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Old 02-14-2010, 07:36 PM   #1
bejuce
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Question Gallstones

Hi everyone,

I spent my post-Valentines dinner last night suffering from abdominal
pain. Couldn't sleep and ended up going to the ER at 5 am. My blood work and urine test were normal, but an ultrasound revealed two gallstones, one of which seemed stuck in the neck of the gallbladder.

So I'll likely be headed into surgery to remove my gallbladder next week or so. I had promised my kids to take them to Disneylad at the end of the week and hopefully I'll be able to do that and have surgery the week after.

I searched the archives and found quite a few posts of others having gallbladder issues while on Hercetin and/or Tamoxifen. Does anyone know if gallstones are considered a side effect of Herceptin? Or are they just the result of back luck, fatty foods, hereditary factors and so on? Is there any link between gallbladder-related conditions post chemo
and future liver mets? Should I be concerned that removing the gallbladder will make my liver more vulnerable to mets?

Thanks!!!

Marcia
__________________
ER+ (30%)/PR-/HER-2+, stage 3

Diagnosed on 02/18/09 at 38 with a huge 12x10 cm tumor, after a 6 month delay. Told I was too young and had no risk factors. Found swollen node during breastfeeding.
March-August 09: neo-adjuvant chemo, part of a trial at Stanford (4 DD A/C, 4 Taxotere with daily Tykerb), loading dose of Herceptin
08/12/09 - bye bye boobies (bilateral mastectomy)
08/24/09 - path report shows 100 % success in breast tissue (no cancer there, yay!), 98 % success in lymphatic invasion, and even though 11/13 nodes were still positive, > 95 % of the tumor in them was killed. Hoping for the best!
September-October 09: rads with daily Xeloda
02/25/10 - Cholecystectomy
05/27/10 - Bone scan clear
06/14/10 - CT scan clear, ovarian cyst found
07/27/10 - Done with Herceptin!
02/15/11 - MVA-BN HER-2 vaccine trial
03/15/11 - First CA 15-3: 12.7 and normal, yay!
10/01/11 - Bone scan and CT scan clear, fatty liver found
now on Tamoxifen and Aspirin


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Old 02-14-2010, 08:52 PM   #2
ElaineM
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Wink Re: Gallstones

I don't know anything about gall bladder surgery or whether or not gall stones are a side effect of Herceptin, but I had gall stones last year which were diagnosed by an ultra sound.
My M.D. wanted me to have surgery, but I wanted to avoid that if possible, so I asked my naturopath if there was anything else I could do to solve the problem.
He told me to avoid fatty foods, including nut butters and prescribed a supplement called Dissolve GS. I don't remember which company makes it, but if you are interested in learning more about it you can do an internet search on it. It took about 6 weeks to get rid of the gall stones, but I was successful and I no longer have pain or gall stones.
If you want to know if gall stones are a side effect of the drugs you are taking you might want to call the drug companies that make your medicines and ask to speak with a pharmacist. I found drug company pharmacists to be very helpful in answering my questions.
I hope you feel better soon. Take care.
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Old 02-14-2010, 09:04 PM   #3
Cannon
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Re: Gallstones

I had my gallbladder out recently, as did my sister, and of course years before that my mother and grandmother. I think they say the risk factors are female, fat, forty-plus and family. It's possible that Tamoxifen and AIs contribute by suppressing estrogen and making it easier than ever to gain weight, but I have not heard of any connection. It was an EASY surgery (even though it was emergency) and have not had any trouble since. I believe there is a small risk of having digestive tract troubles afterwards - but I have Crohn's, so I wouldn't know the difference.

I do recommend that you have the surgery sooner rather than later - emergency is not the way you want to do it.

Rebecca
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Dx 8/06 Age 43 Stage IIIA multifocal throughout breast, largest tumor 5 cm, grade 3, comedo, ER+PR+HER+++
Neoadjuvant A/C 4X Dose Dense
11/06 Bilateral Mastectomy (no choice on the right, my choice on the left)
Taxol+Herceptin weekly x12, continuing with Herceptin, finished one year in 12/07
33 Rads
Femara for 5+ years, staying on (started with Arimidex, switched after about a month, much happier)
Abnormal brain MRI shows no cancer, but "extensive white matter diease" - unknown cause
BRCA negative - lots of cancer in my family
survivor of thyroid cancer
also have Crohn's disease
CT and bone scan say NED as of 5/13
dx with severe cardiomyopathy 5/12 (likely due to chemo and Herceptin), ejection fraction in low 20's, now up to 40, went to 50, latest read 12/13 is back down to 35
1/13 Acute pancreatitis - are you kidding me?
9/13 started Humira for Crohn's. starting to have some energy again
B12 and Vit D both needed supplementation
Cataracts in both eyes noted 6/12 - surgery in the next 2-4 years?
4/14 Kidney stones/blockage/infection - related to Crohn's Disease
5/14 My aunt passed away - she was diagnosed after I was with Stage I - not Her2+, then Stage 4 for about one year
6/14 Scans - still NED, thank God. However, broken rib (I didn't notice) lots of bone degeneration osteopenia/osteoporosis. I also still have cardiomyopathy secondary to chemo.
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Old 02-14-2010, 09:29 PM   #4
Rich66
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Re: Gallstones

