Beth Lehman survived liver cancer | cirrhosis | heptacellular carcinoma | y-90 | hepatic encephalopathy | ascites
- 9 hours ago
- 14 min read
DESCRIPTION
Beth Lehman went through a tumultuous year in 2020. Thanks to heavy drinking, she was diagnosed with cirrhosis, then basal cell carcinoma, a type of skin cancer, followed by hepatocellular carcinoma, a form of liver cancer. She underwent radioactive embolization in order to get a liver transplant. Beth said the two-hour operation wasn’t so tough, but the after-effects were difficult, including nausea and vomiting. Then she experienced a procedure to get rid of the skin cancer on her right temple. She says between her physical and emotional recovery, she advocates for cancer patients and is happier than ever.
Beth’s alcohol consumption had soared to four or five bottles of wine a day. In 2020, she began to have a buildup of fluid in her stomach, known as ascites. For a long time, she avoided consulting a doctor, suspecting a doctor would tell her to quit drinking; but when ascites asserted itself, she sought medical attention. She was diagnosed with cirrhosis. Upon further examination, five tumors were discovered in her liver, which led to a diagnosis of hepatocellular carcinoma, a form of liver cancer.
This diagnosis came after another diagnosis of basal cell carcinoma, but the skin cancer had to take back seat to the liver cancer.
Beth said her care team first had to determine whether the cancer had spread beyond her liver. Thankfully, it hadn’t. In order to complete a liver transplant, doctors wanted to execute radioactive embolization, in which radiation beads would be injected into her arteries through her wrist or groin and targeted at the tumors. However, for that to happen, the tumors had to be 2cm, but her largest tumor was 1.87cm. Incredibly, Beth’s care team told her to go home and let the tumors grow so they would be large enough for it to go through with the radioactive embolization.
Once the tumors grew, Beth went through the procedure, also known as Y-90. She had to go through the procedure a second time. Usually, a second procedure comes eight to twelve weeks after the first procedure. Beth’s second procedure came just four weeks later. She said she was awake during each procedure, each lasted about two hours, but the toughest part was post-treatment, as she had a great amount of radiation in her body, so much that upon returning home, she had to be sequestered from her husband and her pet cats.
Once she recovered from her liver transplant, she had her skin cancer treated. She said her doctors had to go seven layers deep to get all the cancer, but they did such an outstanding job that her incision is not visible.
Beth Lehman once had a lucrative IT position, but these days she works as an advocate for cancer patients, especially liver cancer patients and says she is happier than ever.
Additional Resources:
Support Groups:
The American Liver Foundation https://www.liverfoundation.org
The Liver Circle https://www.thelivercircle.org
Beth’s Nonprofit:
TRANSCRIPT
Bruce Morton: Welcome. This is the @CancerInterviews podcast, and I’m your host, prostate cancer survivor Bruce Morton. For our guest on this episode, the year 2020 was a year like no other. First, Beth Lehman of Atlanta, Georgia was diagnosed with basal cell carcinoma, a type of skin cancer, and shortly after that, she was diagnosed with hepatocellular carcinoma, a type of liver cancer. But we are happy to report that she is with us to tell her story. Now, let’s get to it, and Beth, welcome to Cancer Interviews.
Beth Lehman: Thank you so much. I appreciate you having me here.
BM: Beth, it is our custom to start off by learning a bit about you regarding your life away from cancer. So, help us out and tell us about where you are from, what you have done for work, and what you like to do for fun.
BL: I am a native Georgian. I am originally from about an hour and a half south of Atlanta, but I live in Atlanta now. I went to college in Auburn, Alabama, then moved to Dallas, Texas. I left Georgia for a hot minute, then it just called me back. In my former life, I was an IT consultant. I was one of the ones who saved the world from Y2K. I traveled 51 weeks out of the year, usually flying out on a Monday and coming back Thursday or Friday. In my mid-30s, I got burnt out and came back in-house, here in Atlanta. Fortunately, I met a wonderful man, and we got married in November of 2020 and I quit my job. I retired. I was able to volunteer full time after that, so I did some work with hospice and some heart centers here in Atlanta, and I was a ‘lady that lunched,’ and then illness struck me, and that stopped everything in 2020. It hit us by surprise, to be sure.
