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Old 09-11-2008, 12:08 PM   #1
rebecca0623
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Liver enzymes up - what is this??

Just had second bloodwork for chemo done Wednesday and being sent for PET because liver enzymes up and not going down. This is one test prior to all chemo and one after first TCH. Help - what does this mean?????? Also, now have to learn to give myself neupagen shots as white cells fell from 14,100 to 1,400 in one week. I hear this causes bone pain - any suggestions? Geez.
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Dx June 2008, Age 44
Mother Dx age 54, deceased
1.2 cm tumor right breast, grade 3, ER 4+; PR 3+
HER2 +, invasive ductal carcinoma
Quadrantectomy right on 7/30/08
Path report, all 3 nodes taken were clear!!!!!!
Lymphatic/vascular invasion and sent out BRCA testing
Port in on 9/2/08. Chemo began 9/3/08. TCH (MUGA wrong - echocardiogram says 65% cardiac MRI 59% 9/10/98 elevated liver enzymes, PET scan 9/16/08 all clear.
TC ended 12/17/08
Port blood clot and hosp. 1/2/09
radiation begins 1/8/09


BRCA testing done - results NEGATIVE!

cardiologist said go back to coreg as it helps counteract heart effects of herceptin and slowly increase dosage - now 40mg daily.
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Old 09-11-2008, 07:22 PM   #2
Joan M
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Rebecca,

I'm not sure whether the T in TCH is Taxol or Taxotere, which are related drugs, but Taxol causes liver enzymes to rise.

I had Adriamycin, Cytoxan and Taxol.

In any case, it's good that you are getting a PET scan, just to be on the safe side.

As for the Neupogen, you can get preloaded syringes, and it's easy to just pop one in the top of your thigh, by hold up the skin between your index finger and thumb. Remember to keep the syringes in the refrigerator.

I had no bone pain with Neupogen, but it can happen.

I'm sending good vibes your way for a noneventful PET scan.

Joan
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Old 09-11-2008, 07:48 PM   #3
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I think I received the 'shot' a couple of times during my chemo when my blood count was low. Yes, it made my lower legs very, very heavy. Don't know if it is the so-called 'bone pain'. It is tolerable, though.

Found this paragraph in <breastcancer.org>:

A study that compared Taxol to Taxotere along with other chemotherapy showed that the regimen containing Taxotere was more effective for metastatic disease than Taxol after anthracycline chemotherapy (Adriamycin) has stopped working. It was better in terms of shrinking the cancer, in how long the response lasted, in the time it took for the disease to progress, and in overall survival.
In addition, data show that Abraxane, a newer taxane, may also work better than Taxol or Taxotere with fewer side effects.
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Old 09-11-2008, 08:00 PM   #4
grandma2
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i had neupogen probably a dozen times during my ac and taxotere. the first time was the most excruciating pain i've ever had in my life...all over my body. subsequent shots were not nearly as bad. be prepared with good pain meds (ask onc). mine said tylonel but that would not have touched it in a million years. i've heard that clariten D before shot works wonders but i didn't hear about that till after i had chemo. towards the end of taxotere i had a scary allergic reation to neupogen and had to change to leukine. but i was getting shots several days in a row. i'm only telling you this so that if you have any symptoms that seem extreme to you (like my 103 fever) be sure to call your onc. at once. good luck, gm
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Old 09-11-2008, 09:06 PM   #5
Melissa
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During chemo my liver enzymes were high. They were also high when I first starting taking Arimidix. I was sent for a scan and nothing was found to be abnormal. My liver enzymes are normal now. I did have bone pain when I took neupogen. It was terrible but doable. I stayed in bed (I'm not one to stay in bed) and took Tylenol. Ask your onc about pain medicine just in case. You'll come through it!!! Wishing you the best...
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04/06, (42), 2cm tumor, 7/13 nodes, one positive node under clavicle
mastectomy/reconstruction
grade 3, stage lllb, er-65+, pr-90+, her2+++(80%)
4/AC, 12wks TH then 6wks rads
40 wks herceptin, and tamoxifen.
onc test tamoxifen resistance = poor metabilizer
04/07 ooph & on arimidex
08/07 completed herceptin

04/2022 - 16 year survivor!
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Old 09-11-2008, 10:28 PM   #6
TriciaV
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Smile

