Elevated ALT AST, ALP. I'm freaking out

Options
grrifff
grrifff Member Posts: 104
edited April 2018 in Stage IV/Metastatic Breast Cancer ONLY

Monthly visit to onc, blood work found AST went from 26 to 52, ALT from 30 to 65 and ALP from 67 to 106. Also low platelets. Just last month blood work all normal and CT scan found healing bone lesions and clear liver. Only thing off last month was slightly elevated tumor marker. I broke down in my doctor's office crying. He said a virus can cause something like this. He said breast cancer doesn't usually work like that. It doesn't "turn on a dime". I've been terribly fatigued this month too. No nausea, headaches or bleeding. Anyone have something like this happen and it turn out to be nothing? I'm so scared.

· Share on FacebookShare on Twitter

Comments

  • Husband11
    Husband11 Member Posts: 2,264
    edited March 2018

    Your liver enzyme values are just outside of normal range. They say "mildly elevated" when they are 2-3 times the normal range, which yours are certainly not, and "severely elevated" is 10-20 times normal range. I would put more weight in the recent CT scan than the slightly elevated values. As well, the slightly elevated tumor marker could well mean nothing. My wife's tumor markers were very steady for a long time, then just over a month ago they took a jump upwards, along with some liver values. We agonized over the next 30 days before they were retested. Good news, they were back to normal again when retested. It could have been the cold she had, maybe cold meds affecting her liver values, dehydration, who knows. Focus on the positive recent scan and your Doctor's reassuring words as you wait to be retested.

    · Share on FacebookShare on Twitter
  • Casun19
    Casun19 Member Posts: 111
    edited March 2018

    l am sure your doctor knows best and will Definitely keep an eye on it. But I will tell you I had a jump in liver enzymes where my ALT went into the 200’s AST jumped, but not as much. Scans were showing no change like yours.

    My onc said the same thing. And even said he has seen food poisoning cause this...well needless to say I freaked out!! But numbers returned to normal in 2-3 months. Hope that helps. :)

    · Share on FacebookShare on Twitter
  • grrifff
    grrifff Member Posts: 104
    edited March 2018

    Husband11 and Casun19, thank you for your replies. What about the platelets? Why would those be low? Oncologist said there may be more bone involvement than the CT scan picked up and that the cancer is in the marrow. Also, about 9-10 years ago I had mono. I know the Epstein-Barr virus stays with you and can become reactivated as it has for me in the past. How I felt this past month is exactly how I felt then, extreme exhaustion. I have no pain at all, bone or otherwise. He felt my liver and spleen, not enlarged. I'm keeping my fingers crossed and prayingthat it's nothing.

    · Share on FacebookShare on Twitter
  • pajim
    pajim Member Posts: 2,785
    edited March 2018

    griffff, I know the story I'm about to tell doesn't apply to your situation, but it's to illustrate that the rise could be anything.

    I went to Mexico for Christmas break. Came home, see the doc the next day. He freaks out because my liver tests were like yours. A little higher than normal. "Tequila" I say to him. "CT scan" he says to me. "Sigh, OK" I say. Of course the CT scan came back as the same as eight months ago. And the liver function tests gradually came back to normal.

    Note to self -- do not schedule a visit to the onc right after vacation. It's his hot button. I drink more when I'm on vacation. . .

    You should simply wait a week or two and have another blood test. Too early to worry.

    · Share on FacebookShare on Twitter
  • grrifff
    grrifff Member Posts: 104
    edited March 2018

    A follow up-Today I had an ultrasound of my abdomen, no cancer in my liver but my platelets went down again from 57 to 48. Normal is between 200-300 (thousands per liter of blood) Having a bone marrow biopsy next week to confirm his suspicion of breast cancer cells in marrow. I'm scared. Port will be put in and I start Taxol- two weeks on, one week on. Anyone else have metastasis of the bone marrow?


    · Share on FacebookShare on Twitter
  • Husband11
    Husband11 Member Posts: 2,264
    edited March 2018

    From what I have read, infiltration of breast cancer into the bone marrow is very common.  They say it rarely causes failure of the bone marrow.  Here is a case where it did occur, and was successfully treated with doxorubicin:


    https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4408922/


    · Share on FacebookShare on Twitter
  • peggy_j
    peggy_j Member Posts: 1,700
    edited April 2018

    I hope this isn't a hijack but my routine blood tests showed that my AST went from 22 to 33 in one year, so at the high end of the normal range. It's never been this high (once in 2014 it was 26, but historically in the low 20s). The other results are normal. I have a message into my MO but this is her day off and my PCP took the week off. Any thoughts? I'm wondering if this is a sign of possible liver mets. :( Thanks for any thoughts.

