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Forum Name: Lung Cancer

Question: Liver values


 Karhart - Wed Dec 14, 2005 4:17 pm

Thank you for answering my previous questions. Since my husbands LC is all concentrated in his liver I would like to know at what levels his different liver function tests would be in the danger range. Right now his values are still normal or only slightly elevated. Can you give me a guideline as to what the different values should be (ALT, AST etc.) and at what point would be way too high? In other words, how high before I really should start to worry? He just started a phase II trial and hopefully it will work. Thank you again.
 Dr. A. De la Guerra - Wed Dec 28, 2005 9:17 pm

User avatar Hi Karen, Merry Christmas,

Sorry I couldn’t reply earlier. I think that your husband made the right choice with the phase II trial. About liver function tests and dangerous levels, it’s a complex question to answer.

First of all, the commonly used liver function tests primarily assess liver damage rather than hepatic function. Indeed, these blood tests may reflect problems arising outside the liver, like bone disease (elevated alkaline phosphatase level). Abnormal values often, but not always, indicate something wrong in the liver, and provide clues to the nature of the problem. However, normal values do not always mean that the liver is normal. Of the routine liver function tests, only serum albumin, bilirubin and prothrombin time provide useful information on how well the liver is functioning.

I can give you the normal adult male ranges, but I don’t think it’s going to be of much help. Interpretation of liver function tests is a sophisticated process that physicians make use of in the context of a medical history, physical examination, and other tests such as X-rays or other imaging studies of the liver.

Laboratory analysis are ancillary tests, their values, single-handed, are not useful to estimate the severity of liver illness. Doctors must be aware that values can be higher or lower depending on patient’s nourishment status and vitamin levels, previous diseases, medication intake, hormones levels, etc. Also, values are not linear numbers; an AST that is 300 is not twice as bad as 150 (normal is less than 40), and an AST of 94 and 80 are essentially the same to a liver specialist. Moreover, normal ranges may fluctuate somewhat according to the brand of laboratory assay materials used. In conclusion, these tests have a meaning, but they generally cannot be interpreted without clinical information.

I feel you must let the doctors take care of the liver tests. Although, there are some signs you can be aware of, which are related to liver impairment, like jaundice (yellow color in the skin, mucous membranes, or eyes), confusion, abdominal growth (due to ascites, an abnormal accumulation of fluids inside the belly), swelling of the feet and ankles, and abnormal bleeding. More reliable than lab tests is how is your husband feeling right now.

Hope you find this information helpful.

Best regards,

Dr Torax

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