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Dr. Andrew Rynne

Family Physician

Exp 50 years

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Stage IV colon cancer patient with metastases in liver. Reason for rising of GGT level?

Answered by
Dr. Ketan Vagholkar

Gastroenterologist, Surgical

Practicing since :1989

Answered : 883 Questions

Posted on Thu, 7 Feb 2013 in Colon Cancer
Question: My mother is a stage IV colon cancer patient with metastases in liver and two retroperitoneal lymph nodes involved. Her GGT went from 48 on 21 December to 102 on 9 January to 124 on 15 January. However, her AST and ALT, which were normal on 21 January, went into the 50s on 9 January and went back down to the 40s on 15 January. She is currently on a chemo break. I wonder why GGT is climbing. Also, her CEA was 7.9 on 3 December and jumped to 14 on 9 January. She's been off all chemo taking a break from 21 December. all December she received mild whole body hyperthermia and local hyperthermia on liver in austria, she also received a dendritic cell shot (unloaded) on 14 December. Before coming to Austria, she had cryoablation of liver tumors on 8 November. She was on 5FU+Avastin+Fusilev from XXXXXXX to October following chemotherapy. Stopped Avastin in October to have cryoablation. A pet scan in August showed regression of cancer, a pet scan on 19 November showed slight progression. Genetic tumor test showed that she will benefit from Abraxane+Avastin and from Artemisinin. Our question is should we stop hyperthermia if GGT is rising?
Answered by Dr. Ketan Vagholkar 38 minutes later
Thanks for writing in.
Stage iv colonic cancer with distant metastases has very poor prognosis. Beyond a certain degree of spread palliation in any form does not help . In your mother's case all possible neo adjuvant treatments have been tried . Initially they gave some sort of hope but now the patient is not responding as evidenced by the rising CEA levels.
I feel you should continue with chemotherapy. Hyperthermia may not work so well now in an advanced situation.The rising liver enzyme levels need to be taken into consideration while using ablative methods as they can damage the surrounding liver tissue. Chemotherapy will help to control the growth of metastases though not totally eradicate them.
I hope this answers your querry.
I hope this answers your querry.
With regards
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