Haven't seen a gallstone/liver mets connnection. There are some stone dissolving drug options like ursodiol, depends on what kind of stones.
But i have been following the surgical options due to mom having some rattling around in there. I believe Murtha died in a laparoscopic g-bladder surgery. But he was kinda big and that seems to pose problems for less "open" approaches. They have some newer teeny tiny single incision approaches which I'm not sure are "mature" as they say.

Whatever the procedure, please review this and see what kind of anesthetic is involved:

Opiates/Opioids (accelerates cancer, remedies)
http://her2support.org/vbulletin/showthread.php?t=42074
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Mom's treatment history (link)
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Old 02-14-2010, 11:29 PM   #5
Jean
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Re: Gallstones

ouch, have not had first hand experience, but have had friends who did have gallstones, I saw first hand how much pain they were in.

I think the advice of not waiting for an emergency surgery is wise.

Just wanted to wish you a speedy recovery ....
and enjoy your visit to the mouse! I had many wonderful times in Disney when my son was young.

Take care and best wishes,
jean
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Old 02-15-2010, 05:46 AM   #6
tricia keegan
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Re: Gallstones

I'll second Jeans ouch, a year before bc I had agonizing pain for months and eventually it was diagnosed as gall stones. The pain gets worse the longer you leave it and mine were so inflammed when I eventually had the surgery it took me three weeks to recover.
Sorry you 're facing this, I don't know an answer to your question but agree that surgery is better done sooner rather than later.
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Dx July '05 IDC 1.9cm Triple positive 3/9 nodes positive
A/C X 4 ..Taxol/Herceptin x 12 wks then herceptin 1 yr
Rads x 36 ..oophorectomy August '06
Currently taking Arimidex..
June 2011 osteopenia/ zometa x1 yearly- stopped Zometa 2015 as Dexa show normal bone density.
Stopped Arimidex July 2014- Restarted Arimidex 2015 for a further two years on the advice of my Onc.
2014 Normal Dexa scan
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Old 02-15-2010, 02:19 PM   #7
MJo
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Re: Gallstones

I also have gallstones, which were diagnosed by an ultrasound two months ago. We are watching them, since they are not causing me trouble. Oh, Marcia. I just read my future in your post. Don't know if there is a connection between Herceptin, chemo and gallstones. My mother and father both had gall bladder surgery. Doubt if it makes us more vulnerable to mets, but I'm no scientist.
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IDC, Stage I, Grade 2
Oncotype DX Score 32
Her2++ E+P+, Node Neg.
Lumpectomy 11/04/05 Clear Margins
3 Dose dense AC (Couldn't tolerate 4)
4 Dose dense Taxol & Herc. (Tolerated well)
36 weeks Herceptin (Could not complete one year due to decrease in MUGA score)
2 years of Arimidex, then three years of Femara
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Old 02-16-2010, 04:22 AM   #8
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Re: Gallstones

I am sure that taxol caused gallbladder pain in my case. I am with the naturopath, being careful with what you eat makes a difference. Look up Dr Sandra Cabot, she has a book on the liver cleansing that also sorts out gallbladder problems.
Jackie
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Old 02-16-2010, 12:23 PM   #9
bejuce
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Re: Gallstones

Thank you everyone for your support. I'm meeting with the surgeon this afternoon for a consultation and will probably have surgery next week. I had planned a quick trip to Disneyland tomorrow with the kids (driving from the Bay Area) and my parents and brother think I'm insane to do it. They're all for the surgery to be done immediately so I don't have another attack but I'm pain free and believe I can wait until next week (or even longer) by controlling my diet.

