Conversation: The conversation between human and AI assistant.
[|Human|] Hi Doctor, My name is Umanath Rayar...my dad was detected with Hepatocellular carcinoma last july and undergone a surgery in liver to remove the tumors, operated by a Gastroentologist at Apollo hospital, chennai in august 2012. Two months he felt better...three months after we went for review...during that time we found out that four more tumors were grown around liver and pancreas . He is 70 now and cirrhotic liver condition. Now he is under medication, taking nexavar tablets. His serum bilirubin level is 4 now. your suggestions Doctor?
[|AI|]  Hi. Well, you probably know how serious diagnosis is liver carcinoma, only more serious is when metastasis occur, and it obviously happened. Usually these tumors are seen during surgery, but it is possible that were grown in these 2 months also. Honestly, I have bad experience with such conditions. Usually we consider liver tumors' resection if we have 2 or 3 well-defined liver metastases which don't invade blood vessels , but unfortunately even when every tumor mass is removed, receives are often. Four tumors localized intra-abdominal, near pancreas in patient with liver cirrhosis...this is inoperable for me. And I don't think that any surgeon would reoperate this. Now he should follow oncologist suggestions, have some chemotherapy if possible. Everything else is palliative. Encourage your dad and be supportive.  Hope I have answered your query.