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Topic: Liver Enzymes elevated a bit...

Forum: Not Diagnosed With a Recurrence or Metastases but Concerned —

Meet others concerned about developing a recurrence or metastases.

Posted on: Aug 2, 2019 06:46PM

LeesaD wrote:

Saw my MO Tuesday for check up and bloodwork. First time we've gone six months between bloodwork and appts. I always stress about the tumor markers. TM's ended up being all good... but my AST and ALT elevated a bit. AST is 112 (normal is 10-40). And ALT is 61 (normal is 10-45). My ALP is good and lowest end of normal and Bilirubin normal as well. All other bloodwork is perfect. I've reviewed all my results from the past 2 1/2 years and enzymes were only elevated one other time and that was the one day I was admitted to hospital with severe sepsis from port infection and they said to me either you are a heavy drinker (I don't drink at all) or you've taken alot of Tylenol the past week which was the case as I thought I had the flu and not sepsis so had been taking a lot of Tylenol to keep fever down. Enzymes returned to normal within a week.

So of course I'm concerned as my bloodwork has usually been spot on with what my body is going through. The one difference from last bloodwork six months ago is I had started a clinical trial the day after my last labs in January. It's an aspirin for breast cancer trial where I'm taking either 300 mg of aspirin per day or a placebo. My MO and PCP said they don't think aspirin can cause elevated liver enzymes. I did some research and I found a few sites that says regular aspirin or salicylates can cause elevated liver enzymes. Also I asked if exercise can cause elevated enzymes as I had done a two mile run literally an hour before the bloodwork and also my muscles had been severely sore from a new workout I started a few days prior. MO said no also. Again I did some research and found AST is not only found in liver but also muscle and an elevated AST could possibly indicate muscle injury.

Maybe I'm grasping at straws a bit but just wondering if either of these two things could possibly cause the elevations and not my worst case scenario where of course my mind runs too.I was sent for an abdominal ultrasound yesterday and MO just called and said the ultrasound is good and no issues showing. I repeat bloodwork next Thursday and he's going to run some additional labs as well. Doctor and trial coordinator said stop taking the trial pills for seven days anyway as I'm having another test next week that could involve bleeding so if I am on the aspirin I would have to be off it for a week prior. So for my bloodwork next week I will be off the trial medication for a week.

I don't know. I guess I'm just thinking out loud. Any insights would be greatly appreciated. Only meds I’m on are Anastrozole and Vit D and the trial pill daily.

Oncotype Score 3, 2/4 Sentinal Nodes micromestasis so pushed for ALND for 'peace of Mind' and surprise found 2/14 positive axillary nodes Dx 2/3/2017, IDC, Right, 3cm, Stage IIB, Grade 2, 4/18 nodes, ER+/PR+, HER2- Surgery 3/26/2017 Lymph node removal: Right, Sentinel; Mastectomy: Left, Right; Reconstruction (left): Tissue expander placement; Reconstruction (right): Tissue expander placement Surgery 4/17/2017 Lymph node removal: Underarm/Axillary Chemotherapy 5/8/2017 Cytoxan (cyclophosphamide), Taxotere (docetaxel) Radiation Therapy 8/1/2017 Hormonal Therapy 9/7/2017 Arimidex (anastrozole), Zoladex (goserelin) Surgery 11/16/2017 Prophylactic ovary removal Surgery 1/29/2018 Reconstruction (left): Fat grafting, Silicone implant; Reconstruction (right): Fat grafting, Silicone implant
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Aug 2, 2019 09:12PM wallycat wrote:

Have you started any new supplements? My twin had elevated liver markers with a new supplement; stopped it and everything came back to normal. She's never been dx with cancer.