BM: As for your cancer journey, your diagnoses did not come simultaneously, but that was almost the case. When did you first notice something wrong?
BL: I just want to go back and let everybody know I am an alcoholic, and my alcohol use once I retired had steadily increased. I was a wine drinker, like I said, a ‘lady that lunched with wine,’ and my alcohol use increased and increased. Eventually I was up to four to five bottles a day, and that is what caught up with me. My brain didn’t make me quit drinking, but my body did. In 2020, everything came to a head, and the realization of that fluid built up in my belly. It’s called ascites, sometimes it is called the beer belly or something like that, but if it is too large, it becomes a symptom. I was diagnosed with cirrhosis first, and that time, doctors noticed a little spot on my face. I do have skin cancer in my family. My grandfather died from melanoma at age 42, so it had been on our radar. In July 2020, I went in for a transplant observation regarding the cirrhosis in my liver. During that evaluation, they found cancer. That was a huge shock to me because I had never correlated drinking with cancer. That was the first time I had put two and two together, so the normal progression of cirrhosis is hepatocellular carcinoma. By the time they found the cancer, I already had five tumors. With the rate of growth of cancer, I had had it for a while, but as an alcoholic, I had avoided the doctor, because I Knew he was going to tell me to stop drinking. At that point in time, the little spot on my face, that was basal cell carcinoma, didn’t seem so big anymore. So, I had to say to myself that I had cancer, and what’s next. It didn’t happen that fast, but that’s how it all started for me.
BM: How disconcerting was it to be hit with a cancer diagnosis when you had not experienced any classic symptoms?
BL: It was the biggest shock of our lives. Carcinoma was the last word we thought we were going to hear. I use the word ‘alcoholic’ because the disease doesn’t discriminate. I am no different from the old man on the park bench with a bottle inside a paper bag, but nobody had ever related the cancer to the act of drinking to me. We have to also say that 2020 was the year of COVID, so things were a wreck in our world where to go to. It was like a big truck had hit me, and I didn’t get back for about a week, and like you said, no symptoms.
BM: By the way, we hope you will find the time to like and subscribe to our channel. If you click the bell icon, you will be notified anytime we post an interview. We also want to remind you we are not distributors of medical advice. If you or a loved one seek medical advice, please consult a licensed healthcare professional.
Beth, in terms of you contacting a licensed health care professional, here you were in Atlanta with no shortage of upper-tier health care facilities, and yet part of the equation, complicating the equation was COVID. How difficult was it to find the care you needed?
BL: Our world was so different back then. To complicate things, I had never been in a hospital before any of this. I had only gone to a hospital to visit someone. Like you said, we have such great facilities here. We have Emory and Piedmont. When you have cancer, you are thinking you need an oncologist, but with liver cancer and I am already under the care of the liver team in the transplant clinic, I was wondering what happens next. During COVID, one thing I can point out is that the communication was a little bit lacking. Sometimes you got your results online before the doctor told you. That is kind of a common practice today, but back then it was unusual. So, it was really hard, but I will tell you this: Through the entire situation, our health care workers that led us through that time are to be commended. Some of those nurses are my best friends now.
BM: It is good to know you had a good care team, but people will want to know, Beth, did you have treatment options?
BL: With liver, transplant is the only cure, if you even want to call it a cure. That was what we were looking at, but there were very strict guidelines. First they have to make sure the cancer had not spread. If you remove the diseased liver and replace it with a new one, then the cancer is gone; but if the cancer has spread to other organs, to the bloodstream, then you have problems to make sure that the cancer had not spread. We were happy to learn it had not spread. However, the tumors were still growing. Since I had so many tumors, surgery was not an option, but what they want to do was stabilize the cancer, or put it in hibernation, so that it will not grow anymore, and when the liver is removed, we all know the cancer has gone with it. So, that’s what they attempted to do was put my cancer in hibernation, which is not a medical term. Then we would move forward and get me on the transplant list,
BM: In terms of putting the cancer in hibernation, did that require chemotherapy?
