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permanent liver damage from chemo, irinotecan may lead to increased mortality after liver surgery UPDATED

pete43lost_at_sea's picture
pete43lost_at_sea
Posts: 3915
Joined: Nov 2010

UPDATED COMMENTS

skip reading this post as it discusses liver damage from chemo that may result in death.

sorry about upsetting anyone, have made the title more accurate and put in a warning at the front.

again apologies for anyset caused by the original title not being specific enough.

I still hope we all make it and have a great day, but being informed of the risks and issues of our treatments is why I come here, as well as all the great support.

Now I am finished folfox, I am curious about my long term side effects peripheral neuropathy and impared liver function as my most recent blood test was the worst for liver function. I am also aware that the liver function numbers can indicate mets per surgeon. So I have been reading about liver funtion tests. This study came out of that research.

we all know death can result from chemo complications, the specifics of the nature of liver damage is what I am interested in. I wanted to raise awareness and to share what I have found, its what I have been reading about due to my oiwn impared liver. Now I know I am stage 3 and this study applies to stage 4. I thought the stage4 folks would be interested if they were not aware of the complications that can result from irinotecan.
this was a recent review as well.

from the study "Steatohepatitis, especially due to irinotecan, is associated with increased postoperative mortality. Sinusoidal obstruction syndrome, a severe form of vascular hepatic lesion, associated to oxaliplatin, seems to be linked with an increase of postoperative morbidity"

I am interested in trying to help my liver repair itself from oxaliplatin damage. I am aware of our livers amazing rebuilding capacities, and this demonstrates the serious damage chemo must be doing if it cannot recover from it.

I also take heart from my own liver friendly diet during chemo that I did my best to support this critical organ that gets worked very hard during chemo.

Realising the specifics of the possible liver damage that may result from oxilaplatin and or itinotecan may help some others do research into how to support their livers by diet, water or whatever they find. They will certainly be more aware of side effects and monitor and understand liver function tests more closely.

My own personal opinion is that while chemo has benefits its side effects are not explained in as much detail at the start. I would have liked to be clearly advised about liver function issues post oxaliplatin.

The sarcasm "the joy of chemo" is how I feel. We are dammed if we do, we are dammed if we don't. Maybe this is my way of venting some frustration at the realisation of the true nature of the damage oxaliplatin has caused. Now I am through the treatment I have the luxury to deal with side effects. especially now my gut has settled down.

ORIGINAL POST

the joy of chemo ????????????????
choose your poison carefully
not wanting to scare anyone but i thought this interesting......
will my slightly off scale liver results pickup ?
i have just been reading about the liver and chemo issues.
did anyones onc warn about these risks ???????

hugs,
pete

Bull Cancer. 2010 May;97(5):559-69.
[Hepatotoxicity of metastatic colorectal cancer chemotherapy: systematic review].
[Article in French]
Baumgaertner I, Ratziu V, Vaillant JC, Hannoun L, Poynard T, André T.
SourceService d'Hépatogastroentérologie, Hôpital Pitié-Salpêtriére, 75013 Paris, France.

Abstract
AIM: Hepatic toxicity of chemotherapy for colorectal cancer and its complications after hepatic metastasis surgery are unclear. Studies reporting hepatic lesions after chemotherapy for colorectal cancer and published before July 2009 have been identified by searching the Medline database. Data concerning these hepatic lesions and outcome after surgery are resumed in this review.

RESULTS: Studies concerning the link between hepatic steatosis and chemotherapy have contradictory results but steatosis is clearly associated to an increase of postoperative morbidity. Steatohepatitis, especially due to irinotecan, is associated with increased postoperative mortality. Sinusoidal obstruction syndrome, a severe form of vascular hepatic lesion, associated to oxaliplatin, seems to be linked with an increase of postoperative morbidity, but not mortality. Bevacizumab would not increase, when used in combination with oxaliplatin, the rate of postoperative complications. Some studies suggest a decrease of vascular hepatic lesions when bevacizumab is administered with chemotherapy. The literature concerning hepatic toxicity of anti-EGF-R antibody is freak.

CONCLUSION: The fact that irinotecan may be linked to an increased risk of hepatic failure and postoperative death, which is not the case of oxaliplatine, must be taken in consideration in the choice of the preoperative chemotherapy before resection of hepatic metastasis of colorectal cancer.