Dx 4/07 1 month before turning 50; ILC 1.8cm, ER+/PR+, HER2 neg., Stage 1, Grade 2, 0/5 nodes. Onco score 20, Bilateral Mast., tamoxifen 3-1/2 years, arimidex-completed 4/20/2012
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Aug 2, 2019 09:50PM LeesaD wrote:

Wallycat- No new supplements. I take just anastrozole and vitamin D and the trial pill.
Oncotype Score 3, 2/4 Sentinal Nodes micromestasis so pushed for ALND for 'peace of Mind' and surprise found 2/14 positive axillary nodes Dx 2/3/2017, IDC, Right, 3cm, Stage IIB, Grade 2, 4/18 nodes, ER+/PR+, HER2- Surgery 3/26/2017 Lymph node removal: Right, Sentinel; Mastectomy: Left, Right; Reconstruction (left): Tissue expander placement; Reconstruction (right): Tissue expander placement Surgery 4/17/2017 Lymph node removal: Underarm/Axillary Chemotherapy 5/8/2017 Cytoxan (cyclophosphamide), Taxotere (docetaxel) Radiation Therapy 8/1/2017 Hormonal Therapy 9/7/2017 Arimidex (anastrozole), Zoladex (goserelin) Surgery 11/16/2017 Prophylactic ovary removal Surgery 1/29/2018 Reconstruction (left): Fat grafting, Silicone implant; Reconstruction (right): Fat grafting, Silicone implant
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Aug 3, 2019 08:57AM letsgogolf wrote:

LeesaD... I know you mentioned that you only take a few meds but I thought I would mention that my husband had been on Lipitor for a couple of years when very suddenly his liver enzymes shot way up. I think there are several drugs that can cause a spike. Not sure about aspirin, anastrozole and vitamin D but definitely worth checking out.

Oncotype DX = 3. IDC with Lobular Features. Sentinel Node had Micrometastases - Estrogen 100%, Progesterone 99.89%, Ki67= 3.3% Dx 2/14/2017, IDC, Left, 1cm, Stage IB, Grade 1, 0/8 nodes, ER+/PR+, HER2- Surgery 2/27/2017 Lumpectomy: Left Radiation Therapy 4/6/2017 Whole-breast: Lymph nodes Hormonal Therapy 6/1/2017 Arimidex (anastrozole) Targeted Therapy
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Aug 3, 2019 09:02AM claireinaz wrote:

My liver enzymes go up and down. I had borderline elevations at least one time; one time my MO had me retest in 2 weeks and they were fine. I think we sometimes just catch our bodies at these "moments" where our bodies are seeking homeostasis, trying to balance everything, and you might have just had your blood taken during one of those times. I know that pain relievers like the ones you mentioned can elevate, and intense exercise can also elevate.

I bet you're okay, retest and eliminate all the things you thought might have skewed results perhaps a few days before you retest, and see what happens.

Claire in AZ

9/29/11 ILC, 2 c. stage II grade 1, ER/PR+ HER2-, 6/11 nodes, lumpectomy, DDAC x 4, Taxol x 12, 33 rads, Tamoxifen/arimidex/aromasin, BMX/immed recon 7/3/13 "In the midst of winter, I found in me an invincible summer.” Albert Camus
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Aug 7, 2019 05:23PM KBeee wrote:

A lot of exercise can cause a spike in liver enzymes. Hoping they return to normal this time.

Karen. Dx 8/5/2013, IDC, Right, 1cm, Grade 2, 0/1 nodes, ER+/PR+, HER2- (IHC) Surgery 8/26/2013 Mastectomy: Left, Right Chemotherapy 9/20/2013 Cytoxan (cyclophosphamide), Taxotere (docetaxel) Hormonal Therapy 12/12/2013 Tamoxifen pills (Nolvadex, Apo-Tamox, Tamofen, Tamone) Surgery 1/23/2014 Reconstruction (left); Reconstruction (right) Surgery 1/29/2015 Lumpectomy: Right Dx 2/2/2015, IDC, Right, 1cm, Grade 2, 0/0 nodes, ER+/PR-, HER2- (FISH) Dx 2/25/2015, IDC, Right, 1cm, Grade 3, 0/13 nodes, ER+/PR-, HER2- (IHC) Surgery 2/25/2015 Lumpectomy: Right; Lymph node removal: Right, Sentinel, Underarm/Axillary; Prophylactic ovary removal Chemotherapy 3/31/2015 AC + T (Taxol) Radiation Therapy 8/25/2015 Whole-breast: Breast, Lymph nodes, Chest wall Hormonal Therapy Femara (letrozole)
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Aug 8, 2019 08:50AM LeesaD wrote:

