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Hi Bill

Just to chime in, I agree that your doc seems unfamiliar with hep c, and with its treatment. It seems essential to get at least one more opinion, and from a gastro or hepatologist who does a lot of hep c work.

For the first, and most importatn point, liver cancer is very very rate. Among hep c folks that drops down to just pretty rare, but it is still not at all common. Somewhere between 10 and 25 percent of hep c sufferers MAY someday get cirrhosis (the figures were compile before docs knew to tell patients to avoid smoking and drinking and so on).
This usually takes decades-- 20 or 30 years, for example, would not be uncommon. And THAT's only for the 10 to 25 percent whose fibrosis is going to progress, anyway.

Then of that fraction, about 5 percent--I'mn saying five percent of the 10 to 25 percent, in other words a small number--may go on to develop liver cancer.

So, liver cancer is a rafrer result of hep c, and takes many many years, almost always decades, to develop. It is not your most immediate problem.

That is one example of what a more knowledgeable doc would talk through with you.

Another would be that an ultrasound (I've had more than one) is of very limited use in hep c. A needle biopsy (a very minor procedure) is of considerable value, but an ultrasound can detect only the extremes of liver condition--very fine or very damaged. It's not very useful at all. Doesn't hurt, though, so no harm done.

Just one more example of bizarre info from your doc included in your short post is the idea that there is "no difference" between the available interferons. This is simply not true. There may be reasons why one patient would pick one or the other (yes, I believe the stats on Pegasys are more encouraging), but it is NOT true that there is NO difference.

So, especially since none of us here on this board are doctors, it seems to me that you must, must, get another doc invovlved in your case.

By the way, viral load does not count for all that much with this disease--unlike HIV where it is the most useful measure of disease progress--but for what it's worth, your count of 400,000 is low.

Yes, you'd be better off smoking nothing. Your liver has to handle anything that comes in that way, and although pot has not nicotine, it shares all the tars and formaldehyde and dioxins and other combustion by-products of any other smoky, burning leaves.

Finally, I hope you told the dentist that you've been diagnosed. You owe this to anyone who may come in contact with your blood. I suspect the dentist will think it no big deal, but he or she should know.

Let us know your test results, and what else you learn. And take it easy!!! This disease is, for most of us, no big deal. It can be dealt with.



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