PMID:20167564[PubMed - indexed for MEDLINE] Publication Types, MeSH Terms, SubstancesPublication TypesEnglish AbstractReviewMeSH TermsAntibodies, Monoclonal/administration & dosageAntibodies, Monoclonal/adverse effectsAntineoplastic Combined Chemotherapy Protocols/adverse effects*Camptothecin/administration & dosageCamptothecin/analogs & derivativesColorectal Neoplasms/pathology*Fatty Liver/chemically induced*Fatty Liver/pathologyHepatic Veno-Occlusive Disease/chemically induced*HumansInfusions, Intra-ArterialLiver Neoplasms/blood supplyLiver Neoplasms/drug therapy*Liver Neoplasms/secondaryLiver Neoplasms/surgeryOrganoplatinum Compounds/administration & dosageOrganoplatinum Compounds/adverse effectsSubstancesAntibodies, MonoclonalOrganoplatinum CompoundsbevacizumabcetuximabpanitumumabirinotecanoxaliplatinCamptothecin
LinkOut - more resourcesFull Text SourcesJohn Libbey EurotextMedicalLiver Cancer - MedlinePlus Health InformationColorectal Cancer - MedlinePlus Health Information

Supplemental Content
Related citations
Review Patterns of chemotherapy-induced hepatic injury and their implications for patients undergoing liver resection for colorectal liver metastases. [J Hepatobiliary Pancreat Surg. 2009] Review Hepatic complications following preoperative chemotherapy with oxaliplatin or irinotecan for hepatic colorectal metastases. [Eur J Surg Oncol. 2008]
Review Hepatic complications following preoperative chemotherapy with oxaliplatin or irinotecan for hepatic colorectal metastases.
Morris-Stiff G, Tan YM, Vauthey JN.
Eur J Surg Oncol. 2008 Jun; 34(6):609-14. Epub 2007 Aug 30.Review Consequences of chemotherapy on resection of colorectal liver metastases. [J Visc Surg. 2010]
Review Consequences of chemotherapy on resection of colorectal liver metastases.
Pessaux P, Chenard MP, Bachellier P, Jaeck D.
J Visc Surg. 2010 Aug; 147(4):e193-201. Epub 2010 Jul 23.Review Chemotherapy-associated hepatotoxicity and surgery for colorectal liver metastases. [Br J Surg. 2007]
Review Chemotherapy-associated hepatotoxicity and surgery for colorectal liver metastases.
Zorzi D, Laurent A, Pawlik TM, Lauwers GY, Vauthey JN, Abdalla EK.
Br J Surg. 2007 Mar; 94(3):274-86. Predicting high grade lesions of sinusoidal obstruction syndrome related to oxaliplatin-based chemotherapy for colorectal liver metastases: correlation with post-hepatectomy outcome. [Ann Surg. 2010]
Predicting high grade lesions of sinusoidal obstruction syndrome related to oxaliplatin-based chemotherapy for colorectal liver metastases: correlation with post-hepatectomy outcome.
Soubrane O, Brouquet A, Zalinski S, Terris B, Brézault C, Mallet V, Goldwasser F, Scatton O.
Ann Surg. 2010 Mar; 251(3):454-60. See reviews...

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Clear Turn Off Turn On [Hepatotoxicity of metastatic colorectal cancer chemotherapy: systematic review]...
[Hepatotoxicity of metastatic colorectal cancer chemotherapy: systematic review].
Bull Cancer. 2010 May ;97(5):559-69.PubMedSinusoidal injury increases morbidity after major hepatectomy in patients with c...
Sinusoidal injury increases morbidity after major hepatectomy in patients with colorectal liver metastases receiving preoperative chemotherapy.
Ann Surg. 2008 Jan ;247(1):118-24.PubMedPatterns of chemotherapy-induced hepatic injury and their implications for patie...
Patterns of chemotherapy-induced hepatic injury and their implications for patients undergoing liver resection for colorectal liver metastases.
J Hepatobiliary Pancreat Surg. 2009 ;16(2):137-44. Epub 2008 Dec 18 .PubMedHistological liver injury and surgical outcome after FOLFOX followed by a hepate...
Histological liver injury and surgical outcome after FOLFOX followed by a hepatectomy for colorectal liver metastases in Japanese patients.
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KathiM's picture
KathiM
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Joined: Aug 2005

But in that time's treatment cycle, there were very few other options.

One of the best words of wisdom was to stay super hydrated, the day before, during, and after chemo...to flush the stuff where it didn't need to be...

Hugs, Kathi

(IMHO, death is the absolute LAST option, after all else has been exhausted....)

johnnybegood's picture
johnnybegood
Posts: 1122
Joined: Oct 2008

but i just went thru my fourth chemo treatment for recurrance mets to liver and lung so i am not in a good mood then i come on here for comfort and support and why must people on this board keep posting the statistics.if i wanted to know my statistics i would look them up myself.you know its so hard to live one day at a time with this beast apparently some people like to add feul to the fire.as i sit here typing this i am shaking because i never speak up like this on this board.thanks pete you just made my day...johnnybegood

John23
Posts: 1832
Joined: Jan 2007

There was a motto that adorned the top of the Long Island, NY
newspaper "Newsday" for years...... It said:

"Where there is no vision, the people perish".