Rebecca,

I was diagnosed at 31 and I also did TCH and I also had to take the neupogen injections for seven days after each chemo. My husband gave them to me and we used my stomach as it was the easiest for us to use. I did have a lot of bone pain mainly in my thighs...it felt like a really deep flu like ache. But very doable. I was already on vicodin and that seemed to help me alot. As far as the liver enzymes go.... I didn't have any problems until after chemo and started tamaxofin..... and it was the opposite... my liver became very inlarged and still is, but all my enzymes come back fine. My onc says its the tamaxofin thats enlarging my liver. I was googling liver issues and came across a site...I think something like national liver foundation or something like that...and it listed a few drugs that really have an impact on the liver and tamaxofin was on that list. My onc says once I am off the tamaxofin it will resume normal size. We'll see. But the neupogen is doable and kept my counts where they needed to be and I never got sick with a cold or flu or any other infection... I did really well. I did however get really sick on the TCH, but I am past that part hopefully forever.... remember you will get through it...just take it in stages. Good thoughts to you as you battle on.
Tricia V.
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10/06 -31 years old then had pain in RT breast/Discovered Lump
Dr.s Dx was "it's just an infection" "your too young" "breast cancer doesn't hurt" HUH???
Mammo and Ultrasound found 3 seperate masses largest being 7cm. Dr was sure they were an old breast infection, gave me antibiotics and sent me on my way. after three months of 4 rounds of antibiotics and fighting with the Dr. Finally had a 2nd Dr listen to me and had surgery
1/4/07 Surgical biopsy done :-(
DX stage 3c IDC er+ pr+ Her2+++ 31 years old
2 rounds ACH 6 rounds CTH ,a little healing time and then Mastectomy w/lymph node dissection, 9/27 positive nodes, a little more healing time
5/07 started another 6 rounds of cleanup chemo of CTH- Carboplatin, Taxotere and Herceptin
started Tomoxafin 9/07, Also declared NED 9/07
2009-Lymphedema- sleeve and glove
6-26-11 X-rays show suspicious spot on right 6th rib
8-25-11 another round of X-rays ordered, which also showed same spot on right 6th rib
9-1-11 Onc had bone scan done
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Old 09-12-2008, 05:22 AM   #7
Pam P
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When I was on a different chemo, navelbine, my liver counts were high - but nothing was found in the liver, so it must have been the navelbine effects. Also on navelbine I had to take neupogen shots. I gave myself shots for 3 or 4 days after each treatment. I don't recall any leg/bone pain (but it's been a few years). I gave the shots in my stomach - if I did it quickly it didn't hurt. When I was tentative with the syringe it did hurt, so I learned to aim, take a deep breathe, and push it in fast.
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6/01 IBC er+ her2+stage IIIb; mastecomy
7/01 AC, taxol; radiation
2/02 tamoxifen
9/02 stage IV bone mets femara
1/03 taxotere/herceptin/aredia
6/03 herceptin, aredia & faslodex
1/04 navelbine, herceptin, aredia
2/05 herceptin/aredia
7/05 xeloda/herceptin/aredia
3/07 xeloda/tykerb/aredia
5/08 taxol/avastin/aredia
2/09 gemzar/herceptin/zometa
7/09 Taxol/Carbo/Herceptin, zometa
10/09 navelbine/herceptin & zometa
2/10 herceptin & tykerb & zometa
4/10 add xeloda &aromasin
10/10 dx with dermatomyiositis triggered by cancer
11/10 restart herceptin, tykerb, zometa
12/10 surgery-place rod in R femur to stabilize bone
1/11 radiation to R femur - 20 tx
2/11 2nd surgery - rod in Left femur
2/11 tx eribulen -- suspended dx brain mets
3/11 brain mets wbr 20 tx
4/11 halaven; discontine 8/11 not working
8/11 radiation to left femur 20 tx'
8-9/11 rad to lower spine
9/11 abraxane/herceptin/zometa
9/12 xeloda/herceptin/zometa
12/12 ablation of liver
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Old 09-12-2008, 06:38 AM   #8
SoCalGal
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Rebecca - There is a girl in my group who takes claritan plus benedryl the day before - the day of and the day after and says it eliminates bone pain. I would ask your onc for guidance on the highest dose you can safely take of these.
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1996 cancer WTF?! 1.3 cm lumpectomy Er/Pr neg. Her2+ (20nodes NEGATIVE) did CMF + rads. NED.
2002 recurrence. Bilateral mastectomy w/TFL autologous recon. Then ACx2. Skin lymphatic rash. Taxotere w/Herceptin x4. Herceptin/Xeloda. Finally stops spreading.
2003 - Back to surgery, remove skin mets, and will have surgery one week later when pathology can confirm margins.
‘03 latisimus dorsi flap to remove skin mets. CLEAN MARGINS. Continue single agent Herceptin thru 4/04. NED.
‘04 '05 & 06 tiny recurrences - scar line. surgery to cut out. NED each time.
1/2006 Rads again, to scar line. NED.

