What Does This Blood Report Indicate?

Posted on Tue, 18 Jul 2017

Question: I am a 60 year old female with triple positive metastatic breast cancer. I was first diagnosed in 1998 and was not her2+. I was in remission for 15 years. I had 7 months of weekly taxol for seven small bone mets and 2 lymph nodes. The nodes did not resolve and I had a biopsy which showed me to be triple positive. My doctor put me on herception only and I have had 5 treatments. My 27.29 continues to rise-it is at 325. Last week I had a metabolic panel done and my ast and alt were in the 50's. I freaked and bought an online metabolic blood panel. I got those results and now the alt and ast is in the 80's! In one week! I am terrified I have liver mets and have a pet scan next month. My bilirubin is normal and so is my alkaline phosphate-but on the high end. I feel like I am out of options because nothing seems to work. I feel fine and am overweight with a healthy appetite.

Answered by Dr. Indranil Ghosh (1 hour later)

Brief Answer:
There are many options

Detailed Answer:
Hi
Thanks for your query.

It is probable that only herceptin is not working, that's why the ca 27.29 is rising. But just ALT rise may not be sign of liver metastasis. Of course we need to look at the PET scan.

If indeed this is disease progression, we can add hormone therapy to herceptin, add some chemo to herceptin, add lapatinib to herceptin, or switch to kadcyla. There are so many options nowadays.

So let's wait till the PET scan. Then some plan can definitely be formulated.

Hope this helps.
Regards

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar