Bile duct obstruction/ elevated liver enzymes, anyone?
 

Hi Friends~
Just firing off this quick question while I wait for a cab to take me to the airport to head back to Atlanta.
I've been traveling to Nashville for a PI3Kinase+Herceptin study, after being on TDM1 x 6 months, and then getting booted off for (questionable) progression in lungs.

I've made it through the first 2 cycles/8weeks of weekly visits, had my 1st scans 3 weeks ago that showed everything stable and specifically "unchanged several subcentimeter left hepatic lobe hypodensities."
So this is my 1st return visit since those scans.
I was scheduled to get my Herceptin, and continue on with the 2pills/day of the study drug, but my liver enzymes have come back extremely elevated.
ALT - 409 (previously 39)
AST - 535 (previously 63)
Alkaline Phosphotase - 542 (previously 312)
Billirubin, Total - 1.4 (previously 0.9)

Because it's so abrupt and so high, they're holding all treatment. I'm going to have a liver US asap to determine if a bile duct is obstructed.

I am of course hoping for a simple explanation & a quick fix, but I'm terrified that something else is going on again. It's really hard not to freak out & let my mind snowball into getting kicked off this 2nd trial, and I only have Halaven left, since I've done everything else...

Oh and also, I had a R hepatectomy in December 2005, but have never had issues with elevated liver enzymes until today.

Thanks so much in advance for any words of wisdom and encouragement you can offer.

Keep the Faith~

Jessica

Re: Bile duct obstruction/ elevated liver enzymes, anyone?
 

I hope things work out and they find a simple reason and easy fix. I suspect it just feels like you've done "everything else". There may be options. Maybe post a med history in signature at some point.

Re: Bile duct obstruction/ elevated liver enzymes, anyone?
 

I dont have any advice but do hope this is something easily treated and not what we fear!

Re: Bile duct obstruction/ elevated liver enzymes, anyone?
 

Jessica = I too hope the US will show nothing cancer related and easily treated. Thinking of you and will watch for more updates. Pam

Re: Bile duct obstruction/ elevated liver enzymes, anyone?
 

Dear Jessica -

So sorry to learn that you had to leave the T-DM1 trial and find another treatment. Can you tell us more about this new treatment? Maybe post under the Clinical Trials forum?

Also hate to hear that your liver enzymes are so elevated. There are dozens of possible causes, and I will pray that your bile ducts are not the reason.
Here is a link to Mayo's on the subject of elevated liver enzymes. Maybe you can find another cause that might be reasonable in their long list.

http://www.mayoclinic.com/health/ele...SECTION=causes

Re: Bile duct obstruction/ elevated liver enzymes, anyone?
 

Sorry to hear your having this problem with your liver function tests, Jessica. I hope you are feeling OK and there is a relatively straightforward cause and clear path to resolve it.
Trish

Re: Bile duct obstruction/ elevated liver enzymes, anyone?
 

I do not know what could be going on, but drugs can send your live enzymes into the stratosphere. Why not try some mild thistle while you await your US results?

Re: Bile duct obstruction/ elevated liver enzymes, anyone?
 

Hi -
I think Laurel might have meant MILK THISTLE?

Re: Bile duct obstruction/ elevated liver enzymes, anyone?
 

Ha! I sure did, Steph, thanks!

Re: Bile duct obstruction/ elevated liver enzymes, anyone?
 

Sending prayers your way that the US will be unremarkable and something simple is occurring. Stay strong, we are here for you!

Re: Bile duct obstruction/ elevated liver enzymes, anyone?
 

Jessica,

Just wanted to say 'Hi' and hope things have improved.

Re: Bile duct obstruction/ elevated liver enzymes, anyone?
 