Sometimes we can prevent permanent harm to ourselves when
we have the courage to follow our instincts, instead of just
following the crowd.

Knowing that some things can do permanent damage to the
human body, can be enough to question the validity of using
that product. When we know something is unsafe, our
natural instincts will indicate what our course of action should be.

We really oughta' listen to our "gut feelings" more often. We
should do what we have to, to lose the fear of having cancer
and fight it in any way we can.

Following "the crowd" isn't always best!

You'll do fine, don't worry.

Good health is on it's way!

John

maglets's picture
maglets
Posts: 2402
Joined: Jun 2006

ahhh sweetie....i could not agree with you more

you are not being rude and I think I know a little bit about your personality....for you to say....shut it off!!! is hard for you

don't read it then johnny...on with your chemo...lord knows it's hard enough.....

hang on kiddo.....do your chemo in good faith....I am miss liver and miss chemo and still here.....

mags....hug

pete43lost_at_sea's picture
pete43lost_at_sea
Posts: 3915
Joined: Nov 2010

hi johnny,

I am sorry my post was not really accurate enough, it was late when I posted it.

I am sorry my post caused upset for you. I was a little shocked when I read the study myself as I was not aware of the types of damage chemo does to my liver, or that our chemo's does to our livers. I come here for the support and the stats and studies. we all do research to a great or lesser extent, I have learned heaps the links and discussions here, this post was just away adding some science to the discussion.

apologies,

pete

John23
Posts: 1832
Joined: Jan 2007

Re:
"IMHO, death is the absolute LAST option, after all else has been exhausted...."

In -my- opinion, death should -never- be considered as an option.

There is so many alternatives to try, that it continues to puzzle me why
so many confine their weapons of choice to the "industry's answer" to
the fight against cancer.

Death, is the industry's idea of an "option"; I refuse to buy into that concept!

I wish I could convince others to abandon the idea that death is the
only other option to "mainstream pharma"; There are other options.

Stay well; stay alive!

John

KathiM's picture
KathiM
Posts: 7878
Joined: Aug 2005

I said "after all else has been exhausted"....

That includes a myriad of stuff that goes beyond pharma....

But, having dealt with death alot in my life, I also know that it is part of life. While I will do nothing to hasten my own passing (Note the 'do nothing to hasten' such a taking my own life...my life is too precious to me), I have no fear of it, and will embrace it at the time that is right for me.

Hugs, Kathi

Buckwirth's picture
Buckwirth
Posts: 1272
Joined: Jun 2010

Thank you, there is beauty in what you say.

Blake

pete43lost_at_sea's picture
pete43lost_at_sea
Posts: 3915
Joined: Nov 2010

Hi Kathi,

I have changed the title to be more accurate.
Thanks for mentioning "staying super hyrdrated".

hugs,
pete

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geotina
Posts: 2053
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Thanks for changing the title of this thread. The old one cut like a knife but I know today you meant no harm or insensitivity.

Much of what you posted I already knew and I will agree that knowledge is key in treatment and options.

Thanks - Tina

Buckwirth's picture
Buckwirth
Posts: 1272
Joined: Jun 2010

Could you consider deleting this thread? While mildly interesting, it adds nothing to the pertinent conversations of treatment hope and options for those with metastatic disease (something you do not yet have).

Thanks,

Blake

John23
Posts: 1832
Joined: Jan 2007

Blake -

Actually, if one was about to take irinotecan, this topic should
be of great value!

Re:
"CONCLUSION:
The fact that irinotecan may be linked to an increased risk of
hepatic failure and postoperative death, which is not the case of
oxaliplatine
, must be taken in consideration in the choice of
the preoperative chemotherapy before resection of hepatic
metastasis of colorectal cancer."

Why take something that may cause death or irreparable harm,
if there's something else to take?

Best wishes,

John

Buckwirth's picture
Buckwirth
Posts: 1272
Joined: Jun 2010

But the study had to do with irinotecan *pre* liver surgery, so the list is much smaller than you, or Pete, propose.

"Why take something that may cause death or irreparable harm,
if there's something else to take?"

I don't know John, what is this list of other things we can take? I think you narrowed it down when you posted this:

"Apricot seeds, Oxygenated water, Colloidal Silver, Coral Calcium,
the list is near endless. Time and money is spent on totally unproven
schemes, while valid options are disregarded. I can't figure it out...
What's happened to common sense?"

And you narrowed it further when you posted this:

"And there are so many quack medicines and practitioners, all
trying to capitalize on those that need real help; It's sickening."

Not that I don't agree with what you say, but for someone without metastatic disease, you have a lot of opinions about what those with metastatic disease should or should not be doing.

