Liver?

[RhondaH]

Ever since I started Herceptin 8/05, I have had liver issues. Hepatic failure is listed as one of the "rare" side effects of Herceptin. When I first started Herceptin, my liver enzymes began raising (not sure if due to Herceptin or the Phenobarb I take for seizures as this TOO can increase liver enzymes). November, I had severe pain in my upper right side (gall bladder was taken out 2001) so went to ER and hospital did cat scan of liver and chest xray, everything ok (I was dx Stage 1, ER/PR-, Her2+, no nodes 2/1/05, did 6 rounds of dose dense TEC, 33 rads and began 1 yr of Herceptin every 3 weeks 8/18/05, will be done 8/10/06). Doc put me on every week Herceptin to see if this would bring enzymes down, apparently did. Didn't like doing every week (wanted normalcy) so asked doc if could do every 3 again. He said sure and that it was safe to say the Herceptin was affecting my liver. Not my LAST Herceptin, but the one before a coworker noticed that my hands and feet (looks like a glove, much like when I was going through chemo, but not red) were yellow (but no where else on my body). The yellow comes and goes. Last week I was feeling a bit nauseas (not bad, but a little), but TODAY I feel VERY nauseas. Yesterday, I noticed my one leg is slightly swollen, and I have been itching a bit (this also comes and goes) as well as my right side and back hurt on and off (this may be because of tubing w/ Tony at the water park). I just feel kind of poopy (don't need this as I move in 2 weeks). Also, I haven't had an ECHO since 8/15/05 (my doc is "lenient" about that, my onc nurse said). I PRAY, that this is not mets to the liver, but I was wondering if anyone else had the Herceptin cause a "liver irritation"? I hate feeling like a hypochondriac, but I hate the alternative. Take care and God bless.

Rhonda

[AlaskaAngel]

Hi Rhonda,

I have had mildly elevated liver function tests both before and throughout treatment that continue even now, and finally my doc and I and a gastrodoc agreed that they are just normal for me. I appreciate my doc no end for providing the tests regularly just in case they soar, and for allowing me to talk to the gastrodoc because my right side does ache. I remind myself that we are just as prone to the usual middle-age liver problems as women who don't have breast cancer. I've had a CT that shows nothing, and the only thing that did show anything was the ultrasounds, which continue to show what is thought to be hemangiomas. I would keep having the testing and getting your doc's opinion, and get as good of an understanding as you can about other possibilities like primary biliary cirrhosis, etc. so you can talk your symptoms over with your doc.

AlaskaAngel

[StephN]

That is the "beauty" of this disease, as Lyn perhaps would say.
As we notice new oddities and symptoms it is up to each of US to report them to our medical team. If they are stumped, then we have to keep looking for other causes as A.A. mentioned.
Sorry - Rhonda, but your symptoms as a group are new to me and I have known quite a few women on Herceptin and who have liver mets. I am primarily thinking of the swelling and yellowish color. As one who had a large portion of my liver overtaken by mets, it is something I know a little about. I was never yellowish - only a little greyish when my red blood cells were low. The liver mets CAN sneak up and you won't know it until you are very yellow and sick, as happened with Esther and Linda. The swelling sounds like more than just a slight puffiness from chemo or steroids. A person can live with maybe only 10% of their liver if that part is functioning well. Maybe have bile duct checked. Have you had your appendix out yet?? Thinking now of the nausea.

You may be having some kind of allergic reaction. Or picked up a strange virus (there are a lot of those!). Just some quick thoughts. Sure hope you get it sorted out and feel better very soon.

[Unregistered]

I have had elevated lever enzymes (slightly) from medicines used in surgury and other, even Tylenol. But unfortunately, we cannot afford to 'guess' why, bc survivors must always be on the offensive. BC is very insideeous and thedifference between us and a normal person is that they're not likely to have bc related problems and we...well...are. So many times I thought I had 'age' related or 'normal' things and it turned out to be bc. I know we want so much to be normal and like everybody else but we're not and that's what made me neglect headaches for a long time that were brain tumors. I had a small stroke that could have been prevented if I had faced it and diagnosed it sooner. This from a respected neurosurgeon.

[penelope]

I just posted this on another thread a few days ago.

oh my gosh I thought I was insane or that it was in my liver. I have these weird little "spasms or cramps" well tightness which is really not painful just annoying in my right side. My stomach always feels tight and uncomfortable. Sort of like morning sickness when you can never let your stomach get empty. Could this be from herceptin? I get it ever 3 weeks.

If you have had a CT I am sure you are fine as far as cancer in there. I was unaware that herceptin could raise liver enzymes, mine are also mildly elevated.
Rhonda what size was your primary?

[RhondaH]

1.6 cm, no nodes. My onc feels that the Herceptin must be agitating my liver (this in addition to my phenobarb). My surgeon says that he is finding in his patients MORE side effects than those "listed on the bottle" and that us "early stagers" are writing the NEXT chapter of Herceptin and side effects.

Rhonda

[CherylS]

My liver enzymes were slightly up this time too and I am wondering about Herceptin as well. What kind of AST, Alkaline Phosphate, Bilirubin, ALT etc...numbers have you guys been seeing. My AST was 42,(High range of normal is 45) Alkaline Phosphate, 74, both up from mid teens before bc. Total Bilirubin 0.3. Wish I understood these better. I think it was Lani who put a great post on another board with a link to understanding these tests better, but I am still confused as to whether this is to worry about or not. Appreciate any further input.

[penelope]

Try these links ladies... I found them very helpful. Also my sister who is a hematologist, said that liver function tests should be done fasting. I have never been told to do mine fasting, but am going to try this time.

http://www.healthatoz.com/healthatoz/Atoz/ency/liver_function_tests.jsp
http://www.labtestsonline.org/understanding/analytes/alp/test.html
http://www.answers.com/topic/liver-function-tests

[MCS]

HI Rhonda,


I have a lot of itching also. I know it's scary. what will they tell us next, right? I have realized that with the herceptin, we are finding out things just talking amongst ourselves, just like your doc said- we are writing it. I feel like everytime I have a new symptom, I should write a lttter to genentech and let them know directly. not that they will listen, but you feel like you're contributing.

i think you will be ok. i agree with Steph and her liver diagnosis. I have not checked the links mentioned above yet.

Hang in there

XO

MCS (maria)