First, Maria Rivera noticed the fatigue. Next, she noticed the swelling in her stomach and the weight gain.
“I wondered what was wrong with me,” said Rivera, 48. “I thought my thyroid was going.”
A visit to her primary care physician in Southwest Florida raised other suspicions.
Her doctor was concerned about the swelling and pain in her abdomen.
“She pushed on my stomach, and it hurt a lot. She did some testing, and it turned out that I had liver problems,” Rivera said.
A follow-up visit to a gastroenterologist revealed the source: Rivera had end-stage liver cirrhosis. She was surprised by the January 2014 diagnosis because she never drank or smoked — two common risk factors for developing cirrhosis.
The advanced stage of her liver disease also placed her at a higher risk for cancer. Rivera’s gastroenterologist prescribed “strong medication” to keep her liver functioning and rechecked her every few months.
“He told me we had to keep a close eye on things because I could also develop liver cancer,” Rivera said.
Ultimately, his concerns proved correct. In May 2015, Rivera was diagnosed with liver cancer. Her only treatment option was an organ transplant.
“It’s really hard when you hear the word ‘cancer.’ Your first thought is, ‘I am going to die,’” Rivera said. “I have a lot of good people around me — my husband, children, sisters, sister-in-law, mother, nieces and nephews. I had so much love and support.”
Rivera’s gastroenterologist referred her to the UF Health Shands Transplant Center, where she was placed under the care of surgeon Mark W. Johnson, M.D., FACS, a UF College of Medicine professor of surgery.
Cirrhosis causes the liver to become inflamed and the tissue fibrous, making patients with the disease more prone to developing cancer, he explained.
To “zap” the tumor in Rivera’s liver, radiation was injected directly into the tumor — killing the cancerous lesion and a very small portion of the surrounding liver. Rivera received the one-time radiation in July 2015 and responded favorably to treatment.
“For that type of treatment to be effective, the tumors have to be relatively small and under a certain number. The cancer must also be limited to the liver,” Johnson said. “We follow up with patients for three months to make sure the cancer doesn’t return or get worse. Usually within the following six to 12 months, the person can undergo a liver transplant.”
In Rivera’s case, she received a liver nearly a year later, in June 2016. Transplants have become the standard of care for treating certain types of liver cancer, Johnson noted. Treatments range from curative resection to radiofrequency ablation and chemoembolization of the tumors.
Rivera said she is feeling much better since the transplant.
“Everything has changed,” she said. “I feel so healthy now.”
William Rivera said he was impressed by the level of care and attention his wife received at UF Health.
“Dr. Johnson was an amazing surgeon — so upbeat and positive. Every nurse and other team member we encountered was wonderful. They were so professional, and the quality of care was wonderful,” he said.
Her family is also grateful for Rivera’s second chance at life.
“I can’t thank Dr. Johnson and the rest of the care team enough,” said her son Michael Rivera, a UF junior and member of the Gators baseball team.
Pretransplant coordinators Melissa Kapp, ARNP-BC, and Amy Camire, B.S.N., R.N., and posttransplant coordinator Kortney Misamore, R.N., said Rivera’s courage and positive attitude were inspiring.
“Maria and her family were so gracious and so grateful to have a second chance,” Kapp said. “She will be able to see her children graduate college, get married and have children of their own.”
Added Camire, “It’s very rewarding to see Maria strive and thrive
— and fully appreciate her new life.”
April is National Donate Life Month. Register today to be an organ, eye and tissue donor at RegisterMe.org.