BL: No. Chemotherapy is rarely used in liver cancer, and that’s from my experience with cancer patients now. What they did was a type of radioactive embolization called Y-90. Nowadays, there are many more options for treatment of liver cancer than in 2020, so for someone listening today, you do have a lot more options, but for me, these Y-90 procedures entailed taking live radiation beads and injecting them through your arteries in your wrist or your groin and inserting them into the tumors. For this process to work, you want the tumors to be at least 2cm. It is kind of common sense that if you put the radiation bead into the tumor, you want it to be large so that the healthy tissue around the tumor does not get damaged. At the time of diagnosis, my largest tumor was 1.87cm, so they told me I have cancer, but to go home and let the cancer grow. As a result, I had to wait three months for my Y-90 treatments to start so that my tumors could grow to 2cm.
BM: So, once the tumors grew and it was time for the Y-90 procedure, how difficult was it going through the procedure?
BL: The procedure was not bad at all. You’re actually awake throughout the procedure. It is the after-effects, to which people can relate with radiation. The procedure wasn’t bad, but the after-effects were tough. The dosage was very, very high and so my husband had to stay away from me for a few days. The funny part was that they told not to let any pets get close for ten days, which wasn’t easy because we have a couple of cats. I actually had two Y-90 procedures, four weeks apart. Typically, they do these eight to twelve weeks apart, so the amount of radiation collected inside me was quite high. For me, my biggest symptom was nausea, that and vomiting, but what you have to think about was not only the symptoms of my cancer treatment, but I was also suffering from the symptoms of liver disease, which included hepatic encephalopathy, which has been called a little type of dementia, so it was rough.
BM: So, you experienced all these things after you got home, yes?
BL: Yes. Each procedure was done in like two hours, but it was the after-effects that really, really lingered with me. At this point, I would estimate that I was about 70-75 pounds.
BM: Wow. And these post-treatment difficulties lasted for how long?
BL: The effects of the radiation stayed with me until April 2021 when I got the transplant.
BM: But eventually they did taper off , and against that backdrop, what was life like with a new liver?
BL: Oh my gosh. You know, I knew there was a difference right when I woke up in ICU. I always say the liver is the unsung organ of your body. It has over 500 functions and 100 different diseases that can attack it. As my liver started failing, different body functions began to quit working. When I woke up from surgery, I knew immediately that I felt better. My brain was clearer, and the hardest part was, I had to let my body catch up because my brain felt so great, but I was still so atrophied from the illness. After that, it was time for the skin cancer treatment.
BM: And what was the toughest part of that?
BL: The toughest part of that was the disfiguration to my face, to be vain. I am a girl that likes to look good. The skin cancer was on my temple. I ended up having to go back two inches and about seven layers deep to get all the cancer. My doctor did such a good job, you can’t see the incision. I never lost my hair during radiation, but the medicines they put you on, the immunosuppressants they put you on for life, those made me lose my hair. So, you could see everything. Mentally, emotionally, I was more scared of that than anything else because of my grandfather’s death of melanoma, but I was thrilled to hear the care team tell me, “We got it all.”
BM: As you look back, how does it feel to know that bout with skin cancer, liver cancer and cirrhosis is in your rear view mirror?
BL: Delighted and elated, of course. With my situation, it also comes with the guilt that someone had to pass for me to live because of the transplant part of the process. I do have to admit the first few months after my transplant, although I was cancer free, I had a really hard time, but as time went on, I used the word ‘survivor’ as much as I can. All survivors can say they have this extra notch on their belt. Life tried to throw us a curveball, but look what we did. It is our job to be out there and tell other people that there can be survivors and I think when you are going through cancer that the word ‘hope’ is probably the best word that you can hear, and ‘hope’ sounds different coming from another survivor than it does from a doctor.
BM: Beth, we want to circle back to your journey with liver cancer. If pre-diagnosis, you could say you were 100 percent, in terms of the here and now, how close are you to 100 percent?
