Topic: Liver enzymes, blood work and chemo

Hi all.  Chemo continues to take a small toll on me and continues to be more difficult this time around.  My blood was drawn today and my platelets were low down to 71 which I expected as they continue to decrease since I have started the Gem ox regimen.  However I was surprised to see that all of my liver function has gone up slightly since I have started chemo.  I am trying not to freak out about this. ALK and AST have increased slightly and still within normal range and my ALT is slightly elevated above normal reference range.  Both my surgeon and ONC say not to worry and no one seems to have reason for concern and this is expected.  Obviously easier said than done and I can't help but to worry.  Those who have had surgery and adjuvant chemo, did you see any of these number rise or bounce around once chemo started again?  I am trying my best to not put too much energy into this and worry but it's hard. Do I need to look into this further or ask them anymore specific questions?  Thanks all in advance.  Hugs and blessings.
Porter

Hope, love, strength...2013 and for the years to come, Porter.

Re: Liver enzymes, blood work and chemo

Porter -
Mark's numbers were up and down through out all of his Gemox chemo. His platelets, red and white blood cells were pretty good through out but his liver numbers jumped around. Chemo can cause your liver to work a little harder to get the medications cleaned out of your blood (doing its job). I believe without digging through all his labs that his liver enzymes jumped around quite a bit. Sometimes they would be just a little high or all high out of range. The only one that stayed really good was his bilirubin and the highest it got was 0.7 which is middle normal. Even his Ca-19-9 seemed to jump around some.

I totally understand the worry about them. I obsess about the numbers all the time. I am sure I drive the docs nuts but I think that's my job. smile

Hang in there,
KrisV

Any advice given is based on my experiences and should not be substituted for any medical recommendations. Please speak with your provider before making any changes.

Re: Liver enzymes, blood work and chemo

Thanks Kris your response made me feel better than the docs telling me not to worry.  Ironically my bilirubin too has been low the entire time and has stayed consistently low.  I am also hearing you say that if my ca 19 9 (which I should get tom or the next day) comes back a little higher (last one was 11) that I shouldn't jump the gun and freak out about that either necessarily.  smile How is Mark doing by the way?  I hope he is on the mend and feeling better...
Porter

Hope, love, strength...2013 and for the years to come, Porter.

Re: Liver enzymes, blood work and chemo

Yeah don't worry about it too much. Mark's was still over 300 when we started treatment but it slowly came down although there would be times when it went up a little then down the next draw. It was under 20 when we were done. It bounced a little when he started radiation but it's down again. There is a lot that can affect it including inflammation so it's not 100% accurate for the cancer. Our ONC said that as long as everything else was good they didn't worry. He said they would only worry if ALL the liver functions went WAY high and there were other symptoms like jaundice or itching. So all is good.

He's doing about the same. I drew some labs on him today and that will help make the next decision whether to start TPN (nutrition through the vein) or stick a camera down his throat. I think he was a little better today....more alert and awake so I am hoping.

Thanks, KrisV

Any advice given is based on my experiences and should not be substituted for any medical recommendations. Please speak with your provider before making any changes.

Re: Liver enzymes, blood work and chemo

Porter,
My numbers were up and down throught chemo, also. Of course, I never had surgery to remove cancer.
Bili was usually up after chemo, and RBC and platelets were down after a week or so. Never enough to cancel chemo, so I was happy about that. But my onc would tell me if I could have raw veggies or not! That would be the Princeton onc, not Dr. K. He and I would joke about whether I could have a blt or not.
Chemo is hard on the liver, so numbers jumping is to be expected.

KrisJ
"Don't just have minutes in the day; have moments in time."
Any opinions I give are based on personal experiences, and are not based on medical knowledge. I strongly suggest receiving medical care and opinions.

Re: Liver enzymes, blood work and chemo

My tumor marker went up too but still low and in reference range.  It still makes me anxious to know liver function and now ca 19 9 have all gone up eventhough everyone is saying no reason for concern.  I am also somewhat puzzled that the first regimen of gemcis when I started treatment last August always showed a downward trend, and now with the gemox (all numbers were normal before treatment) shows an upward trend and this time we don't even know if there is anything negative that the chemo is attacking.  I do realize all chemo regimens are different and obviously can affect us each differently.
KrisV, I hope Mark's numbers looked okay today and that he is having a decent day.  KrisJ, thanks for your input smile
Porter

Hope, love, strength...2013 and for the years to come, Porter.

