‘22% of my liver was removed’: Dipika Kakar on the test that detected her 11cm tumour

What exactly is a FAPI scan, and why are doctors increasingly considering it a promising advancement in cancer imaging?

According to Dr Puneet Gupta, Chairman- Oncology Services, Asian Hospital, a FAPI scan can play a critical role in understanding how far cancer has spread before surgery or treatment begins. “When a FAPI scan shows cancer confined only to the tumour, it usually means that the disease is in an earlier stage and that surgery is a better treatment option,” he explains.

However, he cautioned that imaging alone does not determine a patient’s prognosis. “In such cases, while outcomes usually get better, the prognosis still depends on multiple factors like the biology of the tumour and the overall health of the patient, and is not determined solely by imaging. FAPI primarily gives greater confidence with respect to the staging of cancer,” he said.

How does the liver recover after a portion is removed?

Dipika also revealed that nearly 22% of her liver had to be surgically removed to eliminate the tumour. While that may sound alarming, Dr Miglani says the liver is one of the few organs in the human body capable of regenerating itself. “The liver can regenerate itself due to the rapid division of its own cells, and can usually replace its lost volume and function.”

That said, recovery is still a delicate process and comes with possible complications. “There are potential risks, including bleeding, infection, bile leaks, and temporary liver malfunction. Ultimately, how well the liver heals depends upon the overall health of the remaining liver and the amount of reserve function prior to surgery,” he added.

What’s a FAPI scan/representational pic (Photo: Freepik)

Why are FAPI scans being called a breakthrough in cancer detection?

“FAPI scans measure the presence of cancer-associated fibroblasts as opposed to measuring glucose metabolism,” explained Dr Miglani. This difference, he said, allows doctors to obtain clearer images with less background interference.

“This provides an image with improved clarity due to having low background noise surrounding the tumour, resulting in higher tumour-to-background contrast, which assists in defining the tumour, particularly in cancers where FDG-PET does not perform well for detection,” he said.

Can cancer still remain hidden despite a clean scan?

“No, even with advanced imaging modalities like FAPI PET, microscopic spread of the disease can remain hidden,” Dr Miglani explained. “There may not yet be visually apparent disease spread at a cellular level. Therefore, it is common for physicians to combine surgery with other treatments or maintain close follow-up, even when there is no visible evidence of disease spread on imaging.”