Fatty Liver Disease and Tamoxifen

What????? Like I need one more thing to have to worry about....now it's a fatty liver and increased abdominal girth?  It never crossed my mind but now that you have started this thread, I'll be researching the patootie out of this along with everything else I am researching this week.  I just came up with a clinical trial of an aromatase inhibitor vs. Tamoxifen in re: liver issues published this month.  You can bet I'll be emailing my oncologist about this tomorrow!  Thank you for sharing this information!

Oh Yeah,

I went Bilat mx because I wanted to avoid radiation and Tamoxifen.  I had already been prescribed Fosamax because of low bone mass.  I had been taken off of it years ago because of the jaw bone studies.  Bilat mx allowed me to skip radiation & Tamoxifen (previous oopherectomy).

TTA inhibits growth of human breast cancer cells...

http://www.springerlink.com/content/lx3k165612u36228/

Hi Erika:  I have not emailed my onc yet but I have ordered the TTA supplements.  I just looked at my records and I had a liver panel performed last May - and it was normal.  So getting another one less than a year out will not hold much weight I am afraid.  Frankly, I know my onc is not going to have a clue about TTA and I wish I had known about this to discuss it with her during my bi-annual appt. last week! I have to "email" her through the Kaiser system and so I cannot link all of the above websites or references to her.....

I'll let you know....

Lisa:  Severe?  This is outrageous!  Do you mind me asking if your oncologist ever ordered a baseline liver panel?  Was it ever suggested that liver enzymes should be monitored while on Tamoxifen?  I mean, this is well-published.  I do not recall seeing this as a potential risk in any literature given to me!  I am astounded to be learning about this!  My head has been in breast reconstruction threads for the past year.  Gee, I come up for a little air and see this post pop up and horrors!  Look what I find!!

my liver panel was ok, it was the biopsy taken when they took out my gallbladder that showed it

no cancer, but liver disease

edited to say it was seven years ago..

Changes in hepatic enzyme concentrations (e.g., increased serum AST [SGOT] or ALT [SGPT] concentrations) and increased bilirubin and/or alkaline phosphatase concentrations have been reported in patients receiving tamoxifen therapy. Rarely, more severe hepatic abnormalities, including fatty changes in the liver, cholestasis, hepatitis, hepatic necrosis, and death, have occurred. A causal relationship of these adverse hepatic effects to tamoxifen has not been established; however, following rechallenge with tamoxifen, adverse hepatic effects occurred in some patients.

Layne, sometimes I think specialty docs share your "sledgehammer" attitude!  Oncs regard cancer as a snake that has to be killed before it strikes again and to h...l with any other consequences.  

And the poor patient is in the middle of all this!  My mother had COPD & CHF.  Just about any treatment that helped one problem made the other one worse.  It helps if you have a sharp PCP to run things by, but those are a rare breed. 

I was dx with fatty liver years ago although my primary physician does keep an eye on my liver enzymes throughout the year by doing quarterly blood panels.  Next time I get into seeing my primary care physician I will ask him again now that I am on Tamox to do a liver enzyme blood test as has been since February that I have had blood work done and was not on Tamox then.  I saw my Oncologist today and failed to tell him about my fatty liver as I was not aware of Tamox and fatty liver until I came across this thread.

I am already into menopause and have been for a few years now, and having more effects of the menopause probably because of chemo and more so because of the Tamox.  When I saw the Oncologist, he said he will probably keep me on the Tamox for a term and then change me to something else -- we discussed the different meds that I can go on for women that are post menopausal.

Charmaine

Tricia: Thank you so much for sharing this article, much appreciated.  I am gonna contact my Medical Oncologists office and check with his secretary if he has an email address, I would like to share this article with him. 

Charmaine

I'm a 12 year bc survivor who took Tamoxifen and had liver problems. Are you still working on this issue?

Yikes!  I was having huge problems on Arimidex and Femera and the oncs (2) wanted me on Tamox which I refused - glad I did - on Arimidex and Femera I had highly elevated chloresterol, bp and blood sugar readings - after three months everything back to normal except for chloresterol which is only slightly elevated now and it is my fault, also have lost 20 lbs. without dieting and I am able to walk for miles and volunteer two days a week, etc. - the poster that wrote about oncs and the "sledge hammer/snake" scenario is right - my PCP thank God is a great diagnostician and a very sensible young lady who has seen me through this mess - honestly we need more research by drug companies - these drugs just don't work for so many of us and I hate that we aren't told the truth.

Sandy

hah! then my intuition on ordering Liver Function Tests (not Liver Tumour Markers) to ensure that my mother's liver is in good working order is right! before taking either Tamoxifene or chemo or Herceptin-- have your Liver Function Test-- to ensure its not a pre-existing condition.

sometimes we really have to rely on intuition and gut feel-- even if it seems (at least initially) our logic is not making terms with it.

someone told me that intuition was given to the female species only and not given to men... proud to be a woman.

if oncologists cannot make the liver/tamoxifene connection, they probably do not make the liver/chemo+herceptin connection either..

ladies, if you are taking any of these (tamox/chemo/herceptin) same goes for those who are taking Vit C or Vit B infussions -- consult a hepathologist first-- get them (hepathologist and oncologist) to talk to each other..!

I am 45 and new to the forum and thought I should share my continuing treatment and hurdles. On March 24th of 2009 I had a Bilateral Mx followed by 6 rounds of Chemo, reconstuction and Tamoxifen. In September of 2009 I started the Tamoxifen and within 2 months had pain in my back behind the right side of the floating rib, accompanied by aching joints and swelling. In Jan of 2010, while thinking this was all normal after Chemo, I shared this with my MO who ordered a blood panel and a MRI. Later the same day I had a Annual Pelvic Ultrasound (standard for those on Tamoxifen). The MRI showed a shadow on my right floating rib close to the the spine. He ordered a bone biopsy, at the same time they found a dermoid cyst in my left ovary. It was recomended to remove both ovaries. The Bone Biopsy came back negative. The pain continued and I tried to just live with it, thankful that both biopsies showed no cancer.

I had my final reconstructive surgery in June 2010. Meanwhile the pain in my upper right abdomen continued. By November 2010 the pain increased and was also not just in the backside but in the front too. My MO had me stop the Tomoxifen for 2 months to see if the symptoms went away. The swelling, aching joints and some fatigue went away but not the pain. In January of 2011. He did a blood panel and had me start Arimidex. My panel came back indicating "Fatty Liver" he said it wasn't serious and would do another blood panel in 3 months. He also told me to loose the weight I had gained all the previous year and mostly in the middle. Before the March 2009 surgery I weighed 127 and now weigh 157-160, I am 5'5". I eat mostly organic, vegetables whole grains and fish. The only meats eat are pasture fed and not too often. I don't drink soda. I rarely drink alcohol, a few times a year and only one drink.

In April of 2011 I had another blood panel indicating lower counts but still fatty liver. We would continue to test every 3 months. In May the pain worsened and I went in again as the area was tender to touch, he sent me for a Bone Scan and Ultrasound. All came back clear, no gallstones, liver or gallbladder tumors and no bone tumors, thank goodness. I still have the pain, mostly after eating. I have an appointment with my GP on the 22nd, and I am considering another MO. I am at a loss and really don't want to take the Arimidex. Tamoxifen and Steroids(taken day before, of and day after Chemo) can lead to "Fatty Liver" and my MO is aware of this. All he wants to do is watch it right now. Ugghhhhh!