Not sure whether my gallstones are a result of chemo or not, but I doubt it. In any case, when I did my abdominal CT scans after being diagnosed (almost a year ago) there was no evidence of gallstones, so looks like they developed this year. Maybe my diet? Genetics (runs in my family)? What I really need is for this not to be an impediment to my treatment and ultimate cure of this cancer...
__________________
ER+ (30%)/PR-/HER-2+, stage 3

Diagnosed on 02/18/09 at 38 with a huge 12x10 cm tumor, after a 6 month delay. Told I was too young and had no risk factors. Found swollen node during breastfeeding.
March-August 09: neo-adjuvant chemo, part of a trial at Stanford (4 DD A/C, 4 Taxotere with daily Tykerb), loading dose of Herceptin
08/12/09 - bye bye boobies (bilateral mastectomy)
08/24/09 - path report shows 100 % success in breast tissue (no cancer there, yay!), 98 % success in lymphatic invasion, and even though 11/13 nodes were still positive, > 95 % of the tumor in them was killed. Hoping for the best!
September-October 09: rads with daily Xeloda
02/25/10 - Cholecystectomy
05/27/10 - Bone scan clear
06/14/10 - CT scan clear, ovarian cyst found
07/27/10 - Done with Herceptin!
02/15/11 - MVA-BN HER-2 vaccine trial
03/15/11 - First CA 15-3: 12.7 and normal, yay!
10/01/11 - Bone scan and CT scan clear, fatty liver found
now on Tamoxifen and Aspirin


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Old 02-16-2010, 05:32 PM   #10
BonnieR
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Re: Gallstones

I had gall stones several years ago. Prior to cancer. By the time of the second "attack" the surgeon recommended removal before it became an emergency. The surgery was laproscopic and unenvetful. So much easier than the old days.
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Post menopause
May 2007 Core biopsy, Rt breast
ER+, Pr-, HER2 +++, Grade 3
Ki-67: 90%
"suspicious area" left breast
Bilateral mastectomy, (NED on left) May 2007
Sentinel Node Neg
Stage 1, DCIS with microinvasion, 3 mm, mostly removed during the biopsy....
Femara (discontinued 7/07) Resumed 10/07
OncoType score 36 (July 07)
Began THC 7/26/07 (d/c taxol and carboplatin 10/07)
Began Herceptin alone 10/07
Finished Herceptin July /08
D/C Femara 4/10 (joint pain/trigger thumb!)
5/10 mistakenly dx with lung cancer. Middle rt lobe removed!
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Old 02-16-2010, 06:59 PM   #11
Jackie07
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Re: Gallstones

Marcia,

Are you going to be driving?

Here's a link from Mayo Clinic about gallstones:

http://www.mayoclinic.com/health/gal...SECTION=causes
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http://www.kevinmd.com/blog/2011/06/doctors-letter-patient-newly-diagnosed-cancer.html
http://www.asco.org/ASCOv2/MultiMedi...=114&trackID=2

NICU 4.4 LB
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Life-long Central Neurocytoma 4x5x6.5 cm 23 hrs 62090 semi-coma 10 d PT OT ST 30 d
3 Infertility tmts 99 > 3 u. fibroids > Pills
CN 3 GKRS 52301
IDC 1.2 cm Her2 +++ ER 5% R. Lmptmy SLNB+1 71703 6 FEC 33 R Tamoxifen
Recc IIB 2.5 cm Bi-L Mast 61407 2/9 nds PET
6 TCH Cellulitis - Lymphedema - compression sleeve & glove
H w x 4 MUGA 51 D, J 49 M
Diastasis recti
Tamoxifen B. scan
Irrtbl bowel 1'09
Colonoscopy 313
BRCA1 V1247I
hptc hemangioma
Vertigo
GI - > yogurt
hysterectomy/oophorectomy 011410
Exemestane 25 mg tab 102912 ~ 101016 stopped due to r. hip/l.thigh pain after long walk
DEXA 1/13
1-2016 lesions in liver largest 9mm & 1.3 cm onco. says not cancer.
3-11 Appendectomy - visually O.K., a lot of puss. Final path result - not cancer.
Start Vitamin D3 and Calcium supplement (600mg x2)
10-10 Stopped Exemestane due to r. hip/l.thigh pain OKed by Onco 11-08-2016
7-23-2018 9 mm groundglass nodule within the right lower lobe with indolent behavior. Due to possible adenocarcinoma, Recommend annual surveilence.
7-10-2019 CT to check lung nodule.
1-10-2020 8mm stable nodule on R Lung, two 6mm new ones on L Lung, a possible lymph node involvement in inter fissule.
"I WANT TO BE AN OUTRAGEOUS OLD WOMAN WHO NEVER GETS CALLED AN OLD LADY. I WANT TO GET SHARP EDGED & EARTH COLORED, TILL I FADE AWAY FROM PURE JOY." Irene from Tampa

Advocacy is a passion .. not a pastime - Joe
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Old 02-16-2010, 07:01 PM   #12
Jackie07
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Re: Gallstones