3/07 Heartbreaking news - mets! lungs.sternum. Try Tykerb/Xeloda. Tykerb/Carbo/Gemzar. Switch Oncs.
12/07 Herceptin.Tykerb. Markers go stable.
2/8/08 gamma knife 13mm stupid brain met.
3/08 Herceptin/tykerb/avastin/zometa.
3/09 brain NED. Lungs STABLE.
4/09 attack sternum (10 daysPHOTONS.5 days ELECTRONS)
9/09 MARKERS normal!
3/10 PET/CT=manubrium intensely metabolically active but stable. NEDhead.
Wash out 5/10 for tdm1 but 6/10 CT STABLE, PET improving. Markers normal. Brain NED. Resume just Herceptin plus ZOMETA
Dec 2010 Brain NED, lungs/sternum stable. markers normal.
MAR 2011 stop Herceptin/allergy! Go back on Tykerb and switch to Xgeva.
May-Aug 2011 Tykerb Herceptin Xgeva.
Sept 2011 Tykerb, Herceptin, Zometa, Avastin.
April 2012 sketchy drug trial in NYC. 6 weeks later I’m NED!
OCT 2012 PET/CT shows a bunch of freakin’ progression. Back to LA and Herceptin.avastin.zometa.
12/20/12 add in PERJETA!
March 2013 – 5 YEARS POST continue HAPZ
APRIL 2013 - 6 yrs stage 4. "FAILED" PETscan on 4/2/13
May 2013: rePetted - improvement in lungs, left adrenal stable, right 6th rib inactive, (must be PERJETA avastin) sternum and L1 fruckin'worsen. Drop zometa. ADD Xgeva. Doc says get rads consultant for L1 and possible biopsy of L1. I say, no thanks, doc. Lets see what xgeva brings to the table first. It's summer.
June-August 2013HAPX Herceptin Avastin Perjeta xgeva.
Sept - now - on chemo hold for calming tummy we hope. Markers stable for 2 months.
Nov 2013 - Herceptin-Perjeta-Avastin-Xgeva (collageneous colitis, which explains tummy probs, added Entocort)
December '13 BRAIN MRI ned in da head.
Jan 2014: CONTINUING on HAPX…
FEB 2014 PetCT clinical “impression”: 1. newbie nodule - SUV 1.5 right apical nodule, mildly hypermetabolic “suggestive” of worsening neoplastic lesion. 2. moderate worsening of the sternum – SUV 5.6 from 3.8
3. increasing sclerosis & decreasing activity of L1 met “suggests” mild healing. (SUV 9.4 v 12.1 in May ‘13)
4. scattered lung nodules, up to 5mm in size = stable, no increased activity
5. other small scattered sclerotic lesions, one in right iliac and one in thoracic vertebral body similar in appearance to L1 without PET activity and not clearly pathologic
APRIL 2014 - 6 YRS POST GAMMA ZAP, 7 YRS MBC & 18 YEARS FROM ORIGINAL DX!
October 2014: hold avastin, continue HPX
Feb 2015 Cancer you lost. NEDHEAD 7 years post gamma zap miracle, 8 years ST4, +19 yrs original diagnosis.
Continue HPX. Adding back Avastin
Nov 2015 pet/ct is mixed result. L1 SUV is worse. Continue Herceptin/avastin/xgeva. Might revisit Perjeta for L1. Meantime going for rads consult for L1
December 2015 - brain stable. Continue Herceptin, Perjeta, Avastin and xgeva.
Jan 2016: 5 days, 20 grays, Rads to L1 and continue on HAPX. I’m trying to "save" TDM1 for next line. Hope the rads work to quiet L1. Sciatic pain extraordinaire :((
Markers drop post rads.
2/24/16 HAP plus X - markers are down
SCIATIC PAIN DEAL BREAKER.
3/23/16 Laminectomy w/coflex implant L4/5. NO MORE SCIATIC PAIN!!! Healing.
APRIL 2016 - 9 YRS MBC
July 2016 - continue HAP plus Xgeva.
DEC 2016 - PETCT: mets to sternum, lungs, L1 still about the same in size and PET activity. Markers not bad. Not making changes if I don't need to. Herceptin/Perjeta/Avastin/Xgeva
APRIL 2017 10 YEARS MBC
December 2017 - Progression - gonna switch it up
FEB 2018 - Kadcyla 3 cycles ---->progression :(
MAY30th - bronchoscopy, w/foundation1 - her2 enriched
Aug 27, 2018 - start clinical trial ZW25
JAN 2019 - ZW25 seems to be keeping me stable
APRIL 2019 - ONE DOZEN YEARS LIVING METASTATIC
MAY 2019 - progression back on herceptin add xeloda