HI Everyone~

Thanks for keeping up with me & sorry I haven't been back to post an up-date.
It's been quite a rollercoaster these past 4 weeks and life has gotten really complicated again.
I'll start a new post, as I have new findings (mets in colon-has anyone ever heard of this???) and have been dropped for the 2nd study - the PI3Kinase/Herceptin study, and will be starting Halaven next week.
As for the liver enzyme issues - I had a liver CT that came back clean - no masses causing obstructions or dilated vessels - which was/is wonderful news. And I met with a hepatologist and have been having labs drawn 2x week for the past 4 weeks. Fortunately, the LFT's have just gradually come down to WNL on their own.
The hepatologist didn't have any ideas of what might have caused the spike, other than exposure to some weird virus, as my eosinophils were elevated too. But he said there was no reason to go in and poke & prod & biopsy my liver if the LFT's were returning to normal on their own.
However, in terms of the study, the LFT's would have had to return to normal within 21 days of suspending treatment in order for me to continue. Since it took 28 days, I was booted off the study.
That came with it's own bag of frustrations, because originally I was told there was no time limit, then I was told there was, but that the PI would petition for an exemption and I would be able to start back this week, and then finally told that the sponsor denied the petition and I was taken off study.

All of this was going on while I was waiting to speak with the GI doc regarding my colonoscopy results. I fill in the details on my new post, but as I mentioned earlier, there are 2 areas of my colon that looked "inflamed" that the GI doc took biopsies and now turn out to be BC mets.
I feel totally blindsided by that news because I have never heard of BC mets to the colon.

I go see my onc today @1pm to start making plans to start Halaven. I have run the gamut of all the approved combos for MBC and Halaven is the only one I haven't had. Thank God it's available, bc as we scoured around looking for another study for me, we've had no luck.

I'm feeling very defeated again. Like I just can't take the humiliation of working so hard & fighting so hard and tolerating so much only to be blindsided by this disease
invading another part of my body.
In addition to all of this, my sweet father suffered a catastrophic stroke the ~12 weeks ago. The same week that I was traveling to Nashville to screen for the PI3Kinase study & there was no way I could travel to Hawaii to see him and my Mom. Then I was on weekly visits to Nashville for the study for the next 6 weeks, so I still couldn't get to Hawaii. Finally, when I moved into the q3week visit schedule of the study I went right to Hawaii. It was on my return visit to Nashville that the liver enzymes spiked, and then all this other stuff started happening. I'm stunned by all of this and can't figure out how I'm going to tell my Mom, as her plate is so full, taking care of my dad, who still isn't able to speak, but by the grace of God is getting physically stronger every day.I just don't want to give her one more thing to worry about, but at the same time I just want to run to her for her comfort when I'm feeling so scared and defeated.

Trying to keep the faith~

Jml

Re: Bile duct obstruction/ elevated liver enzymes, anyone?
 

Your braveness astounds me! Really you are a true fighter. I am so glad that there is a chemo available which will get things back in check.
I have never heard of bc mets to the colon. I suspect this is very rare.
Glad you've checked in and wishing you good luck for the new treatment.
Ellie

Re: Bile duct obstruction/ elevated liver enzymes, anyone?
 

Gods blessing to you and your family! If I can be so bold, I would have told my mon about my dxs but she past away 3 months before I new! I wish I could talk to her everyday. Some one told me once "God doesn't give you more than you can handle" I believe it. If your mom is as strong a woman as you are her load will be light enough to help you too. I do mean this in a warm ,loving, heartfelt way! Peace

Re: Bile duct obstruction/ elevated liver enzymes, anyone?
 

Sending peace and hugs your way. I know you have many decisions to make, but share it with your family. Just as you are there to hold them up, they are there to share your load! Stay strong and keep trying, the Halaven may be the answer! We will be praying for you every step of the way!

Re: Bile duct obstruction/ elevated liver enzymes, anyone?
 

Oh Jessica;
I just want you to know that I am sending my prayers and support your way. I truly hope that things will work out and treatments will get you back on track. I wish I could take some of this struggle away from you.

Love & Hugs,
Kris......