Has anyone else's chemo been put on hold? Liver issues.

Zenmushroom

Hi there. I'm a 30F. Stage II. Post Lumpectomy. Her2+ Est + Proj -. Currently going through chemo. On the AC + THP regimen. Made it through the AC with nausea from hell (puked blood even), but still got through it. Taxol seemed like it was a breeze in comparison. No nausea. Also, no neuropathy yet and only very slight pain (knock on wood). The only major issue is that I wake up multiple times a night to pee (like 5-10 times) and have a hard time getting to sleep. One time I pissed blood, but a UTI was ruled out, and all my urine kidney tests said I was normal.

However, by my third taxol infusion they found my liver enzymes were escalating. ALT was 250. I'm not drinking alcohol, doing any supplements or even taking any pain killers. All I do is take a low level multivitamin (it's a kids MV in fact) and benadryl to help me sleep.

Doctor put my chemo on hold a week.

Fastforward, ALT dropped to 150. Doctor decided to go ahead and give me another taxol + perjeta + herceptin infusion, but lowered my dose.

Week after, ALT escalated to 300.

Got my liver checked via ultrasound. Everything looks normal.

Asked my doctor if I could take milk thistle herb for my liver, she said "no."

Doctor said she's planning to put my chemo on hold until my liver goes back to normal. Am worried. Anyone else go through this? I'm also worried they might stop my taxols entirely, even though I've only done 4 and have 8 more to go (although no one has said yet that they're planning to do this).

exercise_guru

I didn't experience this but I do know a bit about liver enzymes. Are they giving you the herceptin and perjeta with the taxol? Is this weekly taxol?what is the chemo schedule?

I have read that perjeta can cause quite a bit of diarrhea. So maybe provide a bit of reference to how you are handling that. Also how are your white blood cells and such?

Zenmushroom

I'm supposed to be doing weekly taxol, and herceptin + perjeta once every three weeks. But my liver situation has a thrown a monkey wrench into all that. My diarrhea-like-poop isn't that bad. Just happens like one time after I do the Perjeta and then goes away. I don't think I'm doing anything to manage it, I think I'm just lucky I guess.

White blood cells are low of course, but not as low as they were after the AC. And since I've been off chemo for a week, they've had a chance to go up. I've even had some hair grow back. What am I doing about my low white blood cells? Nothing really. Just washing my hands a lot, sleeping in a bed separate from my boyfriend, and being super cautious. Had a yeast infection during the A/C that got pretty annoying, but aside from that, nothing super bad happened as a result of my low WBC.

exercise_guru

Well I can share my story and maybe you can glean something from it that will help. Ofcourse the gut in Chemo is really tricky so don't be too hard on yourself if this isn't doable. After Chemo my gut was just a mess and a year later my liver markers shot through the roof and would not come down. Finally I met with a dietician and she put me on yogurt and a probiotic ( something I didn't take during Chemo) but after that she suggested I try to lower my liver markers by following an easy protocol getting up in the morning a few times a week not on consecutive days. I will just cut and paste what she suggested I do.

Here are the instructions for the Liver Flush:

The best time to do this is first thing in the morning, however it can be done in the mid-afternoon or evening (on an empty stomach). Whisk together 2 tablespoons of extra virgin olive oil and the juice of ½ of a fresh lemon. Be aware that is mixture has a very strong olive oil smell, however it tastes like lemons. It will not cause diarrhea. It will flush bile and toxins out of the liver and gallbladder into the intestines where is will be excreted. Eating a high fiber snack or meal about 15-30 minutes after flushwill help insure that toxins are excreted because the fiber binds to the bile. Metamucil, a bowl of oatmeal or a high fiber food. This should be done every other day for 10 days for a total of 5 times.

I am not sure that with Chemo your gut could handle this but in hindsight I think I would have tried it while I was on chemo because I have cumulative problems from Chemo that are effecting my liver markers now. Its not a horrible crazy wierd idea so maybe it might help get those liver markers back down and clean all that chemo out .

I know this is a very emotional time. I remember being overwhelmed and I had a lot of issues during chemo. Just keep doing what you can Hopefully the markers will come down so you can resume chemo.

There is another protocol for healing the gut. They use it a lot with cancer patients who can't keep weight on during Chemo. I had to use it during chemo because I had a wound from my port that would not heal it is Glutamine and arganine. The cancer dietician gave me packets of it then I had to buy them on my own and they were crazy expensive. Its a product called Juven you can click on that to see if it might be helpful. I bet after AC your gut is shot. My dietician did say there is contraversy about glutamine because ofcourse they want to kill the cancer but its worth asking your MO about. I got a prescription for it but my insurance was still jerks and wouldn't cover it so I ordered it off of Amazon.

Here is what my dietician wrote about Glutamine

L-glutamine is an amino acid found in food and the most abundant amino acid in our bodies. It is the preferred source of fuel for the cells that line the small intestine - called enterocytes. I recommend taking at least 10 grams a day. It comes in powdered form that you can mix with food or a smoothie. Taking 5 grams (5000 mg) twice a day would be most beneficial.

https://smile.amazon.com/Nutricost-L-Glutamine-Powder-500-Glutamine/dp/B00SHXE7VK/ref=sr_1_7_a_it?ie=UTF8&qid=1527692728&sr=8-7&keywords=l-glutamine+powder

I found this article but I haven't read it it yet. Its on my list because I have had so many issues post Chemo

The Role of Nutritional Supplements in the Treatment of Cachexia in Cancer Patients—The Registered Dietician's Perpective

Zenmushroom

Did the oil/lemon thing help bring your liver markers down

exercise_guru

Sorry I can't be more help with that because I just met with the dietician last week and they won't check my liver markers for 3 months. I am going to do this cleanse with coconut oil because I hate the taste of olive oil. My dietician said that would work as well. My ultrasound on my liver was normal so they really believe that it is just toxicity in there that I need to clean out. I have a higher BMI so probably some of the fat in my liver is trapping junk that needs to get out.

star2017

I developed a fever and low wbc that delayed treatment by a week and then shingles that delayed another week. After that I was back on track

Zenmushroom

Thanks Exercise_guru for the advice. Be sure to ask your doctor about the oil/lemon thing though, because I've read mixed reviews on the practice, and some of these homeopathic recipes aren't really based on any kind of sound medical science.

exercise_guru

Oh I agree but I can't imagine metamucil 30 minutes after 2tblsp of olive oil and lemon juice are going to do anything bad especially since they checked my gall bladder and all is well just fatty liver and high liver markers but then again I am two years out of chemo so that's a different Bal game.

I hope your markers go down

exercise_guru

Also she is a clinical dietician I was referred to by my Gastroentologist so I have some confidence she won't steer me wrong

exercise_guru

Any luck with your liver enzymes? Hope Chemo is going well.