Thank you all for your input. So appreciated. Abdominal ultrasound was good. Repeat bloodwork and some additional labs being done this morning. We shall see.
Oncotype Score 3, 2/4 Sentinal Nodes micromestasis so pushed for ALND for 'peace of Mind' and surprise found 2/14 positive axillary nodes Dx 2/3/2017, IDC, Right, 3cm, Stage IIB, Grade 2, 4/18 nodes, ER+/PR+, HER2- Surgery 3/26/2017 Lymph node removal: Right, Sentinel; Mastectomy: Left, Right; Reconstruction (left): Tissue expander placement; Reconstruction (right): Tissue expander placement Surgery 4/17/2017 Lymph node removal: Underarm/Axillary Chemotherapy 5/8/2017 Cytoxan (cyclophosphamide), Taxotere (docetaxel) Radiation Therapy 8/1/2017 Hormonal Therapy 9/7/2017 Arimidex (anastrozole), Zoladex (goserelin) Surgery 11/16/2017 Prophylactic ovary removal Surgery 1/29/2018 Reconstruction (left): Fat grafting, Silicone implant; Reconstruction (right): Fat grafting, Silicone implant
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Aug 12, 2019 04:39PM LeesaD wrote:

Update- repeat bloodwork taken 9 days after first is perfect. Enzymes back down way into normal ranges. My AST went from 112 down to 22 and ALT went from 61 back down to 19. I had stopped the trial drug and exercise for seven days prior to the repeat bloodwork so one of them had to be the cause I would think of the elevations. I’m going back on trial drug and I’ll have my PCP re test the enzymes in six weeks and if they’re elevated then I think that is the culprit. My MO says he doesn’t think either one is the cause but he’s happy everything is back to normal.
Oncotype Score 3, 2/4 Sentinal Nodes micromestasis so pushed for ALND for 'peace of Mind' and surprise found 2/14 positive axillary nodes Dx 2/3/2017, IDC, Right, 3cm, Stage IIB, Grade 2, 4/18 nodes, ER+/PR+, HER2- Surgery 3/26/2017 Lymph node removal: Right, Sentinel; Mastectomy: Left, Right; Reconstruction (left): Tissue expander placement; Reconstruction (right): Tissue expander placement Surgery 4/17/2017 Lymph node removal: Underarm/Axillary Chemotherapy 5/8/2017 Cytoxan (cyclophosphamide), Taxotere (docetaxel) Radiation Therapy 8/1/2017 Hormonal Therapy 9/7/2017 Arimidex (anastrozole), Zoladex (goserelin) Surgery 11/16/2017 Prophylactic ovary removal Surgery 1/29/2018 Reconstruction (left): Fat grafting, Silicone implant; Reconstruction (right): Fat grafting, Silicone implant
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Aug 13, 2019 11:53AM wallycat wrote:

Excellent news. I'm shocked they would not suspect medication as a cause with such dramatic results. I guess your "experiment" to re-introduce and recheck will be telling.

Thanks for updating us and so happy you can relax.

Dx 4/07 1 month before turning 50; ILC 1.8cm, ER+/PR+, HER2 neg., Stage 1, Grade 2, 0/5 nodes. Onco score 20, Bilateral Mast., tamoxifen 3-1/2 years, arimidex-completed 4/20/2012
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Aug 13, 2019 03:33PM LeesaD wrote:

Thanks wallycat! I’m so relieved. And yes I don’t understand how my oncologist and my PCP don’t think there is any correlation 🙄 as both of them kind of dismissed me when I asked if it could be the trial drug or the exercise and both said nope. And it’s not even like the enzymes were just a little lower, they were drastically back down to completely normal range with 7 days of no trial drug and no exercise. It’s ok for now.... will see what happens with the results in six weeks. Rught now I’m all good and so relieved all is back to normal.
Oncotype Score 3, 2/4 Sentinal Nodes micromestasis so pushed for ALND for 'peace of Mind' and surprise found 2/14 positive axillary nodes Dx 2/3/2017, IDC, Right, 3cm, Stage IIB, Grade 2, 4/18 nodes, ER+/PR+, HER2- Surgery 3/26/2017 Lymph node removal: Right, Sentinel; Mastectomy: Left, Right; Reconstruction (left): Tissue expander placement; Reconstruction (right): Tissue expander placement Surgery 4/17/2017 Lymph node removal: Underarm/Axillary Chemotherapy 5/8/2017 Cytoxan (cyclophosphamide), Taxotere (docetaxel) Radiation Therapy 8/1/2017 Hormonal Therapy 9/7/2017 Arimidex (anastrozole), Zoladex (goserelin) Surgery 11/16/2017 Prophylactic ovary removal Surgery 1/29/2018 Reconstruction (left): Fat grafting, Silicone implant; Reconstruction (right): Fat grafting, Silicone implant
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Aug 13, 2019 06:05PM KBeee wrote:

Great news!!!! The explanation, "it couldn't be the drug" gets really old to us cancer patients......seriously......acknowledge that teh drugs can have side effects...even unexpected ones.

