. When you’re on the street. When evening falls so hard, I will comfort you.”
At my appointment, he’s all excited to show me the tools he will use. He’s got my MRI pics pulled up on big screens. He smiles and exudes such confidence. I talked with the nurses and learned that Dr. Malloy greets everyone with respect and joy! He’s building the bridge in my mind to prep me for the bridge he builds in my liver.
They use a small needle that is about a 22 gauge. This makes it easier to get in and out with little or no bruising. He works with the CAT scan technologist who is also named Karen. She’s a sweetheart. Once it is in place right on the tumor he begins to give it an alcohol bath.
I was a little nervous and asked some questions about whether the tumor would “leak” or “seed” tumor cells into the rest of my body when he punctures it.
“I’ll take your part, when darkness comes and pain is all around.”
I trust Dr. Malloy with all my heart. He is a great teacher. I learned from him that primary liver tumors from HCC are encapsulated tumors. That means a super low risk of seeding. He told me that as he draws the needle out, he will do it slowly, dribbling Ethanol Alcohol as he withdraws. That leaves a deadly trail behind to dry out any cancer cells.
It is the least invasive procedure for me right now and has the bestest outcome. There are risks involved any time you go poking around in there especially since the tumor location is near my primary bililary duct, hepatitic vein, and gall bladder. It increases the chance of many complications.
We don’t think about those.
“Sail on silver girl. Sail on by. Your time has come to shine. All your dreams are on their way. See how they shine? If you need a friend, I’m sailing right behind.”
We focus on how the alcohol causes the tumor cells to dry out. It works kind of like a dehydrator. The drying alters the cells and weakens the tumor structure. It can take a few sessions, but hopefully I’ll have a transplant before long!
There is criteria for the tumor to get this ablation:
It has to be encapsulated and with well defined fibrous outer edges
Less than 3 cm
Not near the surface of the liver
I’m a candidate since I don’t have any ascites or jaundice. My liver is end stage, but compensated. Thanks to my liver loving diet, I plan on keeping it that way!
Like a bridge over troubled water, I will ease your mind.”
I hope this eases the mind of anyone who is facing HCC and waiting for a transplant. It has eased mine writing about it today. This blog about Ethanol Alcohol Ablation for HCC started and stopped several times. Ya gotta pic the days when you can delve into the dark places, right? I love all my besties and am overjoyed at all the prayers, love, and well wishes coming my way. Procedure is Monday.
We just radiate love and joy to each other, don’t we? That’s how we roll in the battle against HCV, cirrhosis, and HCC. MMMM Wah! xo Karen:)