My Liver Cancer Blog

On Nov. 3 I had the second CT scan since starting chemo-immunotherapy, after 6 cycles. (The first scan was in August, after 2 1/2 cycles, and showed no decrease in the size of the main tumor, but one node of the tumor had shrunk by about 1/3. I don’t even really know what this means since no one had mentioned a “node” before). Like last time I got very anxious while waiting for the results, but at my most recent appointment, a resident showed us images from the August and November scans side-by-side, and my husband, the resident, and I all agreed the tumor looked a little bit smaller, so I was hopeful the radiologist’s report would confirm our impression.

And, indeed, it is better news this time. Before, the tumor was 10.4 cm x 8 cm (I told you it was big…), and now it’s 9.7 cm x 7 cm. I wish it showed more of a decrease, of course, but that’s not nothing. And I still have 2 cycles to go, and perhaps 1 or 2 more after that, depending on whether my oncologist can get access to this new targeted therapy, zenocutuzumab, slowly or quickly. He is open to continuing the current chemo-immunotherapy if the next scan, after cycle 8, shows more shrinkage. After all, why stop something that’s working, especially if the new drug hasn’t yet arrived? (On average, this protocol of 8 cycles of gem/cis/durva shrinks tumors by 25 – 30%, so if I could get it down to 7.5 cm x 6 cm, I’d be delighted. At the moment, that doesn’t seem realistic, but we’ll see).

Maybe as important, the tumor is “not as vascular” as it was before, meaning there are now fewer blood vessels carrying nutrients to it, which may also contribute to its continuing shrinkage. According to AI on Google, “Lower vascularity can sometimes be associated with slower tumor growth, as tumors need a robust blood supply (angiogenesis) to deliver the oxygen and nutrients required for rapid proliferation.”

Moving on to treatment-related news, I was worried this week that I wouldn’t be able to start cycle 7. My platelet count was really low last Thursday (side effect of chemo), and my oncologist gave it a 50/50 chance of popping back up over the weekend into the normal range. And I could see the effect on my skin – lots of bruises. But pop back up it did (see graph below), just enough so that on Monday I was able to proceed. And I had my sister and my niece with me this time, which made me joyful.

How I love my resilient body! And how I love the iron-rich dinners my honey cooks for me – go bivalves! (FYI, in case you’re unaware, as I was until recently, oysters, clams, and mussels are rich in iron).