Last month I had a CT scan and chest x-ray. My scan came back with a showing of some ascitic fluid around the upper aspect of my liver. My oncologist said that this fluid might be just some post-radiation effects. Or it could be a cancer. He said there was not enough fluid there to do a biopsy and that we should just wait till January for another CT scan.

I was wondering if anyone has come across?

My spouse was diagnosed June 99 with Stage IV NSCLC (Lung cancer). I could go through a long story of 11 cycles of chemotherapy in a clinical trial, brain and cerebral spinal fluid metastases, whole-brain radiation and
~6 cycles of intrathecal chemotherapy which was aborted when fluid again built up in her chest June this year and was subsequently admitted to hospice.

Our experience with fluid in the chest: there was fluid last year which was drained and didn't substantially recur throughout systemic chemotherapy which consisted of Taxotere and Vinorelbine. When fluid returned to the chest during intrathecal chemotherapy with Topotecan, the fluid required draining only once. Ultrasound and an X-ray showed that the fluid is still there but it's asymptomatic.

My spouse is now suffering from ascites in the abdomen. We've had multiple outpatient paracenteses and just last week opted for a small removable catheter to be inserted which permits me to draw out fluid daily, 200mL minimum. Additionally, the most recent oultrasound shows two 2cm^3
(Cubed) tumors, one per liver lobe. I've heard and read and have been told by our doctors several different messages:
- ascites is due to liver disease, the cause could be blockage of the filtering process that normally occurs
- low blood protein levels can cause and/or are signs of ascites. Osmosis occurs, leading to ascites having high protein levels.
- cancer somewhere in the abdomen Some links on management of ascites:
- http://www.mylifepath.com/article/gale/100269973
- http://www.tirgan.com/ascites.htm
- http://intouch.cancernetwork.com/handbook/FluidComplications.htm#Ascites To summarise, the various sites mention several methods:
- eliminate the cancer that causes the problem (Sounds easy)
- avoid salt in your diet
- take diuretics
- drain fluid for symptom control
- for ascites that recurs, hardware can be installed which shunts ascites fluid to the bloodstream (We didn't opt for that)

Additionally, ascites can be categorized as exudative and transudative. Initially one doctor thought the abdomenal fluid was coming from the chest but the accumulation was too rapid and the fluid was visibly different in color and texture. Some of the websites even categorize by color. But I think this may be anecdotal.

My watchout, based on personal experience, doctor's orders and website suggestions, is to watch protein levels, salt intake and have the blood and ascites fluid periodically analyzed. The former for protein, albumin, LDH, the latter for cytology, protein, LDH. The websites put it all much better than I can. Do a Yahoo search for "+ascites +prognosis" and it'll yield a good list and they'll even tell you what to ask for when doing the analysis. Our cancer pain specialist says that ascites can be tracked down to its source through ultrasound.

We manage the ascites with the daily fluid drains. We anticipate, many say vainly, that the process in the abdomen causing the ascites can be eventually halted so we don't mind living with this for now. At this stage, each day without pain and suffering is by itself another 24 hours to be thankful for.

I congratulate you on your successful treatment of cervical cancer. If there was something that could be done to "protect" your liver from any metastases, I'm sure your doctors are watching out for you. But try and be proactive. We learned the hard way July 99 when my spouse complained of "flashing lights" at her peripheral vision on one occasion. A brain CT scan showed two highlighted focii which should have been followed up by further tests a month or so apart. This lack of watching over this, turned into brain mets months later and cerebral-spinal fluid mets, both of which are death sentences in and of themselves with median life expectancies measured in weeks.

I'm not a doctor nor make any suggestions for treatment, just sharing my experience as a caregiver for the past 16 months. If any bored readers wish to peruse my statements and pick them apart as has been done before in this website, try walking in my shoes and watch their spouse go in and out of comas, cry out in anguish, suffer from depression and beg for peace. Mercifully, btw, I speak in the past tense. We're all trying as hard as we can and if medical science had had all the answers, my spouse would be back to developing midrange software, travelling, playing tennis as a rated USTA member and enjoying life again.