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LFT for advanced PCa

Fleet Foot
Posts: 15
Joined: Feb 2021

My GP has ordered yet another blood panel for me because for the last two tests my AST levels have been higher than normal.  I think he thinks I either drink too much or am a drunk!  I had a total of four glasses of wine in the last six weeks in between tests.  The AST still went up a couple of points.  Does anyone out there know if this same standard blood panel would show that my PCa has metastasis to my liver or bones?  Or should I suggest to my GP or urologist to order an LFT blood panel, that I understand might indicate metastasis?  Thanks in advance.

Josephg
Posts: 296
Joined: Jan 2013

Folks more experienced than me is this area will reply and offer suggestions to you.  In my lay opinion, data from blood tests alone is not a conclusive indicator of PCa metastisis.

My concern in replying to you is that in my lay opinion, you should not be the one to be suggesting testing procedures to your medical professionals.  If they are doing their job correctly, they should be the ones recommending specific tests to you, based upon existing data on you and their collective medical experience.  If you are not comfortable with what your current medical professionals are doing, or not doing, then perhaps it is time for you to seek the advice of another set of medical professionals.  Trust is essential to a good doctor-patient relationship.

If you have metatastic PCa, or if you suspect that you may have metatastic PCa, then in my lay opinion, you should be consulting with a Medical Oncologist, as they would be most qualified to give you sage advice and direction, regarding treatment options and alternatives.

I wish you the best of outcomes on your PCa journey.

Georges Calvez
Posts: 542
Joined: Sep 2018

Hi there,

A raised AST level can indicate all sorts of things, really it is a flag that an experienced medical practitioner should use to order further tests, I doubt that anyone would try and make a firm diagnosis on the basis of that alone. I suppose that it could indicate metastases to the liver, but they are a long way down the list of possible reasons.
https://www.webmd.com/a-to-z-guides/aspartate_aminotransferse-test#1

Best wishes,

Georges

Clevelandguy
Posts: 702
Joined: Jun 2015

Hi,

I don't know of any blood tests to see if Pca has spread to your liver or bones. A PET scan is good for picking up metastasis.  I don't think an LFT test will tell you if the cancer has spread.  From what I know LFT can show various types of liver damage but not cancer.  I have included links you might want to read.

https://medlineplus.gov/lab-tests/ast-test/

https://www.mayoclinic.org/tests-procedures/liver-function-tests/about/pac-20394595

 

Dave 3+4

Georges Calvez
Posts: 542
Joined: Sep 2018

Hi there,

An elevated calcium and alkaline phosphatase level is indicative of bone metastases, but this is a pretty crude test, if you have a couple of small ones then they could be normal.
I find that my doctors are very amenable to reasonable requests as long as they have some supporting evidence.
https://www.rogelcancercenter.org/bone-metastasis/diagnosis

Best wishes,

Georges

amdenver
Posts: 18
Joined: Dec 2020

This new PSMA-PET scan may be an option for you, if you're in their area, or have travel feasibility.

They ask for a referral from your Uro, or Oncologist, and 6 months of medical history, to be sent to them from your physician. Current (upfront payment) cost is $3300 which your health insurance may or may not cover.

https://www.uclahealth.org/psma

Hope this helps and wish you well for your PCa journey.

VascodaGama's picture
VascodaGama
Posts: 3390
Joined: Nov 2010

FF,

In another thread of yours you were concerned with the possibility in having PCa recurrence due to high triglycerides levels in spite of having an undetectable PSA. Here you go further by thinking that your high ALT is indicative of PCa metastases in liver. I think that you are allowing your mind mimicking causes to justified the PSA as faked  and are blaming the statins as the culprit for the good results.

You need to trust the PSA results and follow the opinions of your oncologist/surgeon. After all, PCa metastases wherever they are located produce PSA serum that would increase with growing spreading tumors.

High levels of liver blood markers can be related to many causes in substances metabolism or due to the lack of proper functioning of other organs, particularly the kidneys. You can order an LFT blood panel, together with other blood tests repeating the PSA, the Testosterone and T4, and check the kidneys (24hours urine test), if that gives you peace of mind. 

Your signs of fragility may derive from your experience with the cancer case of your daughter. In your “about me" page you commented to have experienced  “sissy cancer”. The  situation is different. Get the strength to overcome this moment of anxiety. 

Best wishes.

VGama

 

 

Fleet Foot
Posts: 15
Joined: Feb 2021

VGama, et.al.,

 

You're absolutely correct.  I am effectively driving myself nuts worrying about my PCa metastisizing.  I know that, but can't seem to help it.

I should have the answer by mid-March. My GP did agree with me though.  He's scheduled me for a hepatic panel on March 9th.

