Young male in his twenties came with unresectable liver cancer (cholangicarcinoma) with obstructive Jaundice despite PTBD (external biliary drainage catheter) in situ.
He returned from Australia where he was denied any therapy.
He reached a top hospital in Gurgaon and was again declined therapy there and went back to his home town (Nepal) in June 2020.
The PET CT scan of June 2020 here shows the central location of cancer in liver (encircled and arrowed) causing the jaundice due to obstruction.
He heard of Dr. Singhal at Apollo and came for a second opinion in Sep 2020.
Undeniably he was late.
His scan showed much massive disease as compared to June (as seen in the scan, encircled and arrowed) with liver dysfunction, increase in liver enzymes and bilirubin of 8mg/dl.
He was optimized with liver supportive medicines and counseled for worse outcome if chemotherapy was tried, but he had the zeal to live.
He was started on UK-ABC 02 protocol with relatively liver safe drugs.
Low and behold he got infected with Covid after his first dose, with massive lung involvement.
A fighter is always a fighter. He fought that and came out.
His therapy however got delayed by another 3 weeks.
He resumed chemotherapy which was instituted with utmost care and liver supportive therapy throughout.
With in 2 cycles there was remarkable response in the November scan as is evident below. There was marked metabolic response. He is continuing chemotherapy with couple of episodes of cholangitis well managed with antibiotics.
