› Forums › General Melanoma Community › Elevated liver levels after 2nd IPI infusion
- This topic has 9 replies, 3 voices, and was last updated 12 years, 4 months ago by
NYKaren.
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- December 28, 2011 at 10:45 pm
Hi All,
I haven't posted for a couple months since I shared that my dad's scans showed dozens of mets and we were meeting to discuss treatment options. Unfortunately, my father in law died suddenly a few days before Thanksgiving and things have been so hectic since, when it rains it pours right?
Hi All,
I haven't posted for a couple months since I shared that my dad's scans showed dozens of mets and we were meeting to discuss treatment options. Unfortunately, my father in law died suddenly a few days before Thanksgiving and things have been so hectic since, when it rains it pours right?
The Onc told my dad they were going to do IPI + Dacarbazine (sp). The Onc and the hospital had never used the treatment before, and when we had his appt to discuss treatment options, he had a cut out magazine article and held it out and said this is what we are going to do, exactly what they did in the clinical study described in the article. When I asked questions, he would flip through the article to try to answer my questions – clearly no clue about any of this other than the few bits he had read just before the appt. I felt like I had more information from all of you than he did, not confidence inspiring. They decided to wait another 10 days to actually start the treatment due to a possible infection in my dad's foot from the radiation, and then when they ordered the IPI it didn't come in on the shipment and they had to postpone out another several days, so it was 2 weeks before they started treating his melanoma after scan results came in. At long length, they started and he tolerated it quite well, some nausea, fatigue and abdominal discomfort, but that was it and all blood tests were perfect. Plus all of the tumors on the outside in his groin, armpit and head (which had all multiplied in the 2 weeks that we waited to start IPI) all started shrinking and many diappeared altogether by the time he went for the 2nd treatment. We were all thrilled. He had his second treatment and he said he felt the same as before, but I suspected that the last 10 days or so before he was to have his 3rd infusion, he wasn't feeling as well as before. He had some weight loss by this time as well. So the day before the 3rd infusion, he did the battery of blood tests and his ALT and APT levels were out of range this time. The Dr said he is not supposed to continue with treatment as the levels were 4 times above the threshold to continue, but that for sure without a third treatment he would likely succumb quickly to the cancer, within weeks not months. He said he wanted to do the treatment and then hope that his liver can handle it and heal, since my dad was only 59, very strong before all of this happened and was in perfect health other than the melanoma. My dad agreed to take the risk and had his 3rd infusion last Thursday, and now we are in a wait and see pattern with his liver. The Onc did not prescribe him anything else.
So that is where we are at. Does anyone know why he might not be prescribed anything for the liver levels? I saw in lots of case studies that I researched on the internet that most everyone was given Prednisone or other things to try to counteract/control the liver levels. Also, for anyone who might have had a simliar experience with IPI, what did you do to help with liver healing? The Onc told him absolutely no supplements, drink water and no meat. That was it. Seems pretty primitive to me, and I was hoping there are other suggestions or success stories I might be able to share with my dad. My stubborn dad is getting a bit more openminded about health and diet type information right now, and I would love to hear what has worked for others. I have searched the forum, but it is so hard to scan through so much info. I sure wish he was able to come on here himself for support and guidance.
Thanks for any information you might want to share and HappyNew Year to everyone,
Trisha
- Replies
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- December 29, 2011 at 5:43 am
Trisha, thanks for the update on your dad's condition. Sorry to read of the elevated
liver enzymes levels. Abnormal results can be caused by many things. However, as your
dad has advanced melanoma there are 2 likely causes. One could be due to the toxicity of
any drugs that he has been given and the side effects of any medications that he has
that he has had recently.If there are liver mets, the other likely cause could be the cancer itself. This
would mean that the liver is less able to perform the important functions that it
usually carries out.For some general info see: http://liverenzymes.net/ and
http://en.wikipedia.org/wiki/Liver_function_testsI suspect that the doctor is worried about the condition of your dad's liver and really
doesn't want to overload it with more medications at the moment.Hope this helps
Frank from Australia
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- December 29, 2011 at 5:31 pm
Good afternoon to all. Trisha i think it would be useful if you could provide us with some more information. For example has your father had any liver mets noticeable in any scans? Curently is he recieving ipilimumab as monotherapy or in combination with decarbazine? As far as i know now ipilimumab is used mostly as monotherapy.
As for the liver numbers it is a bit strange to me that they were normal in previous bloodwork and in 3 weeks time they got so high.. It does not seem (at least to me) to be related with melanoma rather than it might be a counteraction of ipilimumab's action, inflamations in liver for example. It makes sense to wait some time untill they got to a normal range and then proceed to the next dose. In case that this does not happen and they still are high do not get upset, maybe ipilimumab does already what is meant to do. The recomended ipilimumab's dose is 4 infusions in total- however i doubt that this is always the case. Different people have different immune system, hopefully your father's immune system is kicking melanoma and do not need more ipilimumab..
However it sounds really promising that your father's tumors respond to ipilimumab! That is great Trisha and i suggest you rather focus on that and do not upset yourself so much concerning liver numbers. I hope everything goes just fine Trisha.
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- December 30, 2011 at 12:26 am
Oh my, Trisha, I typed a reply to you this afternoon…gone!
The gist of it is that I hope your dad will consult an onc and his/her team solely devoted to the treatment of Melanoma.
