Tumor markers and liver function

[Stephanie]

Hi, all. I usually post with questions regarding my mom, but this time I have one about myself. You gals are such a wealth of information, I thought someone might have an idea about my situation.

I am Stage IIa, with clean scans before chemo except for a 2mm spot on my liver that they swear is a cyst. I started my six cycles of FAC in August. Since starting the chemo, my ALT, AST, Alk phosphate and LDH enzymes have doubled with each chemistry panel (which has been pulled every two-three weeks). All four are out of the normal range, although not by enough to alarm the docs. Apparently the 5-FU is very hard on the liver--I'm a little worried about how high the enzymes will go, since they rose quickly after just 2 rounds of chemo.

The other part of this situation is my tumor markers. The CA 27-29 was drawn before my surgery, and was 28.1 while the tumor was still in me. After surgery, the markers dropped to 15.9. I was thrilled, and figured this drop also meant that I'm sensitive to the markers. Three weeks later, the CA 27-29 jumped to 34.8, which is higher than what it was when I still had the tumor in me. The number is still in the "normal" range, but yikes.

I find it hard to believe that I suddenly developed mets in a couple of months. The only thing I worry about is that somehow something was missed on the PET, as I have lobular cancer, and the mets can be sneaky. So, my question is--do you think the irritation to the liver from the 5-FU could be making the CA 27-29 rise?

Thanks in advance!

[AlaskaAngel]

Hi Stephanie,

Based only on my own experience, chemo can do that. I had a cyst/hemangiomas in the liver at diagnosis. I had CAF in 2002 and although I didn't get a marker prior to doing chemo, it was on the high end at the end of chemo and didn't really stay low until a while after I completed rads and had started tamoxifen. My LFTs bounced all over through chemo and through the following 4 years, always less than 200 and occasionally borderline normal, before settling down this year.

A.A.

[Barbara H.]

Hi Stephanie,
Chemo can cause liver enzymes to go out of the normal range. I am on a trial and the treatment is doing the exact same thing to me. If they go too high I may need to skip treatment one week. I am on the Herceptin DM 1 trial.
Good luck,
Barbara H.

[Esther]

Stephanie, chemo can make your liver enzymes jump up and dying off cancer cells can make your CA27-29 go up as well.

So it's possible you have cancer cells in your system that are being knocked out by the chemo and your body is processing them out as they die off. Keep that thought in mind as you go through treatment, you're knocking those little pesky cancer cells out of the park!!!

You're being monitored closely, so they will be on top of this, try to relax and have faith that everything is coming along as it should.

Discuss your concerns with your onc at your next appt.

[Stephanie]

Thanks, ladies. I appreciate the input!