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Liver Abnormalities

Anonymous user (not verified)

Maybe some of you are tiring already of my pesty questions, but I was wondering if any of you have had either a history of Hep C (since "cured" before starting RCHOP), and/or if anyone had any elevated levels in your ALK Phosphatase, ALT, AST liver tests before and/or after starting RCHOP.

Here's the thing.  In my verbose saga I mentioned Terry's Hep C diagnosis in 2009.  Since he responded to the stomach injections of Interferon I had to give him for 6 months to "cure" it, his PCR, and subsequent/yearly blood tests have all been normal.  THANK GOD!, even at the ER when he was admitted just before they removed his tumor.  BUT, ever since, those three indicators of liver inflammation have been elevated.  At first, the oncologist and we agreed that it was due to all the antibiotics he had to have to prevent and treat infections, post-op.  We're obviousy concerned that these recent elevations are there because his liver may now be compromised with the lymphoma, even though that staging PET didn't indicate any organ involvement. Hopefully, the CMP they run next week will indicate a return to normal for these or, at a minimum, they have stabilized.  I guess my question on this topic would be for anyone who had similar liver test abnormalities before starting their RCHOP and whether or not the chemo only made them worse.  If so, what did they do to keep their liver from suffering extreme damage?  Do those tests worsen with treatment or level off at this point and, generally, not worsen?

Just curious . . . should we be questioning this issue more with our team?  Is this just part of the whole side effect "gift" of chemo?

After my last inquisition on hair loss, I have to say I feel like I'm monopolizing the Discussion Board option.  I'm sorry; but, I'm finding so much information, hope and inspiration from all of your experiences and you've all been so forthcoming and generous sharing this, not so pleasant, time in your lives.  Through your responses I surmized that the average time frame for hair loss, it would appear, is at about Day 14 to Day 19 after your initial "hit".  Terry and I are at Day 14 today . . . so, although we're hoping he'll be spared, we want to also be prepared for what we may still see.

THANK YOU, for anything you may be able to offer on this, my latest, query!

Dawn

Rocquie's picture
Rocquie
Posts: 815
Joined: Mar 2013

Hi Dawn, please don't feel that you are monopolizing the message boards. Or that we are tiring of your "pesky" questions. You and Terry are at the beginning of your lymphoma journey and you naturally have many questions. You are not starting any more threads than I did when I first joined. 

New members are always welcome, especially ones as active as you have been. People like me who have been around for a while want to help; that is why we are here. People like you and Terry help keep us interested. 

I can't personally help with the liver question, but someone here might.

Keep those posts coming!

Cheers,

Rocquie

 

Max Former Hodgkins Stage 3's picture
Max Former Hodg...
Posts: 2985
Joined: May 2012

Dawn, high liver enzymes are common during cancer treatments....I know there have been threads here on it in the past. Perhaps you can find them, but it won't be easy.   With a past that includes Hep C, I would be surprised if your husband's levels were ever normal, but I'm sure you've monitored them closely. 

Following trauma in 1986, I went into liver failure, and had Biliruben numbers that were 180 times above normal (one-hundred-and-eighty), but they all came back in to spec later.  I was a bright pumpkin color durig that time. A secretary from work came in to the ICU to visit me, and I recall her saying to another person, "He's orange !" I have had high liver enzymes ever since, a fact I know from profoundly high cholesterol and triglycerides levels. My doctors are not worried.

During my chemo, my oncologist always ignored the liver values, and said we had to worry about more pressing matters.  When my AST/ALT was roughly double normal ranges, he did not even mention the results during our biweekly CBC reviews, until I asked about them.  Like virtually all medical oncologists, he is Board Certified in internal medicine as well as oncology. (I've never read the C.V. of a medical oncologist who wasn't certified in internal medicine, actually.)

Years later I asked my GP about this, and he, who was a sagely, older guy who did not excite easily, agreed. He then added, "In internal medicine, there is a general, unwritten rule that, short term, we ignore enzyme results that are not at least three times normal ranges."

I would forget about the liver results for now. The doctors see them before you do. If they are not worried, relax yourself also is the healthiest thing for now.  This is true in general also. What Terry has encounted so far (elevated enzymes, hair loss) are standard fare, par for the course.  If you need to worry, his doctor will share that with you on a timely basis. But I pray that day never comes for the two of you,

max

Anonymous user (not verified)

I fear I have been a little neglectful in checking for everyone's awesome responses to all my questions and concerns.  So, today I made it a priority to check through some of my older posts and came across quite a few that I feel I should respond to.

Since my post about Terry's liver tests . . . I posted an "update" of sorts out there somewhere on this site.  In case you haven't come across it, let me just say that at our last appointment, the day of Hit #2, last week . . . the oncologist and we were greatly relieved to see that Terry's tests had returned to within a healthy "normal" range.  We are chalking it all up to the number all the antibiotics he was on for such a long time after his surgery in April.  Whewww, dodged that bullet I think, as I know this junk can do a number on a person's liver, not to mention everything else.  And, yes, with his history of Hep C, we are always treading carefully with anything that could do further damage. 

We were most excited to find out that his LDH levels are now within normal range too!  Last week's labs showed it had gone down to 185.  AND, we discovered that it was never all that high.  We started out, after his surgery to remove his tumor, at "only" 226, with the max range here in our lab at 200.  That told us that, perhaps, his DLBCL was not as diffuse as it could have turned out to be, right?

Anyhow . . . thanks for all the support and information once again.

For the record . . . Terry's awesome, handsome head is all "fuzzy" now with the images one conjures up whenever anyone mentions "chemo".  I don't necessarily care for the look, myself; but he is hanging on to each and every thing he can he can control and shaving his head, completely, happens to be one of those for him.  All in due course, I suppose.  I don't think it will be long before it all goes, but he is walking tall and I am so very proud to be his wife.

Love you all.

Be well!

Dawn

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