This is such a new drug; doctors and patients are discovering new side effects every day–just look at the posts on here regarding vision problems.
Feeling confident that one's team is on top of all the new treatments and clinical trials available is key and does wonders for the attitude and sense of hope.
Meanwhile, it's great that your dad's seeing a response, and I hope he continues to do so.
I hope and pray that in the coming year we can all kick melanoma's nasty, horrible, evil butt!
Take care,
karen
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- December 30, 2011 at 12:26 am
Oh my, Trisha, I typed a reply to you this afternoon…gone!
The gist of it is that I hope your dad will consult an onc and his/her team solely devoted to the treatment of Melanoma.
This is such a new drug; doctors and patients are discovering new side effects every day–just look at the posts on here regarding vision problems.
Feeling confident that one's team is on top of all the new treatments and clinical trials available is key and does wonders for the attitude and sense of hope.
Meanwhile, it's great that your dad's seeing a response, and I hope he continues to do so.
I hope and pray that in the coming year we can all kick melanoma's nasty, horrible, evil butt!
Take care,
karen
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- December 30, 2011 at 12:26 am
Oh my, Trisha, I typed a reply to you this afternoon…gone!
The gist of it is that I hope your dad will consult an onc and his/her team solely devoted to the treatment of Melanoma.
This is such a new drug; doctors and patients are discovering new side effects every day–just look at the posts on here regarding vision problems.
Feeling confident that one's team is on top of all the new treatments and clinical trials available is key and does wonders for the attitude and sense of hope.
Meanwhile, it's great that your dad's seeing a response, and I hope he continues to do so.
I hope and pray that in the coming year we can all kick melanoma's nasty, horrible, evil butt!
Take care,
karen
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- December 29, 2011 at 5:31 pm
Good afternoon to all. Trisha i think it would be useful if you could provide us with some more information. For example has your father had any liver mets noticeable in any scans? Curently is he recieving ipilimumab as monotherapy or in combination with decarbazine? As far as i know now ipilimumab is used mostly as monotherapy.
As for the liver numbers it is a bit strange to me that they were normal in previous bloodwork and in 3 weeks time they got so high.. It does not seem (at least to me) to be related with melanoma rather than it might be a counteraction of ipilimumab's action, inflamations in liver for example. It makes sense to wait some time untill they got to a normal range and then proceed to the next dose. In case that this does not happen and they still are high do not get upset, maybe ipilimumab does already what is meant to do. The recomended ipilimumab's dose is 4 infusions in total- however i doubt that this is always the case. Different people have different immune system, hopefully your father's immune system is kicking melanoma and do not need more ipilimumab..
However it sounds really promising that your father's tumors respond to ipilimumab! That is great Trisha and i suggest you rather focus on that and do not upset yourself so much concerning liver numbers. I hope everything goes just fine Trisha.
-
- December 29, 2011 at 5:31 pm
Good afternoon to all. Trisha i think it would be useful if you could provide us with some more information. For example has your father had any liver mets noticeable in any scans? Curently is he recieving ipilimumab as monotherapy or in combination with decarbazine? As far as i know now ipilimumab is used mostly as monotherapy.
As for the liver numbers it is a bit strange to me that they were normal in previous bloodwork and in 3 weeks time they got so high.. It does not seem (at least to me) to be related with melanoma rather than it might be a counteraction of ipilimumab's action, inflamations in liver for example. It makes sense to wait some time untill they got to a normal range and then proceed to the next dose. In case that this does not happen and they still are high do not get upset, maybe ipilimumab does already what is meant to do. The recomended ipilimumab's dose is 4 infusions in total- however i doubt that this is always the case. Different people have different immune system, hopefully your father's immune system is kicking melanoma and do not need more ipilimumab..
However it sounds really promising that your father's tumors respond to ipilimumab! That is great Trisha and i suggest you rather focus on that and do not upset yourself so much concerning liver numbers. I hope everything goes just fine Trisha.
-
- December 29, 2011 at 5:43 am
Trisha, thanks for the update on your dad's condition. Sorry to read of the elevated
liver enzymes levels. Abnormal results can be caused by many things. However, as your
dad has advanced melanoma there are 2 likely causes. One could be due to the toxicity of
any drugs that he has been given and the side effects of any medications that he has
that he has had recently.If there are liver mets, the other likely cause could be the cancer itself. This
would mean that the liver is less able to perform the important functions that it
usually carries out.For some general info see: http://liverenzymes.net/ and
http://en.wikipedia.org/wiki/Liver_function_testsI suspect that the doctor is worried about the condition of your dad's liver and really
doesn't want to overload it with more medications at the moment.Hope this helps
Frank from Australia
-
- December 29, 2011 at 5:43 am
Trisha, thanks for the update on your dad's condition. Sorry to read of the elevated
liver enzymes levels. Abnormal results can be caused by many things. However, as your
dad has advanced melanoma there are 2 likely causes. One could be due to the toxicity of
any drugs that he has been given and the side effects of any medications that he has
that he has had recently.If there are liver mets, the other likely cause could be the cancer itself. This
would mean that the liver is less able to perform the important functions that it
usually carries out.For some general info see: http://liverenzymes.net/ and
http://en.wikipedia.org/wiki/Liver_function_testsI suspect that the doctor is worried about the condition of your dad's liver and really
doesn't want to overload it with more medications at the moment.Hope this helps
Frank from Australia
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