Liver Cirrhosis & Periampullary Cancer: She Lived 2 years 3 months While on Herbs

The last time I talked to KL (H-596) was on 9 June 2013. She was doing fine. She had just gone to see her doctor on 3 June 2013 and her ultrasound result did not show anything amiss. Her health had not deteriorated either.

Video recorded on 9 June 2013

Ultrasound of Abdomen

25 April 2011 – first visit

3 June 2013 – last visit

 

1. Liver cirrhosis with portal hypretension

2. Cholelithiasis

3. Dilated CBD, due to distal CBD stones.

 

 

1. Liver cirrhosis

2. Dilated CBD and distended gallbladder due to periampullary tumour at the head of pancreas.

The results of her Liver Function Test showed improvements over a  period of time after KL was started on our therapy (see Table below).

Parameter

29 Apr 2011

6 May 2011

1 September 2012

3 June 2013

Total bilirubin

143.6

111.4

71.0

41.2

Direct bilirubin

105.1

83.9

36.3

25.0

Alanine transaminase

132

102

60

55

Alkaline phosphatase

171

177

143

192

GGT

147

127

321

217

AST

197

161

96

80

CA 19.9

nil

nil

33.7

21.8

When KL first came to seek our help she was severely jaundiced (yellowing) but over time her biliburin dropped to 41 from 143. Her CA 19.9 had also improved. When she last came on 9 June 2013, KL was her normal self. The only concern we had at that time was she still had jaundice — even though her bilirubin level had decreased substantially.

Another concern was whether the stent which was installed earlier had to be changed. It appeared at that point in time nothing was amiss. I suggested to her family that in the event that there was a blockage, KL had to be brought to the hospital immediately.

It was with sadness to learn that on 14 July 2013, her family members woke up in the morning to find her in a pool of blood. A blood vessel must have ruptured. KL was immediately sent to the hospital but the doctors could not do much. A day later, KL passed away.

KL managed to live a pain-free life for 2 years and 3 months while on our therapy.

Medical History

KL ‘s problems surfaced  in April 2011 when she became jaundiced. She went to the hospital and was diagnosed with liver cirrhosis with moderate ascites. Her CBD (common bile duct – see diagram below) was dilated probably due to a lesion. Further investigation revealed presence of multiple stones in the gallbladder and distal CBD.

A biopsy of the Papilla of Vater was performed and indicated villous adenoma with high grade dysplasia, highly suggestive of underlying periampullary tumour at the head of the pancreas.

Subsequently ERCP (endoscopic retrograde of cholangiopancreatography) was done and a by-pass stent was installed. KL was told that surgery to remove the tumour could not be done at this (Penang) hospital. If she wanted to undergo an operation, she could go to a university hospital in Kuala Lumpur.

KL refused  surgery and came to seek our help on 29 April 2011.

What You Should Know About Liver Cirrhosis

  • Cirrhosis is scarring of the liver as a result of continuous, long-term liver damage. Scar tissue replaces healthy tissue in the liver and prevents the liver from working properly.
  • The damage caused by cirrhosis is permanent and can’t be reversed. Cirrhosis cannot be cured.
  • Cirrhosis progresses slowly, over many years, gradually causing your liver to stop functioning.  http://www.nhs.uk/conditions/cirrhosis/Pages/Introduction.aspx 
  • After heart disease and cancer, cirrhosis is the third most common cause of death in people aged 45-65 years.

http://www.natap.org/2002/Oct/103002_2.htm

  • Liver cirrhosis is usually far advanced before it is diagnosed.
  • Medicines do not help regenerate new liver cells.
  • Causes of liver cirrhosis: alcoholism, chronic hepatitis B/C.
  • Certain other diseases like nonalcoholic fatty liver disease (NAFLD) and certain medications can cause liver cirrhosis. Autoimmune inflammation of the liver, abnormal levels of iron and copper leading to metabolic disorders, and disorders of the biliary system can lead to liver cirrhosis.
  • Cirrhosis prognosis is poor.
  •  Life expectancy of patients diagnosed with cirrhosis in the second stage, will be about 6 to 10 years. When cirrhosis of the liver is diagnosed during the last stage, the life expectancy is about 1-3 years.
  • Lifestyle changes are the cornerstone of the treatment for the disease.

http://www.buzzle.com/articles/cirrhosis-prognosis.html

People with liver cirrhosis may develop complications:

  • When the liver is heavily scarred, the blood cannot get through the liver at the normal pace due to obstruction presented by the scar tissue, thus creating a higher than normal pressure in the portal vein – the main vein feeding the liver (portal hypertension).
  • The portal hypertension often causes ascites (accumulation of fluid in the abdominal cavity).
  • The portal hypertension may lead to the formation of varices. Varices have thin walls and they may rupture and bleed. The two main locations where bleeding is likely to occur are the lower oesophagus /upper stomach and the perianal region. Oesophageal varices are likely to bleed most heavily, and is often difficult to control.
  • Cirrhosis sometimes may lead to jaundice (yellowing of the whites of the eyes and/or the skin) due to the accumulation of bilirubin in the blood. If the bilirubin is excreted in the urine, the urine may turn dark.
  • Cirrhosis may also lead to hepatic encephalopathy, which manifests as fatigue or confusion.
  • People with cirrhosis often bruise easily. The level of platelets in the blood may be lower than normal if the spleen is enlarged.