Re: Liver enzymes, blood work and chemo

Dear Porter, I have not said much because I am not versed in Chemo and side effects. I just wish every time I see you post that everything would back to normal. I think about you a lot and wish there was something I could do. For now I will send you some cyber hugs! {}{}{}{}

Teddy ~In our hearts forever~ATTITUDE is EVERYTHING
Any suggestion I offer is intended as friendly advice based solely on my own experience. Please consult your doctor for professional guidance.

Re: Liver enzymes, blood work and chemo

Like Lainy said.  I too am following your posts but have no answers for you.  I wish everything would improve for you and everyone else dealing with all these issues on here.    Just know I am thinking of you and all the others and keep hoping for better days ahead.  smile

Love & Hugs,
Darla

"One Day At A Time"

All of my comments and suggestions are just my opinions and are not a substitute for professional medical advice.   You should always seek the advice of your physician or other qualified health care providers.

Re: Liver enzymes, blood work and chemo

Porter,

My LFTs and tumor marker went up during treatment.

Re: Liver enzymes, blood work and chemo

Hi Porter, I love your new Avatar! You look very Hollywood! Hope you can make the visit here this summer.

Teddy ~In our hearts forever~ATTITUDE is EVERYTHING
Any suggestion I offer is intended as friendly advice based solely on my own experience. Please consult your doctor for professional guidance.

Re: Liver enzymes, blood work and chemo

Thanks again all for the support and responses. As my once and surgeon know I get very anxious about all this sstuff which I know is totally natural and normal smile but they are both assuring me that there is no reason for concern. My surgeon literally said "don't panic, there is no reason to panic." The once said the ca 19 9 is normal and don't worry about it going up and the absolute value right now as its still in normal range. So I'm gonna do my best and take their advice and trust them for now. Its comforting to hear that others too saw their numbers bounce around during treatment as well and sounds like a common and normal effect.
Lainy I will be coming thru this sued I just don't know when yet wink

Hope, love, strength...2013 and for the years to come, Porter.

Re: Liver enzymes, blood work and chemo

My ONC not once. wink

Hope, love, strength...2013 and for the years to come, Porter.

Re: Liver enzymes, blood work and chemo

Porter, Please try to not stress about it. Stress is BAD. Try to relax and listen to the docs.
One thing that might help... Try to eat a bit better this month: less meats and sugars, more veggies and fruits. Less alcohol, especially right before your blood draw. It usually works for me!

KrisJ
"Don't just have minutes in the day; have moments in time."
Any opinions I give are based on personal experiences, and are not based on medical knowledge. I strongly suggest receiving medical care and opinions.

Re: Liver enzymes, blood work and chemo

Thanks again all. With the week off last week numbers bounced back to normal and nothing of importance was elevated. So that helps alleviate some of my anxiety. They also lowered my dosage of Oxaliplatin to help with platelets , counts, and side effects. I would imagine this could be common. I also brought up Melinda's story and the kind of immunotherapy that has been benefial for her. My onc hadnt heard of it but I'm glad I brought it to her attention. wink
Porter

Hope, love, strength...2013 and for the years to come, Porter.

Re: Liver enzymes, blood work and chemo

Porter, 

Glad to hear things are getting back to normal and that you are feeling less anxious.  Look forward to hearing more good news from you in the future.

Love & Hugs,
Darla

"One Day At A Time"

All of my comments and suggestions are just my opinions and are not a substitute for professional medical advice.   You should always seek the advice of your physician or other qualified health care providers.

Re: Liver enzymes, blood work and chemo

Porter....I'd be worrying too....needlessly perhaps....but I'd be questioning and worrying all the same.  That said....glad to hear that you are feeling less anxious and are moving forward.  I'm right behind you....doing the Gem/cis...restarting May 21st.  I'll probably be posting similar anxiety laden posts.  smile 

Huge,
Iowa Girl
Julie T.

"Just for today, I can get through anything."  Hey....I'm a cancer survivor, not a doctor.  The opinions I state are my own, based on my personal experiences or knowledge.  As always, talk to your doctor about your concerns and treatment.