Neoadjuvant Chemotherapy Patients

margo · 05-05-2009, 07:07 AM

For patients who have had neoadjuvant chemotherapy:

Has anyone developed Nonalcoholic steatohepatitis (NASH)? It is a disorder characterized by hepatic steatosis, and is known to progress to inflammation and fibrosis with a risk of developing hepatocellular carcinoma (HCC).

I have an appointment at Johns Hopkins for a biopsy to confirm CT and MRI results, and to assess the presence of tumour necrosis factor (TNF). Other than neoadjuvant chemo, I have no other risk factors for hepatic injury.

I am almost 5 years out from a diagnosis. Every day is a gift.

Let me know.

Cheers,

Cannon · 05-05-2009, 07:42 PM

No news, but a response. No, never had it, never heard of it. My neoadjuvant was does dense A/C.

My liver blood tests have been wacky.

What do they think they may see on the CT scan?

Wishing you the best,
Rebecca

Cannon · 05-05-2009, 07:51 PM

I see I misread - you are going for biopsy, which seems to be the only way to diagnose this liver disease, and distinguish from fatty liver (which I do have, and am overweight). It doesn't seem that there is much to do about NASH

from NIH site link below:

Currently, no specific therapies for NASH exist. The most important recommendations given to persons with this disease are to

reduce their weight (if obese or overweight)
follow a balanced and healthy diet
increase physical activity
avoid alcohol
avoid unnecessary medications

http://digestive.niddk.nih.gov/ddiseases/pubs/nash/
Nonalcoholic steatohepatitis or NASH is a common, often “silent” liver disease. It resembles alcoholic liver disease, but occurs in people who drink little or no alcohol. The major feature in NASH is fat in the liver, along with inflammation and damage. Most people with NASH feel well and are not aware that they have a liver problem. Nevertheless, NASH can be severe and can lead to cirrhosis, in which the liver is permanently damaged and scarred and no longer able to work properly.
NASH affects 2 to 5 percent of Americans. An additional 10 to 20 percent of Americans have fat in their liver, but no inflammation or liver damage, a condition called “fatty liver.” Although having fat in the liver is not normal, by itself it probably causes little harm or permanent damage. If fat is suspected based on blood test results or scans of the liver, this problem is called nonalcoholic fatty liver disease (NAFLD). If a liver biopsy is performed in this case, it will show that some people have NASH while others have simple fatty liver.
Both NASH and NAFLD are becoming more common, possibly because of the greater number of Americans with obesity. In the past 10 years, the rate of obesity has doubled in adults and tripled in children. Obesity also contributes to diabetes and high blood cholesterol, which can further complicate the health of someone with NASH. Diabetes and high blood cholesterol are also becoming more common among Americans.

margo · 05-08-2009, 01:00 PM

Thank you for the additional information from the NIH site. Very helpful, indeed. My liver surgeon told me that the changes in my liver are due to the neoadjuvant chemo (NC), and that this is a finding that is increasing as more patients receive NC. My BMI is too low, and I do not have other risk factors for steatosis. Originally, I had mets to my liver, so I a bit anxious when any change is noted.

Thank you again,

M