Pruritis (systemic itching) and signs of jaundice

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Pruritis (systemic itching) and signs of jaundice

Postby alanams » Mon Apr 21, 2014 6:21 pm

Good evening everyone,

Well, I have a new complication, jaundice. My liver function tests were going uo during my last course of chemotherapy. Just this past week, I developed extremely painful itching and was not able to sleep through the night. I checked my urine bilirubin and it's elevated, as well as slight yelowing of the skin. I do not have pain in the abdomen, so gallstones does not sound like the cause. I did get over an extreme bout of constipation a few weeks ago.

Have any of you encountered this type of condition - cholestasis. The implications of surgery terrify me.

Thank you and best to all.
51 M, Stage IVb CRC; Colon bypass surgery 7/12. Mets to liver, lungs and lymph nodes; 12 sessions of Folfox 4/13 & 12 with Folfiri & Avastin 2/14. Biliary blockage delays chemo treatments; ERCP with 3 stents, and 2 biliary catheters (7/14).

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Re: Pruritis (systemic itching) and signs of jaundice

Postby Patience » Mon Apr 21, 2014 7:27 pm

Since I just happened yesterday to be searching about liver mets, the word "itch" caught my eye. Jaundice from a dysfunction of the liver can result in itching:

The yellowing can happen if the bile duct has been blocked by the cancer. Bile is made by the liver from waste products in the blood. If the bile duct is blocked, these waste products then build up in the bloodstream. As they are yellow, they make the skin and eyes yellow. This yellowing is called jaundice. If you have jaundice, your urine may also be very dark coloured.

Itchy skin is caused by waste products collecting in the skin. Your doctor may be able to give you tablets to help control the itching. But you can only really get rid of it if the jaundice is treated. In other words, if the bile duct is no longer blocked.

I hope this complication ends up just being something temporary, best of luck.
"Sweet dreams till sunbeams find you.
Sweet dreams that leave all worries behind you."

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Re: Pruritis (systemic itching) and signs of jaundice

Postby gfpiv » Mon Apr 21, 2014 8:03 pm

I had the same issue - mild jaundice, and pruritis (which was worse during the night). It was due to elevated levels of bilirubin in my blood; at one point my TBIL reached 14 ( 1.0 or less is normal). It can be caused by the liver being taxed in many cases (e.g. due to disease, blockage, or many txs of chemo), but in my particular case I was "lucky" that it turned out to be an obstruction in my bile ducts. I had a radiological expert at MSKCC put in a stent and it worked wonders for me...although I had other non-expert docs look at my scan and not see the blockage first. It did take over a month afterwards til my tbil went back down to normal and all the itching subsided, but in my case, my color came back relatively quick.

I wish you good luck in dealing with this, I know how frustrating it can be. My itching was never controlled with meds, but I believe some docs feel naltrexone may help.
DX stage IV CC Jan '10, numerous unresectable liver mets
FOLFOX + Avastin Feb-Jul '10
Colon resection, HAI install Aug '10
Systemic FOLFIRI and hepatic FUDR Dec'10-May'12
Chemo break May'12-pres (tumors calcified & stable, knock on wood)
Billiary bypass surgery and SBRT on pesky liver met in 2015

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Re: Pruritis (systemic itching) and signs of jaundice

Postby dianne052506 » Mon Apr 21, 2014 9:09 pm

Had same thing happen with inflammation of bile duct in2010. A course of prednisone took care of the inflammation and it hasn't come back. I felt like I was itching on the inside, it was so bad. Hope your problem is resolved easily.Dianne
May 06 Stage IV CC: liver,ovarian mets
Oct 07 inoperable lung mets
Feb 08 - Apr'12 chemo
allergic to oxaliplatin, irinotecan
Aug '12-Feb'14 Genentech PD-L1/Avastin trial
Mar '14 -radiation to largest lung nodule
still recovering; looking at trials again

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Re: Pruritis (systemic itching) and signs of jaundice

Postby CRguy » Mon Apr 21, 2014 10:04 pm

alanams wrote: The implications of surgery terrify me.
Thank you and best to all.

Hey buddy, now that you are back after some of your Mexican treatments I would just give a head's up about keeping up with your regular docs here, and following up on the new signs. Icterus (jaundice) can result from a number of things which may need to be checked out further.
Don't just assume it is cholestasis.
It may be, but might not.

You know my old saying "you miss more for not looking than not knowing."
Not everything requires a surgery, but everything we go through does require a lot of investigation......... keep looking !

Cheers and best wishes
PM if you need to chat
Caregiver x 4
Stage IV A rectal cancer/lung met
13 Year survivor
my life is an ongoing totally randomized UNcontrolled experiment with N=1 !
Review of my Journey so far

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Re: Pruritis (systemic itching) and signs of jaundice

Postby Bob_Weiss » Tue Apr 22, 2014 1:14 pm

Itching can also be caused by iron deficiency. I had low iron for a long time after chemo was completed. My oncologist recommended an iron supplement, which quickly cleared up the problem. For safety, I still take an iron pill about twice per week, because I have given up eating red meat.
Stage 3 R/C -1 node+ ( 7/09)
5 wks radiation, 2 wks chemo: 5FU (8-9/09)
Rectal surgery: tumor removal (11/09)
10 rounds Xeloda: 3000mg/daily 1 wk on/1 wk off (1/10-6/10)
Supplements: Aspirin, Calcium, Vit. D3
03/27/17: 7+ yrs. since surgery--still NED

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