John23
Posts: 1832
Joined: Jan 2007

Re:
"I don't know John, what is this list of other things we can take?
I think you narrowed it down when you posted this:"

You apparently did not read the "conclusion" in your haste
to be argumentive.

Please read that "Conclusion" again to understand what the
"other thing" to take is.

Thanks, and good health to you.

John

Buckwirth's picture
Buckwirth
Posts: 1272
Joined: Jun 2010

Not that I don't agree with what you say...

John23
Posts: 1832
Joined: Jan 2007

I missed this remark the first time around!

Re:
"Not that I don't agree with what you say, but for someone without
metastatic disease, you have a lot of opinions about what those
with metastatic disease should or should not be doing.
"

Man, Blake.... You sure are brutal !

So you'd prefer to have separate forums set up to accommodate
cancer victims by what? Stage? Or by how far the cancer's travelled?
What exactly should be required?

Did your oncologist have cancer? Is your oncologist presently
suffering with a metastatic cancerous condition? If not, why should
that physician be giving you advice?

A little OT, but to explain a thing or three:

I considered myself a stage 3c, because my 1st oncologist said
that it's what I was. The second onco, the surgeons, radiologists,
etc, etc said I was a stage 4...... That was back in 2006. So I
considered my stage a 3c, since that gave me a better shot.
Hell, I'm no fool. If I have a chance to do better, I'll grab
that golden ring before it passes by; 3c it was! It was a toss-up,
and I chose the lesser of the two evils.

My rude awakening came in Jan of 2011, when an oncologist
I never met before, was at the foot of my hospital bed. She was
telling me that I wouldn't live out the year unless I did chemo;
that not many stage 4 victims make it that long, even with chemo,
but at least chemo will give me a chance.

She told me she had two stage 4 patients presently, that have
lived almost two years so far, thanks to chemo treatments.

I asked what changed my stage from a 3c to a 4? She looked
at the records she was holding, and noticed that she was looking
at the wrong records. She thought my 2006 operation was what
just occurred in Jan 2011.

She said that I apparently was a stage 4 from 2006. Imagine that?
She thought I had been operated on in 2011 and had a major
tumor removed, and would need chemo if I expected to live a year.

After she regained her composure, she said that it would be
beneficial for me to get chemotherapy treatments now, anyway.

So even though they had said I had cancer throughout my lovely
bod, they didn't hand me proof. Consequently, I can't offer you
proof either. But I do now acknowledge the fact that I had been
a stage 4 and didn't have much time to live. I guess I'm just one
helluva lucky guy, since we don't believe in alternatives around
here, right? Well, you've just given me reason to feel the same!

Blake (and others), don't allow cancer to scare the hell out of you.
You have a right to live, and a right to use whatever means will
provide you with a continuance of life.

But be careful about taking what might kill you, in your effort to
stay alive.

And -that- my dear Blake, was the point of Pete's post, and
the dialog held within it's text.

"It doesn't have to make you sick to make you healthy."

Stay well,

John

Buckwirth's picture
Buckwirth
Posts: 1272
Joined: Jun 2010

Your story is interesting, and I understand why your Oncologist in '06 recommended chemo and feared stage 4. The problem is, the dx of stage 4 requires some kind of metastasis, and in all your stories (you've posted it many times, though I do like the new wrinkle from January) you never had any. Yes, you probably should have, but you did not.

The Oncologist in January needs to work on her bedside manner. Without any organ metastasis my doctors see no reason I have a two year expiration date, they actually think I have a really good outlook. It sounds like she made a faux paus and could not figure her way out of it.

OTOH, she only had two patients that had made it two years? Maybe she needs to get into another profession...

We actually had this whole conversation once before (minus this bit from January). I look at your case, as you reported it, and I see someone who had a close call with the grim reaper. Someone who was saved by an unusually lucky surgeon. In other posts you have actually said the same.

I also see someone who fits the definition of stage 3, not stage 4.

Maybe your tea (I know, its not tea) made a difference. Maybe it kept those loose cancer cells from settling in a new home and going about their business of endless division.

You are lucky John, and I envy you that luck.

On the issue of separate forums: No. There are more similarities to our disease than differences. That does not change the fact that treatment is determined by stage, and the treatment for stage 4, while similar, is different from the earlier stages. Our choices are fewer. None of those choices is easy, and we look for the best information we can. You have a path, others may share it. I have a path, others may share that. Neither of us believes that those paths are equal.

Your path may be the right one, but it is not mine and never will be.

As to Pete's post, well you are kinder to him than I am.

