Liver Mets Question

mary c · 10-05-2005, 09:30 AM

I was wondering if someone could help me... in December of 2004 I started taxotere as I was told that I had a 7cm tumour on my liver - my liver counts were well over 200 - after the first chemo, my liver counts drastically fell and shortly after became normal (below 21) and still remain normal. My question is... why are my liver counts fine when the tumour has not shrunk??

Mary

jessica · 10-05-2005, 11:11 AM

Hi Mary~
I have a long, however successful history with liver mets. I'm NED (again) after battling a stubborn spot for ~8mos. That's great news that your liver function is back to normal!
I guess my first question is, how do you know the tumor hasn't shrunk? Have you had a follow up scan? If you've had a CT or MRI, those studies will still image scar tissue that is left behind. However, a PET scan will show you what is actual live, metabolic tissue vs. necrotic or scar tissue.
All of my follow up/re-staging scans are PET, b/c the CT's always show scar tissue.
Hope this info is helpful.
Keep the Faith!

mary c · 10-05-2005, 11:16 AM

Thanks Jessica - I have had 2 CAT scans - both have implied that it could be a collection of blood cells (hemangioma), so I am really confused - I guess I should be trying to get a PET scan done.

Mary

StephN · 10-05-2005, 12:01 PM

Hi Mary c -
I too have a history with major and aggressive liver mets. All is under control now, my liver is clean as a whistle except for a small spot that they call a hemangioma, and I am NED for over 3 years at this point. A PET scan was what we used to confirm that the last few spots were indeed scars and I could get off the chemos.

When my liver mets were discovered my liver was some 60% involved with tumors, some big as my fist and too many others to count. BUT - the interesting thing is that my liver function were NORMAL, all but one value.
So, my med onc said that this was a very good sign that my liver was very healthy and functioning properly aside from the tumors.
I also learned that a person can live with only about 10% of their liver in good working order.

The liver in one organ that will completely regenerate.
One problem with having scans only when we develop cancer is that the docs don't have something prior to compare with. So, there are always some spots that show up that are due to other causes and not cancer.

Esther · 10-06-2005, 08:02 AM

Mary, I had extensive liver mets also, 90% of my liver was covered in tumors. I was functioning with less than 10% of my liver and my liver was shutting down when I was diagnosed.

From my experience, the liver enzymes are an indication that your liver is functioning properly, and that you are not in a life-threatening situation at that moment. Your liver enzymes can be normal and still have active cancer there.

With me, the ct scan had a really hard time telling the difference between an active liver tumor and scar tissue. One ct scan actually said the tumors were incresing in size, when that was not in fact the case.

A pet/ct scan was what we finally used to determine what was scar tissue and what was active tumors. The report actually read "previously treated metastatic lesion" for healed spots.

So your tumor may have shrunk some, and they just can't detect it via the scan method they are using. though if your liver enzymes are good, it would seem to me you are on the right track.

al from Canada · 10-06-2005, 09:28 PM

Dear Mary,

Linda has had liver mets for over 18 mos and we can't figure out if we are beating them into remission or not. The intial report said 85% mets, all liver chemistry was through the roof and she was starting to jaundice. We gained at least 10%, so there was 75% active cancer, her counts were dropping and jaundice was gone....all within 8 weeks. That brings us to 16 months where all imaging has shown 75% active cancer despite herceptin, navelbine, xeloda.......go figure but pretty discouraging.

3 days ago she had a PET scan where that may shed some light onto things.

As for the counts, there are 6 we look at and all may get elevated for different reasons. For example; ALK PH. is elevated by other organs including bones; ALK by wine; Bilirubin by biliary blockage, damage or compression and even gall bladder problems; BUT gamma GT is the one most professionals associate directly with liver damage.

They also never draw conclusions by reading these counts in isolation; they look at the interactions between them to zero-in. In other words, one of these markers could elevate X 100 and you could have nothing what-so-ever wrong with your liver. I will post the PET results when I get them.

Take care,
Al

mary c · 10-08-2005, 02:40 PM

Thanks for the information Steph, Esther and Al!

Mary

Al - I am in Ontario too - did your wife get her PET scan done in Hamilton? Did your doctor request it or did you do it on your own??

al from Canada · 10-08-2005, 05:19 PM

Mary,

Yes we got it in Hamilton. Linda is on the list for the vaccine trial in Seattle and it was Seattle who requested the scan, but we went through our local onc.. They want to get a handle on the tumor load.
Regards,
Al

mary c · 10-10-2005, 05:38 PM

Thanks Al!

mamacze · 10-10-2005, 07:28 PM

Al,
Please keep us posted on the PET scan results; give Linda a hug for us.
Love Kim from CT

Gina · 10-12-2005, 11:40 PM

Did your wife ever try hitting the liver mets with a 5-day Z - pak prior to a herceptin only infusion??? or will her liver function not support this strong antibiotic as its half-life of 68 to 72 hours is longer than most any other on the market and not the easiest on the liver or kidney function?? If she were deemed able to try it, then after the herceptin, infusion...flush the body with things like pure water, chicken soup, artichokes dipped in vinegar, olive oil, etc..etc.--not fruit juice at this point??? This simple remedy has saved me and folks I know many times...it does not seem to be a permenant solution but does sometimes, give you a chance to get ahead of the her-2...also, are your wife's serum her-2 tumor markers being evaluated on a regular basis and what do they look like compared to the various ups and downs of the other 6 liver related counts??? FYI, it has been my experience that the GGT is always elevated when you have her-2 active in the liver, fyi...but I don't think it always means "liver damage" but is an indication of a certain alcohol-like chemical (I need my notes..) elevated in the liver--which of course, can lead to liver damage as if her-2 in the liver isn't already damaging enough. smile..I have a whole REALLY long boring theory about GGT..yes, longer than some of my others posted here...on this site...but tonight, as it is quite late in VA, I WILL SPARE YOU ALL...smile.

Cheers,
Gina

Maryanne · 10-13-2005, 11:35 AM

Gina,

are you saying that liver levels can rise while on Herceptin? All my scans were fine as well as liver levels,before starting chemo,Since going on Herceptin they are now rising, I will be going for a screening pet scan next week to find out more....of course I am thinking the worst.
Maryanne