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

pete43lost_at_sea
pete43lost_at_sea Member Posts: 3,900
edited April 2011 in Colorectal Cancer #1
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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Comments

  • johnnybegood
    johnnybegood Member Posts: 1,117
    KathiM said:

    Yes, I was warned....
    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....)

    sorry to be rude
    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
    John23 Member Posts: 2,122
    KathiM said:

    Yes, I was warned....
    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....)

    Kathi

    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
  • John23
    John23 Member Posts: 2,122

    sorry to be rude
    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

    johnnybegood -

    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
  • KathiM
    KathiM Member Posts: 8,028
    John23 said:

    Kathi

    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

    John, if you notice....
    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
    Buckwirth Member Posts: 1,258
    Pete,
    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
  • Buckwirth
    Buckwirth Member Posts: 1,258
    KathiM said:

    John, if you notice....
    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

    Kathi
    Thank you, there is beauty in what you say.

    Blake
  • geotina
    geotina Member Posts: 2,111
    Hope:
    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
  • John23
    John23 Member Posts: 2,122
    Buckwirth said:

    Pete,
    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

    Blake -
    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
  • maglets
    maglets Member Posts: 2,576

    sorry to be rude
    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

    oh you go johnny
    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
  • maglets
    maglets Member Posts: 2,576
    geotina said:

    Hope:
    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

    amen
    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
  • Buckwirth
    Buckwirth Member Posts: 1,258
    John23 said:

    Blake -
    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

    Best wishes to you John
    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
    John23 Member Posts: 2,122
    Buckwirth said:

    Best wishes to you John
    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.

    Blake

    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
  • pete43lost_at_sea
    pete43lost_at_sea Member Posts: 3,900

    sorry to be rude
    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

    sorry johnnybegood
    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
  • GaryinUK
    GaryinUK Member Posts: 62
    maglets said:

    amen
    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

    discussion is worthwhile
    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
  • Buckwirth
    Buckwirth Member Posts: 1,258
    John23 said:

    Blake

    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

    Not that I don't agree with
    Not that I don't agree with what you say...
  • pete43lost_at_sea
    pete43lost_at_sea Member Posts: 3,900
    geotina said:

    Hope:
    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

    Hope: we all still have it
    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
    jjaj133 Member Posts: 867
    maglets said:

    amen
    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

    Oh, this must be the
    Oh, this must be the "sometimes we disagree part"? Mags, mind if i join you in the sand?
    judy
  • pete43lost_at_sea
    pete43lost_at_sea Member Posts: 3,900
    maglets said:

    amen
    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

    my heads in the sand as well, it safer there
    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
    pete43lost_at_sea Member Posts: 3,900
    GaryinUK said:

    discussion is worthwhile
    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

    thanks gary
    hi gary,

    sorry about your partner. I appreciate your comments.

    Pete
  • pete43lost_at_sea
    pete43lost_at_sea Member Posts: 3,900
    KathiM said:

    Yes, I was warned....
    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....)

    I am glad you were warned
    Hi Kathi,

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

    hugs,
    pete