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Topic: Elevated liver enzymes and now petscan. Freaking out now!

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

Meet others concerned about developing a recurrence or metastases.

Posted on: Dec 8, 2019 10:12AM

bd_55 wrote:

I'm a long time reader but this is my first time posting. My mom was diagnosed with bc in 2018. Her treatment plan was to start Femara which shrunk her breast tumors and lymph node. She had a lumpectomy and radiation this year. In August she had a clear mammogram. We went to her Oncologist appointment this Thursday and he mentioned that at her last appointment 3 months ago her APL level was elevated at 145 not exactly sure the ranges from lab but he said 120 was the upper number and her other levels were normal. He wanted to retest and probably run scans just to make sure everything is ok. I asked him could it be cancer and he said he didnt think so probably inflammation from liver or bone. He said he wouldn't lose sleep about it. Easier said then done! I started googling and freaked out. I realised my mom started taking Trulicity which we forgot to mention before the last blood test. When I googled trulicity I came upon a website the said it could increase your APL levels. (who knows how legit the website is) I called the doctors office the next day to let them know about the medication she is taking. Later that day the nurse calls to tell me they got the info and the blood work came back and now her APL is 119, but her AST is 41 and ALT is 78. Just a bit above normal range. She said Doctor wants to do a petscan. Now Im freaking out. I know her liver levels were elevated when her regular doctor ran blood tests before diagnosis of bc. She had a ultrasound done a few years ago but just showed fatty liver. She is taking a statin medication which can elevate her levels. But now that the doctor wants to do a petscan im so worried that he thinks of mets why else would he run this test? has anyone dealt with something similar?

​IDC, stage 2b, Grade 2, 2/4 lymph nodes. Femara 2018 Lumpectomy 2019 Femara 2019
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Dec 8, 2019 12:47PM - edited Dec 8, 2019 12:54PM by wallycat

Many drugs elevate liver enzymes. DH is being monitored regularly because of the cancer treatment protocol he is on and wanting to maintain the integrity of his liver. Lots of scans for him too (though he is stage iv).

These days, docs have to protect themselves from lawsuits. To my mind, a scan to rule out cancer is good. That means he takes it seriously not that he expects to find it. Best to you both.

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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Dec 9, 2019 08:15AM KBeee wrote:

Sounds like the doc is just being extra cautious and not wanting to make assumptions.

Karen. Dx 8/5/2013, IDC, Right, 1cm, Grade 2, 0/1 nodes, ER+/PR+, HER2- (IHC) Surgery 8/25/2013 Mastectomy: Left, Right Chemotherapy 9/19/2013 Cytoxan (cyclophosphamide), Taxotere (docetaxel) Hormonal Therapy 12/11/2013 Tamoxifen pills (Nolvadex, Apo-Tamox, Tamofen, Tamone) Surgery 1/22/2014 Reconstruction (left); Reconstruction (right) Surgery 1/28/2015 Lumpectomy: Right Dx 2/2/2015, IDC, Right, 1cm, Grade 2, 0/0 nodes, ER+/PR-, HER2- (FISH) Surgery 2/24/2015 Lumpectomy: Right; Lymph node removal: Right, Sentinel, Underarm/Axillary; Prophylactic ovary removal Dx 2/25/2015, IDC, Right, 1cm, Grade 3, 0/13 nodes, ER+/PR-, HER2- (IHC) Chemotherapy 3/30/2015 AC + T (Taxol) Radiation Therapy 8/24/2015 Whole-breast: Breast, Lymph nodes, Chest wall Hormonal Therapy Femara (letrozole)
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Dec 12, 2019 01:29PM bd_55 wrote:

Thanks ladies! Still waiting for the insurance to approve the Petscan. I'm not really sure why he chose petscan instead of a CT scan or MRI.

​IDC, stage 2b, Grade 2, 2/4 lymph nodes. Femara 2018 Lumpectomy 2019 Femara 2019
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Dec 13, 2019 04:37AM Missmom79 wrote:

bd_55, I believe petscan can be combined with CT. How elevated are they ? They can mean other things as well.


