Started on Jevtana and fluctuating liver tests

[dunde8889]

Hello,

My dad was recently found to have metastasis to the lungs and liver along with some bone involvement. He has been on treatment for over 2 years with lupon throughout and zytiga until it stopped working.

He has received two treatments of Jevtana first on 8/5 and 8/26. His liver test before Jevtana were ALT 190 AST 130 ALP 513 and bilirubin 0.8. PSA was 79.

On 8/22 his liver tests were ALT 95 AST 65 ALP 475 and bilirubin 1.2 (abnormal). PSA was 85.

Today one week after his second Jevtana treatment his liver tests went up - ALT 135 AST 80 ALP 505 and bilirubin 1.7.

What does it mean? We were thinking Jevtana was working after the repeat tests were all lower, but now they seem to be going up. Does it mean chemotherapy is not working?

[Tall_Allen]

Maybe discuss adding carboplatin to it if his blood counts are OK.

[dunde8889 in reply to Tall_Allen]

Will ask about it. He will also get a cat scan to see what is going on in the liver. The shocking result just came back and showed the psa is 140 when it was 80 seven days ago right before his second Jevtana treatment. Could this be a psa flare?

[Tall_Allen in reply to dunde8889]

What does the oncologist say?

[dunde8889 in reply to Tall_Allen]

We got the result yesterday online so haven't had a chance to speak with him since its the weekend. We will ask on Tuesday, but he already wants a cat scan to be done. I'm hoping its just a psa flare rather than the chemo not working.

[ronnie1943]

Hi, my name is Lynn, sounds like to me that your Dad and my husband are about at the same point. Husband has bone, lymph node and liver mets. He qualified for the Clinicial trial Lu-177 was denied, still in the trial but will be put on Xtandi instead of the Lu-177 infusions.

We were very disappointed not getting approved for the Lu-177 being that Sam, husband, scan showed the required PSMA.

Our first oncologist wanted to put my husband on the chemo. Carboplatin, may still be going that route at some point??

Sincere best wishes... 🙏🏻. Lynn

[Hidden]

I would have thought trying Xtandi would have been a better move before using a sledge hammer. The "blows" from Xtandi are gentle, and will go away in a few days if that turns out to be the wrong move. The blows from chemo last for years, and cannot be reversed. Neither Chemo or Xtandi kill any cancer cells - they just slow the growth and what remains of the immune system has to do the actual killing of the weakened cells. I think when chemo fails, it is because there is not enough immune system left to put up a fight.

Don't forget about the simple things that can make all the difference. Danger lurks in the gut as chemo also kills off the "working population" of bugs in the intestines. Do not let the gut "die" until it sets like concrete - this can lead to bleeding (no stools or black stools). You must keep things moving (with as mild fix that gets the job done). Of course you can also get a runny gut and that will deplete the electrolytes, and that can get serious in hours, as can aggressive laxatives.

Many bugs are specific to one food, so you can get suddenly "allergic" to that food (like onions). It will take weeks for these bugs to come back. The major danger from chemo is a trashed immune system (in which the gut bugs play the major supporting role). The only way to help the immune system to recover fast is to eat raw foods (zero sugar) and raw fruits you peel yourself. Cooked food need enzymes you are going to be short of - raw food comes with its own enzymes to digest them (cooking destroys these enzymes).

There seems to be a problem with Chemo - there is no way to assess (until more work is done on this) if the chemo will in fact increase the cancer (the trashed immune system allows the cancer to grow as there is no immune system to slow it down). For others, it works like a charm. I think the Oncos are too keen to "try anther one and see if that does the trick" when the first one or two have failed and things are getting worse. It is not clear from your description which way your dad's treatment is going. Keep seeking the answer to that one. But raw food in either case is going to help. Good luck!