Liver CT

Options
exercise_guru
exercise_guru Member Posts: 716
edited November 2018 in Not Diagnosed With a Recurrence or Metastases but Concerned

I could use some advice.Here goes... I am 3 years post diagnosis and finished herceptin 18 months ago. This past year or so my liver markers doubled. My MO was of no help so I insisted he send me to a gastroenterologist. This doctor ordered complete blood work and found my cholesterol was around to 270. He has been encouraging me to reduce my body fat because it's more than likely a fatty liver. UnfortunatelyI haven't really been able to get more than 10 pounds off.


My follow up labs four months later continue to show high liver markers and cholesterol. He wants me to go on a stating so I have to find one that works with tamoxifen. He is also going to send me to a dietitian to assist in increasing my weight loss.

Since it has been 14 months since my livers markers continue to be double the recommended amount he wantes to do a liver biopsy to verify his suspicions that it is a fatty liver.

Instead after hearing my concerns he decided to just order a liver CAT scan with imaging to verify that it's not breast cancer in my liver. While it is a more expensive test it would also verify fatty liver as well as ruling out cancer. In the past they did an abdominal ultrasound but didn't see anything that looks like a lesion or a spot this is why he thinks it's a fatty liver.

Could anyone please give me some perspective on if this is a good idea to have a CAT scan and would it show anything? Did anyone who has had problems with cancer in their liver have a cat-scan. Did an ultrasound provide diagnostic verification of mestatic cancer.

For background this would only be an abdominal CAT scan because that's all he could order it wouldn't be my lower pelvic region or what I assume is a full cat that they do if a breast cancer patient is node positive. Prior to this I had double breast cancer that was diagnosed with a mammogram and biopsies I was node negative so they didn't pursue further Imaging and now they no longer perform screening other than blood work every 6 months. They tried taking me off tamoxifen but this did not improve my cholesterol or liver markers. The entire situation started after I had a total hysterectomy.


I could sure use some perspective in advice I'm not sure if I'm on the right track or not and I'm committed to try to lose more weight but I'm having a heck of a time with it even exercising and reducing extra calories. I'm truly hoping this is just a fatty liver but I am relieved that there at least taking me seriously.

· Share on FacebookShare on Twitter

Comments

  • KBBNola
    KBBNola Member Posts: 1
    edited May 2018

    Hi exercise guru. An ultrasound is not the best test to determine breast cancer liver mets (can miss 30-40%, I believe.) A CT scan of you abdomen (not pelvis) would be the most appropriate test. That said, fatty liver can certainly increase your liver functions. I would get the CT scan and if no masses seen then work on losing weight and avoid alcohol. A plant based diet incorporating legumes, veggies, whole grains and avoiding red and processed meat would be the best since you also have high cholesterol. And of course, gradually increasing your cardio exercise to at least 30 minutes of "huffing and puffing" 5 days a week will help too.

    I hope your results are consistent with fatty liver as this can be fixed with diet and exercise. Good luck!

    · Share on FacebookShare on Twitter
  • Moderators
    Moderators Member Posts: 25,912
    edited May 2018

    Thank you so much for chiming in here, KBBNola! This is excellent advice, and much appreciated :)

    The Mods

    · Share on FacebookShare on Twitter
  • Lula73
    Lula73 Member Posts: 1,824
    edited May 2018

    exerciseguru- I had 2 nodules on my liver show up on a chest CT I had to confirm blood clots in my lungs from tamoxifen. From there it was a biopsy - i didn’t know anything about seeding back then. The radiologist doing the biopsy missed the part about there being 2 nodules and biopsied the first one he found with ultrasound. The pathology came back likely hemangioma, but it didn’t bleed at all which is not typical of hemangioma. So they ordered a PET scan and an MRI of the liver. PET was clear, MRI indicated fatty spots on the liver. Follow up MRI was scheduled for 6 months later to verify any changes. MO said they can actually diagnose mets to liver/primary liver CA with MRI now. So that's the likely protocol you’ll see...CT, PET, MRI. Although it does seem like maybe you could skip CT and go straight to MRI/PET for “suspected mets”.

    With all of that being said, all of the anti-hormonal meds can cause liver toxicity and rising liver enzymes. For this reason, it’s important to stay well hydrated (6-8 glasses of water everyday) to help flush the liver. They can also cause your cholesterol to rise (very important to have a high HDL as its protective). Additionally, tamoxifen is related to increased risk of developing fatty liver regardless if you’re overweight or not. So all those abnormal labs may just be caused by the anti hormonal and nothing to worry about.

    · Share on FacebookShare on Twitter
  • KBeee
    KBeee Member Posts: 5,109
    edited May 2018

    Sounds like the CT is a good next step. Much less invasive than a biopsy. Keep us posted. Hoping for fatty liver, or some other benign reason.

    I had fatty liver noted on a CT while I was on Tamoxifen. I am not overweight at all

    · Share on FacebookShare on Twitter
  • exercise_guru
    exercise_guru Member Posts: 716
    edited November 2018

    I just wanted to update this thread. My gastrointologist wanted to do a biopsy but instead convinced my insurance to do a full abdominal CT. It came back clean with just some stirations of fat.

    He strongly recomended I lost 20 pounds but on Whole 30 ( low fat meat and vegetables) I could only lose 4 pounds. Then I watched "Knives and Forks" and because I have three conditions: high cholesterol, Liver Enzymes and residual neuropathy, I felt it was worth it to try a whole foods oil free eating plan. It was nice because there are a lot of good recipes now and youtube is a treasure trove of great recipes.

    5 weeks later my liver enzymes were all normal even only losing 4 more pounds. Ten weeks later my cholesterol has dropped by 50 points and I will have it checked again in January along with my liver enzymes. It is helping my neuropathy but more I am just relieved that I know that the cancer is not in my liver and that my liver is healing.


    I want to thank the advice on this thread to encourage me to go to a good gastroenteritis and to get referred by my MO so I could get in quickly. He was far more helpful than my MO and I was able to get the help I needed. He is the one who sent me to a dietitian. The hospital dietitian was completely unhelpful but I love the private one I went to. She is not a plant based dietician but was able to turn me onto the Vitamin B and niacin for my nerves and appropriate fibers to remove the fat from my liver. This was especially important as Tamoxifen and Menopause are making weight loss slow and steady. I am grateful my numbers went to normal with only a 8-9 pound loss.

    · Share on FacebookShare on Twitter
  • KBeee
    KBeee Member Posts: 5,109
    edited November 2018

    Great news!!

    · Share on FacebookShare on Twitter

Categories