Karen. Dx 8/5/2013, IDC, Right, 1cm, Grade 2, 0/1 nodes, ER+/PR+, HER2- (IHC) Surgery 8/26/2013 Mastectomy: Left, Right Chemotherapy 9/20/2013 Cytoxan (cyclophosphamide), Taxotere (docetaxel) Hormonal Therapy 12/12/2013 Tamoxifen pills (Nolvadex, Apo-Tamox, Tamofen, Tamone) Surgery 1/23/2014 Reconstruction (left); Reconstruction (right) Surgery 1/29/2015 Lumpectomy: Right Dx 2/2/2015, IDC, Right, 1cm, Grade 2, 0/0 nodes, ER+/PR-, HER2- (FISH) Dx 2/25/2015, IDC, Right, 1cm, Grade 3, 0/13 nodes, ER+/PR-, HER2- (IHC) Surgery 2/25/2015 Lumpectomy: Right; Lymph node removal: Right, Sentinel, Underarm/Axillary; Prophylactic ovary removal Chemotherapy 3/31/2015 AC + T (Taxol) Radiation Therapy 8/25/2015 Whole-breast: Breast, Lymph nodes, Chest wall Hormonal Therapy Femara (letrozole)
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Aug 13, 2019 06:43PM Artista928 wrote:

mine go up and down. Mine though is due to non alcoholic fatty liver where a diet change helps.

Dx'd at 50. Doing it all, all by myself. Stopped Letrozole after 5 weeks. Debilitating se's. Back on Tamox now. Dx 6/2/2015, IDC, Left, 6cm+, Stage IIIA, Grade 3, 1/4 nodes, ER+/PR+, HER2- (DUAL) Surgery 8/6/2015 Lymph node removal: Left, Sentinel; Mastectomy: Left; Prophylactic mastectomy: Right; Reconstruction (left): Tissue expander placement; Reconstruction (right): Tissue expander placement Chemotherapy 11/3/2015 AC + T (Taxotere) Radiation Therapy 5/2/2016 Whole-breast: Breast, Lymph nodes, Chest wall Hormonal Therapy 6/28/2016 Tamoxifen pills (Nolvadex, Apo-Tamox, Tamofen, Tamone) Surgery 12/9/2016 Reconstruction (left): Silicone implant; Reconstruction (right): Silicone implant Hormonal Therapy 2/14/2017 Femara (letrozole) Hormonal Therapy 3/26/2017 Tamoxifen pills (Nolvadex, Apo-Tamox, Tamofen, Tamone) Surgery 9/1/2017 Reconstruction (right): Fat grafting, Silicone implant
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Aug 14, 2019 10:01AM MamaOz wrote:

hi leesa. What is the trial pill? Were you having issues? And hows the prolia treating you. Im still holding out. But my joints are not doing so well

Marina

Mamaoz : chemo 1/.17-4/17 AC/.paxitacil : 3/29 nodes Dx 12/5/2016, IDC, Right, 3cm, Stage IIB, Grade 2, 3/29 nodes, ER+/PR+, HER2- Radiation Therapy 8/7/2017 Hormonal Therapy Arimidex (anastrozole)
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Aug 14, 2019 10:13PM LeesaD wrote:

Hi Mamaoz, I started a clinical trial in January called the ABC trial (aspirin for breast cancer) to see if aspirin as an anti inflammatory can help prevent recurrence. I’m either on daily 300 mgs of aspirin or a placebo🤷‍♀️. My liver enzymes were out of whack at my blood work a couple of weeks ago. I had to stop the trial pill for 7 days anyway in case it’s aspirin as I needed to have a thyroid biopsy (all good) and they repeated bloodwork same day as biopsy and everything was back to normal and enzymes way back down to normal range. Could be a coincidence but who knows. I went back on the trial and I’ll have blood work repeated in six weeks.

