My profile info is below... In our visit for chemo yesterday his bloodwork came back with elevated ALT/AST/BUN-Creatinine ratio- you can see numbers below. Thankfully PSA is going in the right direction. The oncologist wants us to go off of all supplements to get a baseline. We both take some herbal supplements- have been for a couple of years actually- but he did just start cayenne, pomegranate, fisetin, cranberry, potassium ascorbate supplements.
I'm only concerned because his hemoglobin, WBC, RBC and all else actually look great. They have gotten better. Anything in particular that could be causing the high numbers for ALT/AST/BUN?
My husband... age 49
Had enlarged prostate since March 2016. June 2017 was self catheterizing 3/4x/day. Turp 8/4/2017. Father dx prostate cancer at age 74.
8/8/2017 Biopsy of TURP tissue came back prostate cancer
8/10/2017 bone scan and MRI of pelvic region showed Metastasis on vertebral body (T9), pelvic lymph, and prostate is pushing far into bladder.
8/17/2017 met with urologist- GL 4+5=9. Started Casodex (Bicalutimide)
8/21/2017 met with Prostate Oncologist
8/30/2017 First Lupron shot- stopped Casodex (PSA was probably higher initially but not tested)
I would say stopping all supplements is a good place to start, In Pom is it the pills or the Juice? I was taking 150casodex back in the day and drinking pom juice, my liver # went through the roof to 3x ULN. and went down when I stopped the 150 casodex. Speculation was the pom juice, a cyp34a inhibitor , like grapefruit/grapefruit juice, and increased the dose of the casodex making it toxic to my liver. Since then I have been through almost all standard treatments in this cancer and never had a liver problem. Docetaxol chemo is also affected by cyp34a, and can be increased by inhibitors of cyp34a. Docetaxol is another possible culprit as it is cleared by the liver. I too was dxed at 49, I am 61 now ,Gleason 10, I never had the advantage of early chemo, as they just did not know the benefit then, I believe early chemo is a game changer in this cancer, I wish you the best, Dan
Thanks Dan- We are hopeful about the early chemo too- I've read lots of your posts and am thankful for the info you've provided in them. The Pom is in pill form- I would love to just stop that and see what happens but the doc wants to stop all. Then maybe we can add in things as we try it out. The oncologist mentioned that about the chemo- that it could, very slight chance, be the reason. And he did say that casodex can raise liver #s too but my husband isn't on that any more. Thanks for your reply! It helps a ton. Polly
In this NIH article they suggest docetaxol raises LFT in up to half people taking it . I like the Drs. suggestion, and I would be doing whatever I could to get those LFT back in range to be able to take needed meds. livertox.nih.gov/Docetaxel.htm.
all the best, time for a fall ride to see some colors
I kind of like the oncologist's idea. If you're taking 8 supplements and think one of them may be harming the liver, eliminating one at a time might might find the problem, but maybe the liver would crash while you're waiting to get to the one that's the problem. It seems a little more conservative to stop all of them and add them back gradually, then to stop one at a time.
Also, if the problem does not disappear after removing all 8, then we have reason to believe it's the Casodex, not the supplements, that is causing the problem.
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Elevated liver enzymes
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PC has spread to liver!! NEED a HAIL MARY!!