John23
Posts: 1832
Joined: Jan 2007

Re:
"the dx of stage 4 requires some kind of metastasis, and in
all your stories (you've posted it many times, though I do like
the new wrinkle from January) you never had any. "

If you've read my bio as you've claimed, you should have noted
that back in 2006, I had 7 out of 28 nodes testing positive. And,
the tumor grew out through one section of colon, and into an
adjoining section. And yes, I preferred to think of it as a "3c".

By the way, I really hated to join your discussion, since you seem
to have a habit of deleting/editing your posts, leaving an answering
party looking a bit foolish (answering what doesn't exist).

All of this banter is very OT, and of no concern.

The point of the article that Pete posted here, is a very good read
and should not "scare" anyone. All chemotherapy is toxic, and we
all know that (or we all should know that). It's unfortunate when
an oncologist does not make all the information available so the
patient is able to make an informed choice.

Making an informed choice should not be "an option", it should
be a requirement. When one if frightened, it is easy to run into
blank alleyways, but when one can think clearly, they can make
better choices for their survival.

The choice is -not- limited to "mainstream medicine or alternative",
it is also knowing what will cause damage or death, and what will not.
It is the ability to know what medication to choose, or deny,
regardless if it's "mainstream" or an alternative.

Some of the chemotherapy used today, is being used arbitrarily
by too many physicians.

With that in mind, why should anyone accept taking a dangerously
toxic chemical that may cause irreparable harm, when it may not
be needed at all? They can't make an educated choice if they
don't know about the possible irreparable harm.

It's threads like this one posted by Pete, that can provide a newly
diagnosed cancer patient with the arsenal needed to properly question
the physician.

All people have the right to choose their medical care. Not providing
enough information about a specific form of care, is denying a person
of that right to make an educated choice.

I'm glad Pete didn't delete this thread. It's informative, and needed.

Best wishes, as always.

John

Buckwirth's picture
Buckwirth
Posts: 1272
Joined: Jun 2010

I am going to keep this short.

"By the way, I really hated to join your discussion, since you seem
to have a habit of deleting/editing your posts, leaving an answering
party looking a bit foolish (answering what doesn't exist)."

1. I would prefer you did not. I think I actually told you in a PM that I would refrain from responding directly to your posts (in this case, you started the response chain)

2. It is true I have edited posts, never to make someone look foolish, just to correct spelling errors (the iPad has a nasty habit of changing your words) and sometimes to add something. Never to change the meaning of a response.

3. I have also deleted threads (you cannot delete a post). No way for that to make anyone look foolish except me.

With that I am done. You can PM me if you wish, but I will not respond to anything in a thread.

Health to you as well John. Whether you realize it or not you have my respect, and, if we were closer, you are someone I would enjoy having lunch with.

Blake

pete43lost_at_sea's picture
pete43lost_at_sea
Posts: 3915
Joined: Nov 2010

Hi Blake,

I'd prefer to leave the updated post stand.

The fact that irinotecan can result in death in stage4, some are lucky to .

I believed anyone wanting to make an informed decision would already know.
otherwise they should.
If some here don't want to be informed, thye can just skip reading the post. I put a skip notice at the front.

As a stage 3, I find what may lay ahead immensley interesting and helps me with my
anticancer diet and treatments.

Pete

geotina's picture
geotina
Posts: 2053
Joined: Oct 2009

Talk about taking away hope to those with metastatic disease.

Most research the drugs they are taking. Sometimes options are limited.

"Death is an Option" was that really necessary, those with Stage IV disease simply do not think death is an option, most will take chemo, alternatives, whatever they can to keep death from knocking on the door.

Tina

maglets's picture
maglets
Posts: 2402
Joined: Jun 2006

amen Tina.....let's try to support Johnny....this really does not help

ok say I have my head in the sand....don't care!!!!

sorry...mags

GaryinUK
Posts: 63
Joined: Feb 2011

I am the partner of a cancer sufferer, he had mets to the Liver when diagnosed, after his liver was resected , all was well for a shortwhile before a single spot was spotted on the liver after a course of 5FU.
A course of 5FU and Irinitecan followed, CEA started creeping up, it was just 1.2 when the 'spot' was discovered. After the course, the liver had more lesions, inoperable and spread to peritoneal cavity.
Now I have asked why they gave him the full course when the CEA indicated it was not working, now I think I will ask for more answers.
If I had known this would he have agreed to have Irinitecan, no, probaly not. Now he has few options through what they consider normal treatment, he had a terrible trial experience and so we are about to try MCP, we use Arteminsin, but perhaps not a dose that may have an impact.
The entry Pete made is not wrong, it is not distressing, no one has to read it, it is informative and having read a lot of comments on different subjects it fits right in.

Everyone has opinions and some on this site have more and stronger than others, but that does not make them right. Though I do enjoy reading them where there is 'conflict', is that the right word? Discussion, an exchange of views may be better.

If I did not want to read about potential treatments, experiences, opinions, seek support, express my views, I would not be on here.