http://www.hepatitis.org.uk/s-crina/cirrhosis-main-f3.htm 

Treatment for Liver Cirrhosis

Although there is no cure for cirrhosis of the liver, there are treatments available that can stop or delay its progress, minimize the damage to liver cells, and reduce complications.The treatment used depends on the cause of cirrhosis of the liver.

  • For cirrhosis caused by alcohol abuse, the person must stop drinking alcohol to halt the progression of cirrhosis.
  • If a person has hepatitis, the doctor may prescribe steroids or antiviral drugs to reduce liver cell injury.
  • For people with cirrhosis caused by autoimmune diseases, Wilson’s disease, or hemochromatosis, the treatment varies.
  • Medications may be given to control the symptoms of cirrhosis. Edema (fluid retention) and ascites (fluid in the abdomen) are treated, in part, by reducing salt in the diet. Diet and drug therapies can help improve the altered mental function that cirrhosis can cause. Laxatives such as lactulose may be given to help absorb toxins and speed their removal from the intestines.

http://www.webmd.com/digestive-disorders/cirrhosis-liver

What You Should Know About Periampullary Cancer

The Ampulla Vater is a nipple like projection into the duodenum (the first portion of the intestine) into which the pancreatic and bile ducts open. All of the pancreatic and biliary secretion enter the duodenum through the Ampulla Vater.

Liver-andAppulla-of-Vater

Blockage of the Ampulla Vater by the tumor leads to obstruction of drainage of the pancreatic and biliary secretions into the intestine. Blockage of drainage of bile into the duodenum leads to the development of jaundice.

Carcinoma of the ampulla of Vater is a rare malignancy.

For patients with unresectable disease, endoscopic stenting to achieve biliary decompression is an appropriate palliative procedure.

  • Surgical resection with curative intent is the only option for long-term survival.
  • Pancreaticoduodenectomy is the procedure of choice for patients with resectable disease.
  • Unfortunately, most patients with carcinoma of the ampulla of Vater die of recurrent disease. Treatment fails in nearly 70% of patients with poor prognostic features, and these patients ultimately die of their disease.
  • Distant metastasis to the liver, peritoneum, and pleura was the dominant failure pattern after surgery.
  • Radiotherapy, chemotherapy, and chemoradiotherapy have been tried, but response rates probably are low, and an effect on survival is questionable.

Sae Min Kim et al of the College of Medicine, Korea University, Seoul, Korea (in J. Korean Medical Science, 7:295-303, 1992) reviewed 766 cases of surgically treated periampullary cancers in their paper entitled Surgical Treatment of Periampullary Cancer.  They noted the following:

  • 66 percent of patients were in Stage 3
  • 8 percent were in Stage 2
  • 26 percent were in Stage 1
  • Not all cancers can be resected. Resectability rate was 32 percent.
  • Mean post-operative complications was 44 percent.
  • Survival rate at 1, 3, and 5 years in the resected group were 68 percent, 25 percent and 15 percent.
  • In the non-resectable group, survival rate at 1 and 2 years were 7 percent and 0 percent. Non survived 18 months after treatment.

Source:

http://www.uptodate.com/contents/ampullary-carcinoma-treatment-and-prognosis

http://emedicine.medscape.com/article/282920-overview

http://emedicine.medscape.com/article/276413-treatment

Comments

KL had both liver cirrhosis and a rare cancer called periampullary cancers. Even the doctor in a private hospital here was not able to handle the case, preferring to refer her for surgery at a university hospital in Kuala Lumpur. KL refused further medical treatment.

Take time to ponder on the following:

  • What could have happen if KL was to undergo surgery? Would her quality of life be better off or would the procedure make life more miserable?
  • Would surgery extend her life? 

Medical doctors in Korea could give us some idea of what could happen.  To start with not all such cancer can be resected  — even more so with an underlying liver cirrhosis. KL might not be a candidate for surgery at all.

If KL were to undergo surgery, the chances of post-operative complications is very high indeed.  So surgery might not be an attractive option for her case.

KL chose to do nothing — just took herbs and changed her diet. She lived another 2 years and 3 months. According to the Korea study above, even with medical treatment (but without surgery) no one survived after 18 months.

So, KL had her blessing and herbs are not “unproven” or hocus pocus like many “educated” experts may want you to believe.

And above all the family did not have to pay through the nose to keep her well until the last day of her life.

Advertisements