    · Share on FacebookShare on Twitter
  • MJHJAN1014
    MJHJAN1014 Member Posts: 708
    edited April 2018

    Peggy- I would not be overly concerned with the rise in AST. It can elevate with viral infections, or when taking regular NSAIDS for pain. Perhaps your MO would want it redrawn in a month or so to see if it is trending up, but my gut feeling is he or she won't be concerned. Best, MJH

    · Share on FacebookShare on Twitter
  • peggy_j
    peggy_j Member Posts: 1,700
    edited April 2018

    Thanks MJH. Unfortunately it has been trending up: March 2017 it was 22, Nov 2017 it was 27, and now it is 33. For comparison between 2011-2016 it was usually 19-22, and just once, in 2014, it was 26.

    How long can NSAIDS (or viral infections) impact this blood test? I had a bad cold/flu for more than 2 weeks (finally kicked it about a week ago). A few times I took a nighttime cold & flu med that has acetaminophen (325 mg), a cough suppressant dextromethorphan phan) and antihistamine (doxylamine succinate). but the last dose was 10+ days ago. I try to avoid OTC meds. I don't drink alcohol. The biggest lifestyle change I can think of in this past year relates to my bone health. I am more attentive about getting my daily calcium (aiming for 1300-1400 mg a day, including from food) and am trying the alkaline diet (including drinking that mineral water Gerolsteiner, that contains many other minerals too). When I googled I couldn't find any link. But there is a link between elevated AST and pancreatic cancer (which runs in my family). I hate this. Thanks for any thoughts.

    · Share on FacebookShare on Twitter
  • MJHJAN1014
    MJHJAN1014 Member Posts: 708
    edited April 2018

    Have you had any tumor markers drawn? My gut feeling still is that this is not a significant rise. My liver enzymes were normal even with liver mets, and did not elevate until recently. I worked as a laboratory technologist for 30 years, and we used to see very elevated liver enzymes(800's). Usually in the case of liver disease, more than one enzyme is elevated(ALT and ALP). Is it difficult to get a blood sample from you? A traumatic blood draw, or improper handling of the sample can also slightly elevate AST. Hard to say how long AST might stay elevated after infection or NSAID use. I'm still leaning towards the "don't worry" camp! I know your MO will shed light on this. Are you getting any therapy right now for the breast cancer? Best, MJH

    · Share on FacebookShare on Twitter
  • grrifff
    grrifff Member Posts: 104
    edited April 2018

    So after a couple weeks of tests I found out the cancer has spread to my bone marrow and yesterday I started Taxol. I'm devastated. Tumor marker up 137-176-337-434. Bone marrow biopsy last week positive for breast cancer cells. Platelets dropped from 224-169-57-48-43-42. 224 on 2/16 to 169 on 3/16. More importantly my hemoglobin is too low and I will get an infusion next week. I only got 6-7 months on Letrozole, I'm so sad.

    · Share on FacebookShare on Twitter
  • peggy_j
    peggy_j Member Posts: 1,700
    edited April 2018

    Sorry to hear this grriff. Hope the infusion next week helps.

    · Share on FacebookShare on Twitter
  • singlemom1
    singlemom1 Member Posts: 434
    edited April 2018

    I am sorry to hear this grff. I also hope that the taxol kicks that cancer back down!!


    just recently noticed my ALP levels were high the last two times. It was 110 in January and then 114 in March. I also noticed an uphill swing over the last year. Was in 60s and moved to 70s and then 80s. My ALT is normal. I am waiting to hear back from MO. All other blood work looks as usual also. Just wondering if anyone has seen a uphill swing like this on ALP that turned out to be ok?


    · Share on FacebookShare on Twitter
  • Celebrate_Life
    Celebrate_Life Member Posts: 103
    edited April 2018

    Grrifff,

    My liver enzymes were up in December. Over 500. They are back to normal. I avoided drugs that were processed through the liver. Now, things are good. Hang in there.

    Sometimes, drugs don't work for a long time, sometimes, they work for years. It takes time to find the right one. Keep on, keeping on, trying to keep your mind, body and spirit balanced celebrating life each day, making it the best day you can make it!

    · Share on FacebookShare on Twitter
  • Husband11
    Husband11 Member Posts: 2,264
    edited April 2018

    I am so sorry that it has spread. You are in my prayers. Taxol will hopefully stamp it into the ground.

    · Share on FacebookShare on Twitter

Categories