Prolia still ok Had my 4th shot last week and still haven’t had any side effects. Not sure if it’s doing anything to build my bones yet as the anastrozole seems to have put me in full blown osteoporosis per my last bone density test that I had in January when I had been on the anastrozole for 16 months. My endocrinologist is holding out hope the Prolia will kick in eventually. He’ll do another bone density in January.

My joints a little achy too but better since I started brand name Arimidex. Im sorry you’re feeling the same. Hope you are well otherwise!!
Oncotype Score 3, 2/4 Sentinal Nodes micromestasis so pushed for ALND for 'peace of Mind' and surprise found 2/14 positive axillary nodes Dx 2/3/2017, IDC, Right, 3cm, Stage IIB, Grade 2, 4/18 nodes, ER+/PR+, HER2- Surgery 3/26/2017 Lymph node removal: Right, Sentinel; Mastectomy: Left, Right; Reconstruction (left): Tissue expander placement; Reconstruction (right): Tissue expander placement Surgery 4/17/2017 Lymph node removal: Underarm/Axillary Chemotherapy 5/8/2017 Cytoxan (cyclophosphamide), Taxotere (docetaxel) Radiation Therapy 8/1/2017 Hormonal Therapy 9/7/2017 Arimidex (anastrozole), Zoladex (goserelin) Surgery 11/16/2017 Prophylactic ovary removal Surgery 1/29/2018 Reconstruction (left): Fat grafting, Silicone implant; Reconstruction (right): Fat grafting, Silicone implant
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Aug 15, 2019 01:34PM wallan wrote:

Hi Leesa:

My liver enzymes have been slightly elevated for months now. My GP is not concerned; says we will retest in a year. I have read that Arimidex can cause your liver enzymes to be elevated. I did get an ultrasound and it was normal.

So... hugs to you.

wallan

Dx 3/29/2004, IDC, Right, 6cm+, Stage IIIA, Grade 3, 2/18 nodes, ER+/PR+, HER2- Surgery 3/31/2004 Lymph node removal: Right, Underarm/Axillary; Mastectomy: Right Chemotherapy 6/1/2004 AC + T (Taxol) Radiation Therapy 12/1/2004 Whole-breast: Breast, Lymph nodes, Chest wall Dx 1/25/2017, LCIS/DCIS/ILC/IDC/IDC: Mucinous/IDC: Cribriform, Left, <1cm, Stage IB, Grade 2, 0/4 nodes, ER+/PR+, HER2- Surgery 3/8/2017 Lymph node removal: Sentinel; Mastectomy: Left; Reconstruction (left): Tissue expander placement; Reconstruction (right): Fat grafting Hormonal Therapy Aromasin (exemestane), Tamoxifen pills (Nolvadex, Apo-Tamox, Tamofen, Tamone)
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Aug 15, 2019 03:23PM Artista928 wrote:

Tamoxifen can cause liver enzymes to be elevated.

Dx'd at 50. Doing it all, all by myself. Stopped Letrozole after 5 weeks. Debilitating se's. Back on Tamox now. Dx 6/2/2015, IDC, Left, 6cm+, Stage IIIA, Grade 3, 1/4 nodes, ER+/PR+, HER2- (DUAL) Surgery 8/6/2015 Lymph node removal: Left, Sentinel; Mastectomy: Left; Prophylactic mastectomy: Right; Reconstruction (left): Tissue expander placement; Reconstruction (right): Tissue expander placement Chemotherapy 11/3/2015 AC + T (Taxotere) Radiation Therapy 5/2/2016 Whole-breast: Breast, Lymph nodes, Chest wall Hormonal Therapy 6/28/2016 Tamoxifen pills (Nolvadex, Apo-Tamox, Tamofen, Tamone) Surgery 12/9/2016 Reconstruction (left): Silicone implant; Reconstruction (right): Silicone implant Hormonal Therapy 2/14/2017 Femara (letrozole) Hormonal Therapy 3/26/2017 Tamoxifen pills (Nolvadex, Apo-Tamox, Tamofen, Tamone) Surgery 9/1/2017 Reconstruction (right): Fat grafting, Silicone implant

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