BL: Can I use 150 percent? There is no comparison. It is night and day because the cancer invaded such a strong organ of my body and I didn’t know what was going to quit working next. I think I was sicker a lot longer than I actually knew because of the way I feel now. I never thought I could feel this good. I am going to turn 52 next month and I feel like I am 30. I still can’t run a marathon. I still can’t run a 5K, but let’s be clear. I didn’t want to do any of that before the transplant. The only thing that makes life difficult now is that I shattered my tailbone when I was sick due to the brittleness of my bones, so, and this is not a medical term, I am grouted back together with cement. That does cause me issues every now and again, but there is no question I am 1,000 percent above that baseline that I thought I had set for myself for the rest of my life.
BM: And how exciting is that?
BL: I wake up every morning, and I thank God and I thank my donor because I wouldn’t be here without either one of them. My biggest drive is helping other people going through cancer, specifically liver cancer because it used to be they didn’t have a lot of treatment, and when cancer was found, it was too late to do anything about it. Now we have so many more treatments and we have the diagnostic tools to catch it earlier as well. I am thrilled to be out there. I have jobs in which I have been able to go out there and travel make a lot of money, but from my job as an advocate, I am more passionate and happier and wake up every day and ready to go, more so than I did with a working job.
BM: Outstanding. Beth, we are going to wrap up now and when we do, we want to take some time to acknowledge a source of support for anyone diagnosed with liver cancer. It is the American Liver Foundation. If you would, tell us about what it has done for you and what it can do for others.
BL: The American Liver Foundation is a national organization. I mentioned earlier that the liver can be attacked by more than 100 diseases. ALF can support all of those diseases. They have a wealth of information on their website, which is https://www.liverfoundation.org, and they also host walks all across the country. So, if you go to the website, you can see if there is a walk near you. They have support group meetings and online information. I just encourage everybody to go to the site and take a look. If ALF cannot help you, it will find a way to help you.
BM: Beth, want to thank you very much for a story that is both informative and inspirational, and we are thrilled to hear that your life is at 150 percent, not just 100 percent. Thanks very much for being with us on Cancer Interviews.
BL: Thank you, Bruce. I appreciate you having me.
BM: And as we conclude, we wish to remind you that if you or a loved one are on a cancer journey, you are not alone. There are individuals out there like Beth Lehman, organizations like the American Liver Foundation that are there to help. So, until next time, we’ll see you on down the road.
Additional Resources:
Support Groups:
The American Liver Foundation https://www.liverfoundation.org
The Liver Circle https://www.thelivercircle.org
Beth’s Nonprofit:
SHOW NOTES
TITLE: Beth Lehman, Liver Cancer and Skin Cancer Survivor – Atlanta, Georgia, USA
Beth Lehman went through a tumultuous year in 2020. Thanks to heavy drinking, she was diagnosed with cirrhosis, then basal cell carcinoma, a type of skin cancer, followed by hepatocellular carcinoma, a form of liver cancer. She underwent radioactive embolization in order to get a liver transplant. Beth said the two-hour operation wasn’t so tough, but the after-effects were difficult, including nausea and vomiting. Then she experienced a procedure to get rid of the skin cancer on her right temple. She says between her physical and emotional recovery, she advocates cancer patients and is happier than ever.
Additional Resources:
Support Groups:
The American Liver Foundation: https://www.liverfoudation.org
The Liver Circle: https://www.thelivercircle.org
Beth’s Website: https://www.bethlehmanliver,com
Time Stamps:
03:40 Beth’s cancer journey began with a diagnosis of cirrhosis, after which doctors found liver cancer.
05:41 Because the diagnosis was preceded by no classic symptoms, it came as a shock.
07:28 Says getting treatment during COVID wasn’t easy.
09:40 Is asked if she had treatment options.
11:20 Beth said her treatment plan didn’t include chemotherapy, but did require radioactive embolization.
12:57 Describes Y-90 treatment.
15:13 Recalls what it was like living with a new liver.
16:37 Describes the toughest part of her skin cancer treatment.
18:05 Beth says it’s nice to think that she overcame cirrhosis, liver cancer and skin cancer.
19:50 She is asked how close her health is to what it was like before her diagnoses.
KEYWORDS (tags):
cirrhosis
liver cancer
hepatocellular carcinoma
y-90
hepatic encephalopathy
ascites
radioactive embolization