I was told by my Lab Tech wife (of 53 years) years ago that if I didn't take charge of my own health no one else would.  I think I may overthink things in the process.

Thanks again for your input.

 

 

Deadstick
Posts: 5
Joined: Jan 2021

Hi Fleet Foot,

You didn't say what your present PSA was or your present condition, but if your PSA is over .2, you could look into getting a PSMA PET scan.  This sensitive scan can pick up prostate cancer anywhere in the body even at low PSA levels.  At the present time, this test has only been FDA approved in California at UCLA and UCSF.  There are other sites in the USA that you can explore that are being done as part of a study.  I believe that UCLA and UCSF will accept Medicare and it's possible other sites may as well.  PSMA scans have been in use in Europe and other countries for several years.  See this link for the UCLA site:  https://www.uclahealth.org/psma        Also see:

https://www.fda.gov/news-events/press-announcements/fda-approves-first-psma-targeted-pet-imaging-drug-men-prostate-cancer

 

In the USA, Axumin scans are apporved, but your PSA needs to be higher (>5) for a reasonable detection rate.  This test is NOT as good as a PSMA scan but is usually covered by insurance.

 

If your PSA is already high and mets in suspected, you could look into a FoundationOne CDx blood test that may be able to locate prostate cancer circulating DNA in your blood.  It would be best to get a genetic test first.  See this link:   https://www.fda.gov/medical-devices/recently-approved-devices/foundationone-cdx-p170019s015

Also, see this link for a newer urine test to detect prostate cancer:  https://www.exosomedx.com/

My opinion would be to pursue the PSMA scan first.

 

The best to you...hang in there..

 

 

 

Fleet Foot
Posts: 15
Joined: Feb 2021

Dead stick,  thanks for your wealth of info.  Like I touched on above, I'm driving myself nuts with blood results I've never had before thinking (with some justification) that they might be indicators of recurrent PCa.  Semi- annual PCa blood tests have all been virtually undetectabl so I'm coming across as unjustifiably paranoid.  While I do have an hepatic panel test coming up on March 9th my next PCa isn't until the 17th of May.  I had read here recently about the PET scan, which I will mention to my urologist should the PCa blood work come back unfavorably as well as the urine test you mentioned - which I had never headd about previously.  Thanks again.

Max Former Hodg...
Posts: 3690
Joined: May 2012

Fleet,

I will not go through all of the particulars discussed above, but in general, blood panels are not used to diagnose organ cancers.  Blood cancers (lymphoma or leukemia) yes, they have meaningful indicative value.

There is obviously a lot of history and backstory in your case that you have skipped over.  No problem, any question is OK, but you go from some history of PCa straight to possible liver and/or bone metastasis.   That is a HUGE leap.   What stage were you?  What treatments have you had ?  How long ago was your PCa diagnosed ?

AST/ALT can be elevated by many things:  1. alcohol; 2. NASID USE (Advil, Tylenol, Asprin),  3. statin drugs (anti-cholesterol drugs)  4. chemo, and a variety of other things.

You seem defensive on the subject of alcohol, as when stating that the doctor 'thinks I'm an alcoholic.'   Why would he think that ?   My father was one of five brothers.   All five were gifted, hard-working, and three of them became quite rich.    All five died drunk, of liver failure, due to alcoholism.    I know about liver worries.

But, there is absolutley no reason to jump from a little AST elevation to 'metastatic PCa in the liver.'   Certainly not based on the scant factors shared thus far.

A Lipid and Metabolic profile and associated labs is never a bad idea for any person with a history of liver issues.   While not 'cheap,' they are the least expensive tests that we guys routinely have performed here.

GeorgeG
Posts: 152
Joined: May 2017

Cancer is stressful, the shoe is in waiting to drop mode most of the time. That said, this is our reality, it is our cross to bear but it should not define us and we should not if at all possible, let cancer take all of the many great days still ahead away from us from worry. It comes from the loss of control, the fear or anger from being selected by the universe to be in the club. This is the hand we are dealt, lets play it as well as we can. Use the best doctors and facilities that you have access to and then trust them to give you the best care available. They know when to look and what to look for. Research and be involved to whatever extent makes you happy and comfortable but you have many great days ahead and my sense is that it may be better for you to avoid getting too involved in the details. Spend most of them enjoying the best that life has to offer. We have some  "advanced notice" which may not be initially welcome, more than the guy who will be taken out by the driver crossing the centerline tomorrow. He will have no chance to for any more good days. My sincere advice to you is that during this period where you do not have any confirmed bad news, turn it to a different channel and let the doctors do their job. 2 years ago my wife had a scan, found a tumor, confirmed an aggressive ultra rare condition as was gone a few months later at age 54. Thankfully we did not waste many good days. Don't waste your good days. none of us know how many we have left. Hang in there brother you are stronger than you think.

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