JUNE 2019 - "6 mos average survival" LMD & CNS new single brain met - one zap during 5 days true beam SBRT to cord met
10/30/19 - stable brain and cord. progression lungs and bones. washing out. applying for ds8201a w nivolumab. hope they take me.
12/27/19 - begin ds8401a w nivolumab. after 2nd cycle nodes melt away. after 3rd cycle chest scan shows Improvement, brain MRI shows improvement, resolved areas & nothing new. switch to plain ENHERTU. after 4th cycle, PETscan shows mostly resolved or improved results. Markers near normal. I'm stunned but grateful.
10/26/20 - June 2021 Tucatinib/xeloda/herceptin - stable ish.
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Old 09-12-2008, 06:44 AM   #9
PinkGirl
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Hi Rebecca
After 4 chemo treatments, my liver enzymes were very high.
My onc. ordered a CT scan and my liver was fine. The levels
eventually went back to normal.
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Dx Aug/05 at age 51
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Sept 7/05 Mastectomy
4 FAC, 4 Taxol, no radiation
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Old 09-12-2008, 06:45 AM   #10
rebecca0623
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Thanks everyone!! Had first neupogen shot last night and it really burned and kept burning for about an hour. Doc said tylenol which I did but did not touch the pain. I am going to call him and ask about the Claritin or benadryl. I work for a health care company so have plenty of nurses to give me the shot - at least I don't have to buck up to give it to myself!. Thanks for all the great advice, I'll post about the PET after Tuesday test.
__________________
Dx June 2008, Age 44
Mother Dx age 54, deceased
1.2 cm tumor right breast, grade 3, ER 4+; PR 3+
HER2 +, invasive ductal carcinoma
Quadrantectomy right on 7/30/08
Path report, all 3 nodes taken were clear!!!!!!
Lymphatic/vascular invasion and sent out BRCA testing
Port in on 9/2/08. Chemo began 9/3/08. TCH (MUGA wrong - echocardiogram says 65% cardiac MRI 59% 9/10/98 elevated liver enzymes, PET scan 9/16/08 all clear.
TC ended 12/17/08
Port blood clot and hosp. 1/2/09
radiation begins 1/8/09


BRCA testing done - results NEGATIVE!

cardiologist said go back to coreg as it helps counteract heart effects of herceptin and slowly increase dosage - now 40mg daily.
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Old 09-12-2008, 11:25 PM   #11
jhandley
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Smile Reishi mushroom extract raises wbc

Hi Rebecca
During my second lot of chemo I took reishi mushroom extract (Greenridge Immune support). It worked for me..raised up my wbc ,my onc said "your bloodwork is beautiful!"

I took it about 2 days after tx and continued until 3 days before the next one. I was hardly ever sick, no ulcers or anything.
Food for thought.
Jackie (down under)
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Old 09-12-2008, 11:50 PM   #12
Gina
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Ditto on the reishi mushroom to raise WBC's

Even when I was on chemo back in 1998, I did the reishi mushroom and it worked for me...just one note...once you are off blood-lowering types of chemos and just on Herceptin by itself...you might want to discontinue the reishi mushroom daily doses...eating mushrooms or an occasional drop or two is probably ok, but you do not want to find your self in a position where you are raising the WBC's either as there are some concerns about increasing cancer risks...

fyi,
Gina
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