And a link from National Institute of Health:

http://digestive.niddk.nih.gov/ddise...bs/gallstones/
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http://www.kevinmd.com/blog/2011/06/doctors-letter-patient-newly-diagnosed-cancer.html
http://www.asco.org/ASCOv2/MultiMedi...=114&trackID=2

NICU 4.4 LB
Erythema Nodosum 85
Life-long Central Neurocytoma 4x5x6.5 cm 23 hrs 62090 semi-coma 10 d PT OT ST 30 d
3 Infertility tmts 99 > 3 u. fibroids > Pills
CN 3 GKRS 52301
IDC 1.2 cm Her2 +++ ER 5% R. Lmptmy SLNB+1 71703 6 FEC 33 R Tamoxifen
Recc IIB 2.5 cm Bi-L Mast 61407 2/9 nds PET
6 TCH Cellulitis - Lymphedema - compression sleeve & glove
H w x 4 MUGA 51 D, J 49 M
Diastasis recti
Tamoxifen B. scan
Irrtbl bowel 1'09
Colonoscopy 313
BRCA1 V1247I
hptc hemangioma
Vertigo
GI - > yogurt
hysterectomy/oophorectomy 011410
Exemestane 25 mg tab 102912 ~ 101016 stopped due to r. hip/l.thigh pain after long walk
DEXA 1/13
1-2016 lesions in liver largest 9mm & 1.3 cm onco. says not cancer.
3-11 Appendectomy - visually O.K., a lot of puss. Final path result - not cancer.
Start Vitamin D3 and Calcium supplement (600mg x2)
10-10 Stopped Exemestane due to r. hip/l.thigh pain OKed by Onco 11-08-2016
7-23-2018 9 mm groundglass nodule within the right lower lobe with indolent behavior. Due to possible adenocarcinoma, Recommend annual surveilence.
7-10-2019 CT to check lung nodule.
1-10-2020 8mm stable nodule on R Lung, two 6mm new ones on L Lung, a possible lymph node involvement in inter fissule.
"I WANT TO BE AN OUTRAGEOUS OLD WOMAN WHO NEVER GETS CALLED AN OLD LADY. I WANT TO GET SHARP EDGED & EARTH COLORED, TILL I FADE AWAY FROM PURE JOY." Irene from Tampa

Advocacy is a passion .. not a pastime - Joe
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Old 02-16-2010, 07:32 PM   #13
bejuce
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Re: Gallstones

Thanks, Jackie. I'll be driving down tomorrow, it'll be a 5 hour smooth drive. Why do you ask?
__________________
ER+ (30%)/PR-/HER-2+, stage 3

Diagnosed on 02/18/09 at 38 with a huge 12x10 cm tumor, after a 6 month delay. Told I was too young and had no risk factors. Found swollen node during breastfeeding.
March-August 09: neo-adjuvant chemo, part of a trial at Stanford (4 DD A/C, 4 Taxotere with daily Tykerb), loading dose of Herceptin
08/12/09 - bye bye boobies (bilateral mastectomy)
08/24/09 - path report shows 100 % success in breast tissue (no cancer there, yay!), 98 % success in lymphatic invasion, and even though 11/13 nodes were still positive, > 95 % of the tumor in them was killed. Hoping for the best!
September-October 09: rads with daily Xeloda
02/25/10 - Cholecystectomy
05/27/10 - Bone scan clear
06/14/10 - CT scan clear, ovarian cyst found
07/27/10 - Done with Herceptin!
02/15/11 - MVA-BN HER-2 vaccine trial
03/15/11 - First CA 15-3: 12.7 and normal, yay!
10/01/11 - Bone scan and CT scan clear, fatty liver found
now on Tamoxifen and Aspirin


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Old 02-16-2010, 07:51 PM   #14
Jackie07
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Re: Gallstones

Well, I didn't know anybody who's had gallstone. But I've seen how my husband suffering from the kidney stone 'attack'. I'm just not sure it's safe for anyone to be driving when there are a couple of 'known' gallstones present.

