So my mom rechallenged Folfox - Avastin and just finished round 3. The first time she had done Folfox she was on a reduced dosage due to age (79) but this time her Onc said she can use the full dosage since she's able to handle the chemo fairly well.
Few questions in regards to the Folfox affecting her liver panels.
AST / ALT/ ALK were all within range prior. After starting Folfox her AST / ALT / ALK have gone up after the 1st round outside of range but round 2 fell back within range and round 3 way outside of range. Is this normal? Her CEA has also gone up from 7 to 30. Onc does not seem too concerned and said to wait for scan which we should be doing mid August. She also did just overcome Covid.
Any thoughts on why the ALT /AST would just fluctuate like that? Outside of the blood work, her appetite, energy level is great. Walks about 10K steps a day.
Folfox Liver Enzymes
Re: Folfox Liver Enzymes
Hi,
Elevated liver enzymes may be due to chemotherapy. This is a very good article about the effects on chemotherapy on the liver https://www.elsevier.es/en-revista-anna ... 8119316515. The article doesn't specifically reference FOLFOX, though.
Keep in mind that those of us on this forum are not doctors. Your mom's doctor did not seem concerned about your mom's AST/ALT/ALK. If he was concerned about elevated liver enzymes, he may have ordered additional testing. Your mom's oncologist will be watching her closely throughout chemotherapy.
I am not trying to be curt or rude. IMO, your mom's oncologist has given good advice. Cancer is a wait and see condition. You are just going to have to wait it out to see what happens. Look at the positive. Your mom's appetite and energy levels are good. She is exercising every day. Those are really good things.
Good luck to you and your mom.
Paige
Elevated liver enzymes may be due to chemotherapy. This is a very good article about the effects on chemotherapy on the liver https://www.elsevier.es/en-revista-anna ... 8119316515. The article doesn't specifically reference FOLFOX, though.
Keep in mind that those of us on this forum are not doctors. Your mom's doctor did not seem concerned about your mom's AST/ALT/ALK. If he was concerned about elevated liver enzymes, he may have ordered additional testing. Your mom's oncologist will be watching her closely throughout chemotherapy.
I am not trying to be curt or rude. IMO, your mom's oncologist has given good advice. Cancer is a wait and see condition. You are just going to have to wait it out to see what happens. Look at the positive. Your mom's appetite and energy levels are good. She is exercising every day. Those are really good things.
Good luck to you and your mom.
Paige
02/20 Rectal Cancer dx - 4 cm mass; located 9 cm from AV
03/20 CEA 2.7; 0.9; 1.4; 0.9; 0.9; 1.2; 1.0; 0.8; 1.1; 1.0; 1.1; 1.7; 1.8; 1.8
1.9; 2.4; 2.3; 2.8; 2.2, 2.8, 3.2; 3.0; 1.6; 2.0; 1.2; 1.4
04/20 ST Radiation; 04/20 LAR surgery w/ileostomy; ypT3N1bM0; MSS, KRAS G12A
05/20 CAPEOX; 08/20 Ileostomy reversal
12/20 CT scan; lung nodules (watch and wait);
11/22 lung nodule biopsy positive for RC met;
1/23 VATS right lower lobe wedge resection
FOLFIRI 10 cycles
4/24 left brain craniotomy (RC met)
03/20 CEA 2.7; 0.9; 1.4; 0.9; 0.9; 1.2; 1.0; 0.8; 1.1; 1.0; 1.1; 1.7; 1.8; 1.8
1.9; 2.4; 2.3; 2.8; 2.2, 2.8, 3.2; 3.0; 1.6; 2.0; 1.2; 1.4
04/20 ST Radiation; 04/20 LAR surgery w/ileostomy; ypT3N1bM0; MSS, KRAS G12A
05/20 CAPEOX; 08/20 Ileostomy reversal
12/20 CT scan; lung nodules (watch and wait);
11/22 lung nodule biopsy positive for RC met;
1/23 VATS right lower lobe wedge resection
FOLFIRI 10 cycles
4/24 left brain craniotomy (RC met)
Re: Folfox Liver Enzymes
626Patient wrote:So my mom rechallenged Folfox - Avastin and just finished round 3. The first time she had done Folfox she was on a reduced dosage due to age (79) but this time her Onc said she can use the full dosage since she's able to handle the chemo fairly well.
Few questions in regards to the Folfox affecting her liver panels.
AST / ALT/ ALK were all within range prior. After starting Folfox her AST / ALT / ALK have gone up after the 1st round outside of range but round 2 fell back within range and round 3 way outside of range. Is this normal? Her CEA has also gone up from 7 to 30. Onc does not seem too concerned and said to wait for scan which we should be doing mid August. She also did just overcome Covid.
Any thoughts on why the ALT /AST would just fluctuate like that? Outside of the blood work, her appetite, energy level is great. Walks about 10K steps a day.
Best thing is to not be too woried, you risk to stress over nothing. There's nothing we can do better than the actual doctor your wife visits, I hope for the best for your wife's condition. Awaiting an update as soon as posible!
55 year at the time of diagnosis, male
Diagnosed with T1,T2 N0 M0 rectal cancer
Total neoadjuvant therapy or TNT (chemoradiation followed by systemic chemotherapy)
Negative since Feb. '17
No surgery
Watch&Wait approach
I don’t come much to the forum , so if this is not updated it means I remain negative!
Wish good luck to all!
Diagnosed with T1,T2 N0 M0 rectal cancer
Total neoadjuvant therapy or TNT (chemoradiation followed by systemic chemotherapy)
Negative since Feb. '17
No surgery
Watch&Wait approach
I don’t come much to the forum , so if this is not updated it means I remain negative!
Wish good luck to all!
-
626Patient
- Posts: 15
- Joined: Sun Mar 17, 2024 1:28 pm
Re: Folfox Liver Enzymes
Thank you ! Yes, obviously I'd rather not stress but as a caretaker, there's always a bit of anxiety due to the unknown.
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