Pete, thank you, leave it on in my opinion, we should not be afraid to challenge, inform, support, advise, it is what drew me to this site.

Then again this is my opinion, I may not be right, but this time I thought I would give it.

Gary

pete43lost_at_sea's picture
pete43lost_at_sea
Posts: 3915
Joined: Nov 2010

hi gary,

sorry about your partner. I appreciate your comments.

Pete

jjaj133's picture
jjaj133
Posts: 857
Joined: Mar 2011

Oh, this must be the "sometimes we disagree part"? Mags, mind if i join you in the sand?
judy

Buckwirth's picture
Buckwirth
Posts: 1272
Joined: Jun 2010

like the idea of just deleting the thread. Another could be started that was more appropriate.

Like all good families we spat sometimes, and get on each others nerves. And like all good families, we still love one another.

Thanks for changing the title Pete, and I hope you don't ever join the metastatic club.

pete43lost_at_sea's picture
pete43lost_at_sea
Posts: 3915
Joined: Nov 2010

This discussion has been confronting than I imagined and went off in a direction I did not anticipate.

I hoped for a detailed discussion of liver enzymes and alt ast ggt etc etc. people's real liver experiences in the aftermarth of chemo.

All the replies I value.

I guess even talking about the liver damage is too much for some of us to discuss. Obviously I was searching for clues, suggestions to improve our treatments.

But our posts are like children, we create them, bring them up and they go on their own way.

I did not fully appreciate what stage4 meant with regard to permanent liver damage until this thread. I am more grateful I don't have it. I have more empathy for those that do.

I imagine many stage3 would be like myself, our onc's don't tell us what really may lie ahead.

We have such a wide range of opinions and experience and thats our real strength.

We have to be able to peacfully tell our stories and ask for help.

Thats why I added the context in detail.

hugs,

Pete

pete43lost_at_sea's picture
pete43lost_at_sea
Posts: 3915
Joined: Nov 2010

hi mags,

my head is in the sand often as well.

its only when I pull it out of the sand, I get into trouble.

if we cannot share the results of our research here, then where ?

do we have to rely on our doctors 100%, I posted this post to see what we know about the liver.

the good the,
the bad,
the ugly.

hugs,
Pete

pete43lost_at_sea's picture
pete43lost_at_sea
Posts: 3915
Joined: Nov 2010

Tina,

I have changed the title and made it more accurate. My title description should have been better. Already apologised and fixed it. After all this study is very limited and pretty specific. it should not take away hope from stageIV.

The studies value is some descriptions around permanent liver damage due to colorectal cancers chemos. I wanted to see if anyone had specifics about liver damage and how repair. maybe how they recovered. I have heard from a few it can take a year for liver funtion tests to improve.

Hopefully awareness of the chemo risks, if they were unaware may help us make more informed choices re chemo, diet and alternatives.

Pete

jjaj133's picture
jjaj133
Posts: 857
Joined: Mar 2011

Hey Pete, the good news is that i didnt understand half of what it said. The bad news is what i did understand scared me simple. The better news is that facing resection and chemo again, if the onc. mentions that irinotecan----- to me i will say no.
I am sending hugs to ya,
Judy

maglets's picture
maglets
Posts: 2402
Joined: Jun 2006

oh I'm sorry...really I try not to be combative

I feel a little protective about younger hurting people..

doing chemo ...trying to get on..it is all so hard

sure this is a forum for info...no prob...let's not fight......

post whatever

mags

maglets's picture
maglets
Posts: 2402
Joined: Jun 2006

ok here's the deal....i cannot even believe that anything I said would raise an eye

first I am a mother...second a teacher....therefore i just want to protect those in pain...johnny and I went through our first round together and I am just being protective...

I really really do not seek to argue here...but sometimes stats maybe are not so helpful...just sayin...

as I said post what you will....but hold on to others going through chemo also...

mags

pepebcn's picture
pepebcn
Posts: 6352
Joined: Aug 2010

This is just an study just think about ! How many stage 4 had been operated after been treated with oxy or folfiri? MOST OF THEM since there is no other choice, so what are we talking about? What means an increase of mortality if all of them have been treated with those drugs.An increase of mortality compared with? Most of you know that stage 4 means not only distant metastasis, but in most of cases not candidate for surgery unless you achieve a reduction of the tumor, and how to achieve a reduction of the tumor?As per I know only through two ways , oxy or irinotecan. Please don't mention immune clonal antibodies as they are given as complementary therapy together with chemo or alone as maintenance chemo but not as first line treatment!.This is just one between millions of studies about cancer that's all, it sounds a kind of " secondary effects " prospect. Did you ever read a prospect of an aspirin ? did you ever read a prospect of Tylenol ?. Well , once that said l hope this don't become another fight in this board, so let's continue arguing about but with friendly manners as we are doing until now!.Once that said ( again ) congratulations to Pete ,Maglets ,Anne and any other member of the commonwealth of nations , you got a nice show tomorrow! LOL. ( just a bit of fun in such an stressing thread) .
Hugs every body!