Have you got any advice from your doctor about travelling while you are waiting for your surgery?
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http://www.kevinmd.com/blog/2011/06/doctors-letter-patient-newly-diagnosed-cancer.html
http://www.asco.org/ASCOv2/MultiMedi...=114&trackID=2

NICU 4.4 LB
Erythema Nodosum 85
Life-long Central Neurocytoma 4x5x6.5 cm 23 hrs 62090 semi-coma 10 d PT OT ST 30 d
3 Infertility tmts 99 > 3 u. fibroids > Pills
CN 3 GKRS 52301
IDC 1.2 cm Her2 +++ ER 5% R. Lmptmy SLNB+1 71703 6 FEC 33 R Tamoxifen
Recc IIB 2.5 cm Bi-L Mast 61407 2/9 nds PET
6 TCH Cellulitis - Lymphedema - compression sleeve & glove
H w x 4 MUGA 51 D, J 49 M
Diastasis recti
Tamoxifen B. scan
Irrtbl bowel 1'09
Colonoscopy 313
BRCA1 V1247I
hptc hemangioma
Vertigo
GI - > yogurt
hysterectomy/oophorectomy 011410
Exemestane 25 mg tab 102912 ~ 101016 stopped due to r. hip/l.thigh pain after long walk
DEXA 1/13
1-2016 lesions in liver largest 9mm & 1.3 cm onco. says not cancer.
3-11 Appendectomy - visually O.K., a lot of puss. Final path result - not cancer.
Start Vitamin D3 and Calcium supplement (600mg x2)
10-10 Stopped Exemestane due to r. hip/l.thigh pain OKed by Onco 11-08-2016
7-23-2018 9 mm groundglass nodule within the right lower lobe with indolent behavior. Due to possible adenocarcinoma, Recommend annual surveilence.
7-10-2019 CT to check lung nodule.
1-10-2020 8mm stable nodule on R Lung, two 6mm new ones on L Lung, a possible lymph node involvement in inter fissule.
"I WANT TO BE AN OUTRAGEOUS OLD WOMAN WHO NEVER GETS CALLED AN OLD LADY. I WANT TO GET SHARP EDGED & EARTH COLORED, TILL I FADE AWAY FROM PURE JOY." Irene from Tampa

Advocacy is a passion .. not a pastime - Joe
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Old 02-20-2010, 11:01 AM   #15
bejuce
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Re: Gallstones

Hi everyone,

Thank you for your concern over my driving to Disneyland. I made it just fine on Wednesday and had a great time at the park with the kids. We're going back home today and my husband was able to join us yesterday so he'll be doing the driving this time.

I'm scheduled to have my surgery next Thursday and hopefully all will go well. My surgeon left me a voice mail yesterday saying that he had discussed my case with my oncologist and they think it may be a good idea to do an oophrectomy at the same time.

I'm not sure about the ooph given that I'm only 39 and afraid of becoming menopausal so early. I'm also not sure if the data out there strongly supports one for premenopausal women. I'm doing just fine on Tamoxifen (I'm 30% ER+ and an intermediate metabolizer per the CYP2D6 test). Any ideas?

Thanks!!!

Marcia
__________________
ER+ (30%)/PR-/HER-2+, stage 3

Diagnosed on 02/18/09 at 38 with a huge 12x10 cm tumor, after a 6 month delay. Told I was too young and had no risk factors. Found swollen node during breastfeeding.
March-August 09: neo-adjuvant chemo, part of a trial at Stanford (4 DD A/C, 4 Taxotere with daily Tykerb), loading dose of Herceptin
08/12/09 - bye bye boobies (bilateral mastectomy)
08/24/09 - path report shows 100 % success in breast tissue (no cancer there, yay!), 98 % success in lymphatic invasion, and even though 11/13 nodes were still positive, > 95 % of the tumor in them was killed. Hoping for the best!
September-October 09: rads with daily Xeloda
02/25/10 - Cholecystectomy
05/27/10 - Bone scan clear
06/14/10 - CT scan clear, ovarian cyst found
07/27/10 - Done with Herceptin!
02/15/11 - MVA-BN HER-2 vaccine trial
03/15/11 - First CA 15-3: 12.7 and normal, yay!
10/01/11 - Bone scan and CT scan clear, fatty liver found
now on Tamoxifen and Aspirin


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Old 02-21-2010, 07:52 PM   #16
Margerie
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Re: Gallstones

Marcia,

I had what turned out to be gallstone attack/spasms a few months after my third child was born. I guess hormones can cause gall stones/spasms in the gall bladder. All was well untill 3 years later (and now on chemo) when I had another bout. The pain is something else, that is for sure!

I had already decided to get an ooph (I was 38, highly er+, pr+) so my general surgeon and gynecologist did a two for one surgery. Literally they used the same laporoscopic technique, and shared incisions.

I know it is a very personal decision, but wanted you to know that someone else had both done at once Other than feeling like a colicky baby for a couple of days, my surgery had an easy recovery.
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Dx 10/05 IDC, multi-focal, triple +, 5 nodes+
MRM, 4 DD A/C, 12 weekly taxol + herceptin
rads concurrent with taxol/herceptin
finished herceptin 01/08
ooph, Arimidex, bilateral DIEP reconstruction
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