Talk to Cancer Specialist / Oncologist on Liver Serous HCC

Hello Doctor,

I would like to seek your guidance regarding my patient.

Patient Name: Razina Bibi Age: ~65–67 years Known case of chronic liver disease (post Hepatitis C) with cirrhosis (Elastography F4). She was diagnosed with hepatocellular carcinoma in early 2024 and has undergone multiple TACE/TAE sessions. She has been on Lenvatinib for about 6 months.

Recently her tumor markers have increased significantly (AFP ~33,000 ng/mL, PIVKA-II ~24,283 ng/mL).

Over the past few weeks, her bilirubin has been progressively rising (4.1 → 6.0 → 6.3 → 7.4). ALP has remained markedly elevated (~1550–2100). Recent labs also show anemia (Hb ~8.9). Kidney function is currently stable.

Ultrasound previously showed cirrhotic liver with mild ascites, portal hypertension, and splenomegaly. Ascitic fluid analysis shows low protein with no evidence of infection.

Clinically, the patient is currently weak and mostly bed-bound. She has ascites with leg swelling and mild drowsiness with very slow speech