maglets's picture
maglets
Posts: 2402
Joined: Jun 2006

thank you pepe...just going to bed now....here in canada..it is 8pm....the wedding for us will be at 5ish...so for preamble...getting up at 3am

you lucky thing....you can watch in real time...

so much for being colonial...:) :)

wolfen's picture
wolfen
Posts: 1190
Joined: Apr 2009

Thank you for supporting Johnnybegood. It is extremely hard to think you have beat this thing and then soon afterward it comes creeping back on you in full force.

Thank you also, Pepe. Perhaps the key "thought" here is that this is a just a study and results do not apply to everyone. I understand that Irinotecan is used in place of Oxi as Oxi may no longer be appropriate for the patient.

My thoughts are of course of everyone here, and especially for my daughter, Johnnybegood.
I have seen a lot of posts on the board telling new people not to read statistics. Some may be old statistics and some may be too frightening for people. Perhaps this should be one of those times.

And Pete, I think you meant well. I confess that I did not read the entire post because like Judy, I would not have understood all the technical jargon.

All take care,

Wolfen

pete43lost_at_sea's picture
pete43lost_at_sea
Posts: 3915
Joined: Nov 2010

I must have put my foot in it this time.
I am not this interested in the wedding but I hope they have a great nmarriage.

About tylenol, well apparrently in one the many liver papers I was reading its abuse was one of the major causes of liver failure.

hugs,
Pete

Scambuster's picture
Scambuster
Posts: 975
Joined: Nov 2009

Pete,

You may want to read up on Silymarin = Milk Thistle Extract, a known agent for regenerating liver cells. Used for acute liver damage from people over dosing on Paracetamol. Also used by Hepatitis C sufferers / survivors. It has been used for several hundred years. Now available in convenient caps.

There is plenty of information out there. Definitely worth a look and one to add to the arsenal.

Regds
Scam

pete43lost_at_sea's picture
pete43lost_at_sea
Posts: 3915
Joined: Nov 2010

hi scam,

been on milk thistle daily since dx june 2010.
i was still after any other liver suggestions.

pete

Erinb
Posts: 295
Joined: Apr 2010

Thanks for the info.
Erin

pete43lost_at_sea's picture
pete43lost_at_sea
Posts: 3915
Joined: Nov 2010

hi gracie,

thanks for the comments and have a nice break.
the unkind comments here, they are not so subtle.
its almost cyber bullying. thank god we are a community and not
dominated by one persons opinions.

hugs,
pete

pete43lost_at_sea's picture
pete43lost_at_sea
Posts: 3915
Joined: Nov 2010

hugs
pete

Kathryn_in_MN's picture
Kathryn_in_MN
Posts: 1258
Joined: Sep 2009

"CONCLUSION: The fact that irinotecan may be linked to an increased risk of hepatic failure and postoperative death, which is not the case of oxaliplatine, must be taken in consideration in the choice of the preoperative chemotherapy before resection of hepatic metastasis of colorectal cancer."

This sounds like good information to be aware of if you are getting irinotecan before liver resection - especially if you seem to have other trouble with your liver. I'm on irinotecan, but my liver labs are fine. And I don't have liver mets, and am not planning a resection, so this doesn't apply to me. But if it did, it would be just one more piece of information I would use in making treatment decisions. I would likely discuss the pros and cons of using oxaliplatin instead with my oncologist before making that decision.

I really truly do not understand why posting research outcomes is not ok to do here? since when is ignorance the best way to deal with cancer? Has this turned into nothing but a blowing sunshine up your butt site? Is this site only for emotional or spiritual support?

You know what? While I appreciate any form of support, I see the reason for a board specifically dedicated to COLON CANCER to be having facts and information about the disease and treatments. What is wrong with being educated? How can people make the BEST possible decisions without having all the facts?

I'm stage IV, but don't have liver mets right now. I am on FOLFIRI (and Avastin). Still if someone posted a paper about negative impact of irinotecan for someone with their cancer spread to distant lymph nodes, I wouldn't take offense. I wouldn't expect them to remove the post. Are we really supposed to stop and figure out what everyone's staging and treatment protocol is here, and not post anything negative found in research that might apply to every person?

I wish only the best for everyone fighting this awful disease. I'm right in the thick of the battle myself. But I don't think we should be censoring posting FACTS that might help someone, just because it might upset someone else. And I don't think any of us should be asking for that to be done for ourselves, our family members, or friends. Supporting each other is one thing. Asking for censorship and ignorance to facts in the name of supporting someone is quite something else. Turning this into something akin to children's playground rules is ridiculous for a site for adults for a very serious disease.