Dx 8/15/2019, DCIS/IDC, Right, Stage 0, Grade 3
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Dec 13, 2019 05:23AM bd_55 wrote:

At first he said that her APL was 145 everything else was fine. They rechecked and APL is 119 just 3 points above their normal range. But her ATL and AST elevated AST is 41 and ALT is 78. Just a bit above average range. I know she always has elevated liver enzymes before diagnosed with bc due to her statin medication, fatty liver and being over weight. I understand Doctor needs to figure out what's going on but having a petscan makes me assume right away he thinks she might have cancer else where.

​IDC, stage 2b, Grade 2, 2/4 lymph nodes. Femara 2018 Lumpectomy 2019 Femara 2019
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Dec 13, 2019 09:23AM bd_55 wrote:

Just got a call from the Oncologist office that the insurance denied the petscan so they are going to do a CT of the Abdomen and pelvis and bone scan next Friday. I'm praying for good results.

​IDC, stage 2b, Grade 2, 2/4 lymph nodes. Femara 2018 Lumpectomy 2019 Femara 2019
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Dec 14, 2019 08:58PM Lulu44 wrote:

Hello. Right before I started chemo my liver enzymes were elevated and my MO had me get CT of chest, abdomen & pelvis- checking for any Mets or inflammation on the liver in particular & it was mostly unremarkable (just some lung nodules we’re following up on) It sounds like your Mom has a diligent doctor who is proactive which is a good thing. Hoping it turns out to be a fluke like mine was.

Dx 6/28/2019, IDC, Left, 2cm, Stage IIB, Grade 3, 1/5 nodes, ER+/PR+, HER2+ (IHC) Targeted Therapy 7/16/2019 Perjeta (pertuzumab) Targeted Therapy 7/16/2019 Herceptin (trastuzumab) Chemotherapy 7/16/2019 Carboplatin (Paraplatin), Taxotere (docetaxel) Surgery 12/16/2019 Lumpectomy: Left; Lymph node removal: Sentinel Targeted Therapy 1/1/2020 Kadcyla (T-DM1, ado-trastuzumab) Surgery 1/21/2020 Prophylactic ovary removal Radiation Therapy 1/27/2020 Whole-breast: Breast, Lymph nodes Hormonal Therapy 3/6/2020 Aromasin (exemestane)
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Dec 20, 2019 06:19PM bd_55 wrote:

Hi Ladies! I wanted to share that today mom had her bone scan and CT of her abdomen and pelvis and the doctor called me a bit ago saying everything looked clear! I'm so beyond thankful. Thank you

​IDC, stage 2b, Grade 2, 2/4 lymph nodes. Femara 2018 Lumpectomy 2019 Femara 2019
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Jan 2, 2020 10:12AM KBeee wrote:

Great news!!!

Karen. Dx 8/5/2013, IDC, Right, 1cm, Grade 2, 0/1 nodes, ER+/PR+, HER2- (IHC) Surgery 8/25/2013 Mastectomy: Left, Right Chemotherapy 9/19/2013 Cytoxan (cyclophosphamide), Taxotere (docetaxel) Hormonal Therapy 12/11/2013 Tamoxifen pills (Nolvadex, Apo-Tamox, Tamofen, Tamone) Surgery 1/22/2014 Reconstruction (left); Reconstruction (right) Surgery 1/28/2015 Lumpectomy: Right Dx 2/2/2015, IDC, Right, 1cm, Grade 2, 0/0 nodes, ER+/PR-, HER2- (FISH) Surgery 2/24/2015 Lumpectomy: Right; Lymph node removal: Right, Sentinel, Underarm/Axillary; Prophylactic ovary removal Dx 2/25/2015, IDC, Right, 1cm, Grade 3, 0/13 nodes, ER+/PR-, HER2- (IHC) Chemotherapy 3/30/2015 AC + T (Taxol) Radiation Therapy 8/24/2015 Whole-breast: Breast, Lymph nodes, Chest wall Hormonal Therapy Femara (letrozole)
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Jan 2, 2020 10:46PM wallycat wrote:

Happy to hear the good news. We need to remind ourselves that sometimes even bad labs are just a snapshot in time and may not predict or define anything. Thanks for sharing and enjoy the year!

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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