Chemo and Liver Disease

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Cmama55
Cmama55 Member Posts: 4
edited December 2017 in Chemotherapy - Before, During, and After

I am a 2nd time Cancer patient. First was 6 years ago, adenocarcinoma of the cervix. During the chemo for this, I went into liver failure, ended up stopping chemo. Finished with more radiation, plus surgery. Have been in remission for 5 years now. I ended up needing a liver transplant. Waited 2 years on the transplant list, was blessed with a new liver. For 2 years I was for the most part healthy, in and out of rejection. Now I have breast cancer. Was set up with chemo to start Jan 3rd, yet my liver is showing signs of rejection. I'm worried because I have basically 3 doctors. I have a local oncologist who is great, I've seen only him during my first cancer diagnosis, knows my history and saved my life by not giving up and figuring out what was going on with my liver. And then I have a liver transplant team from the University Hospital, and now an oncology team that is working in coordination with the transplant team. My problem is my local oncologist doesn't want chemo to start until my liver gets under control, which makes sense to me. He also advised me that taxotere should not be given to any patient with high ALK or bilirubin levels. However, the oncologist at the University still wants me to start the chemo on Jan 3rd, and she basically won't communicate with my local oncologist even though he has called her several times, and she also told me she would call him as well, but hasn't. I just don't know who I'm supposed to listen to. Right now my Alk is 279 and my bilirubin is 2.4. Haven't even started any treatment yet.

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  • Moderators
    Moderators Member Posts: 25,912
    edited December 2017

    Hi Cmama-

    We want to welcome you to our community! We're so sorry you find yourself here, especially for the second time around. But we hope you find this community to be supportive and informative. That all sounds very frustrating! We're glad you have so many people working on your behalf, and we sincerely hope they can start working together in your best interests. It doesn't sound like starting chemo is a good idea at this point, until your transplant and oncology teams are able to get things under control. We're so sorry that you're going through this confusion, on top of everything else! Please let us know how it all plays out!

    The Mods

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  • muska
    muska Member Posts: 1,195
    edited December 2017

    Dear Cmama, I second what the moderators said above about chemo - doesn't seem like a good idea in your case, at least not until your liver is improved.

    You didn't mention any details of your breast cancer diagnosis or wether you had surgery already. If it is lower stage have they done Oncotype test to determine the benefits of chemo vs risks? If you haven't had breast surgery yet what kind of surgery are they planning? Could you do without chemo, i.e. lumpectomy/mastectomy + radiation? These are just some of the questions that you probably asked already but if you are not clear or have some doubts you should certainly go for a second and third opinion.

    Best of luck to you and Happy New Year!


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  • Shellsatthebeach
    Shellsatthebeach Member Posts: 316
    edited December 2017

    Muska asked some great questions. Not everyone with BC needs chemo. Have you explored risk vs reward?

    I would listen to doctor who said to hold off until liver is under control.

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  • Cmama55
    Cmama55 Member Posts: 4
    edited December 2017

    That makes me feel much better thank you! I will be at the University Jan 2nd for another liver biopsy. I am not agreeing to any chemo at this point.

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  • Cmama55
    Cmama55 Member Posts: 4
    edited December 2017

    I have had a lumpectomy. Margins clear. Stage 2 invasive ductal carcinoma. Two lymphnodes removed, one returned positive. My local oncologist requested the oncotype DX testing awhile back, to find out that the University thought it was unnecessary, and never sent for it. So he is requesting it himself. He would like to wait for those results before making a decision on treatment as well as getting the liver under control. This makes sense to me. I just feel like the University is rushing things when I think there needs to be more precaution taken on account that I am a rare case. They assured me they are, yet with everything happening, they are not. The only reason they're involved is because they are the specialists (the 2nd opinion) and are working with the transplant team, so if anything happens during chemo, my transplant team is literally there. I am surprised that theyre opinion is so different than my local oncologist. I've never had to go against a Dr's opinion before, but I'm truly blessed to have my local oncologist looking out for me. Otherwise, I'd be cluelessly getting chemo on the 3rd, and possibly not getting to return home because I end up in liver failure again. It was a miracle for me to even be given this donated liver and I just feel I need to protect it. Thank you all! I feel much better knowing I'm not just being overly protective by wanting to wait 💕

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  • Cmama55
    Cmama55 Member Posts: 4
    edited December 2017

    I have had a lumpectomy. Margins clear. Stage 2 invasive ductal carcinoma. Two lymphnodes removed, one returned positive. My local oncologist requested the oncotype DX testing awhile back, to find out that the University thought it was unnecessary, and never sent for it. So he is requesting it himself. He would like to wait for those results before making a decision on treatment as well as getting the liver under control. This makes sense to me. I just feel like the University is rushing things when I think there needs to be more precaution taken on account that I am a rare case. They assured me they are, yet with everything happening, they are not. The only reason they're involved is because they are the specialists (the 2nd opinion) and are working with the transplant team, so if anything happens during chemo, my transplant team is literally there. I am surprised that theyre opinion is so different than my local oncologist. I've never had to go against a Dr's opinion before, but I'm truly blessed to have my local oncologist looking out for me. Otherwise, I'd be cluelessly getting chemo on the 3rd, and possibly not getting to return home because I end up in liver failure again. It was a miracle for me to even be given this donated liver and I just feel I need to protect it. Thank you all! I feel much better knowing I'm not just being overly protective by wanting to wait 💕

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