Thank you Pete for posting facts that you found while researching a subject important to you. I'm glad you don't actually have to worry about these facts since you have no liver mets and are not having liver resection. I hope your liver bounces back soon.

pete43lost_at_sea's picture
pete43lost_at_sea
Posts: 3915
Joined: Nov 2010

hi kathryn,

your comments are like gold, i have been attacked here enough, albiet very polite and subtle.

my intentions with this post were strictly honourable and aimed at education and discussion
of anyone interested.

i don't like being abused by pm. so your kind and appreciative words i value.

i wanted to talk about liver damage and our chemo, its what i am experiencing. this study had the buzz words is relevant and the citations are enough to educate anyone who is interested.

i hope my liver bounces back.

good health to you,

pete

pete43lost_at_sea's picture
pete43lost_at_sea
Posts: 3915
Joined: Nov 2010

how to minimise folfox liver damage with adomet

game set and match to good quality research and patience

another food supplement that our doctors have not advised about.
http://en.wikipedia.org/wiki/S-Adenosyl_methionine

this post has been flagged, if it gets deleted so does one medically approved treatment to minimise liver damage while on folfox. see the trial data.

its too late for my liver my folfox is finished.

consider the livers saved by this thread, adomet means less drop off folfox and goto more dangerous chemos. just think about it.

cheers all

pete

The role of S-adenosyl methionine in preventing FOLFOX-induced liver toxicity: a retrospective analysis in patients affected by resected colorectal cancer treated with adjuvant FOLFOX regimen.
Vincenzi B, Santini D, Frezza AM, Berti P, Vespasiani U, Picardi A, Tonini G.
SourceUniversity Campus Bio-Medico, Medical Oncology , Via Alvaro del Portillo 200, 00128 Rome , Italy +39 06 225411123 ; +39 06 225411208 ; b.vincenzi@unicampus.it.

Abstract
Background: Hepatic toxicity is often related to chemotherapy agent administration, and it represents one of the principal causes of dose reduction and chemotherapy delays or discontinuation. S-Adenosyl methionine (AdoMet) supplementation is effective in the treatment of a variety of liver injuries, but it has never been evaluated in the prevention of chemotherapy-induced liver damage. Patients and methods: A total of 105 patients affected by resected colorectal cancer (CRC) were enrolled. Forty-five were treated with FOLFOX IV adjuvant regimen without administering AdoMet, 60 were treated with the same regimen plus supplementation with AdoMet. Liver enzyme levels were assessed before starting the treatment and every therapy cycle. Liver toxicity, chemotherapy course delays, discontinuations and dose reductions due to liver toxicity were recorded. Results: Aspartate aminotransferase (AST) (p < 0.001), alanine transaminase (ALT) (p = 0.003), bilirubin (p = 0.04) and gamma-glutamyltransferase (γ-GT) (p = 0.002) median level at the end of adjuvant therapy were significantly lower in patients treated with Adome. Patients supplemented with AdoMet experimented a lower grade of liver toxicity (p = 0.002) and had a reduced need of course delay (p < 0.0001) and dose reduction (p = 0.031). Conclusions: The results of our study demonstrate a protective effect of AdoMet supplementation in patients affected by resected CRC treated with FOLFOX IV adjuvant regimen.

PMID:21406026[PubMed - in process]

Nana b's picture
Nana b
Posts: 2837
Joined: May 2009

I didn't read all these posts, but I am stage !V and a big girl. Nothing you can say frightens me. I am living each day as though I am healthy and if death knocks on my door, well so be it! It is what it is. Smiles and Laughter....Raquel

Thanks for all the information, it's good to know....knowledge is good.

pete43lost_at_sea's picture
pete43lost_at_sea
Posts: 3915
Joined: Nov 2010

hi raquel,

i have to work on my expression, sometimes i am to blunt, or the meaning gets lost.
but the studies are cut and pasted and really speak for themselves.

hugs,
pete

herdizziness's picture
herdizziness
Posts: 3395
Joined: Apr 2010

Knowledge is good!!!
Winter Marie

Kenny H.'s picture
Kenny H.
Posts: 503
Joined: Aug 2010

Thanks for the info posted on this. My liver enzymes count went bad also (after 12th rd) hoping goes back down in a couple months. Had no idea about some of the possible ways to counter-act it.

pete43lost_at_sea's picture
pete43lost_at_sea
Posts: 3915
Joined: Nov 2010

hi kenny,

i am starting adomet tomorrow, will let you know the results.

would you mind posting or pming your liver numbers and i'll send you mine.

cheers,
pete

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