LDH constantly increasing during chemo (Alimta) - 1253966

meli80
Posts:24

My mom will have her 4th (and for the moment) last Alimta infusion tomorrow. She has been doing really well on it, no side effects or only minimal ones (running nose for a few days, feeling tired around 7th day).

The doctor is keeping her blood values monitored between the chemo cycles and what I have observed is that her LDH value has been constantly increasing during this period, ever since she started with the chemo therapy. It is now at 417 (the upper normal value here is around 240). I already addressed it to her doctor when it was around 360, but he said he was not concerned.

Her liver values have been fine so far, GOT and GPT are now for the first time just a bit elevated (on the uper normal threshold), but gamma-GT and bilirubin are normal.

What are your experiences with LDH values during chemo?

I read that there can be several reasons why it is increased: damaged healthy cells due to (among others) tumor progression, dead tumor cells due to chemo or dead red blood counts (also due to chemo)... I am obviously a bit worried because of the first option here...

Many thanks in advance for sharing your opinion and experience with me.
Meli

Forums
Full Archive

Reply # - February 19, 2013, 11:57 AM

catdander
Posts:

Hi Meli, It sounds like your mom is doing fairly well. It's so good to hear. Also you can stop worrying about the LDH. I had to do a search on Grace to find an answer because I couldn't remember hear about it. It's always nice to learn of something "not" to worry about. But it can be upsetting and scary until you do.

Dr. West stated in a previous thread,

" LD is lactate dehydrogenase, which is also sometimes abbreviated as LDH. It's included in some general chemistry or liver function panels, but it's a pretty non-specific marker of cell turnover. It often rises in the setting of progressing cancer, but it's so non-specific that it tends not to be that helpful. We don't tend to use it for direct clinical decision-making in lung cancer." Reply #3 http://cancergrace.org/forums/index.php?topic=1729.0

Take care and keep us posted,
Janine

Reply # - February 19, 2013, 02:35 PM

carrigallen
Posts: 194

I agree with Janine. The LDH is not a consistent marker of response to treatment in this type of cancer. As you mention, the LDH could be elevated due to tumor burden (bad) or it could be due to tumor death (good). It could also be elevated due to diseases or conditions not directly related to the cancer. You have to look at it in context. The 'proof is in the pudding' - how she feels, and how her scan looks. Hopefully it will be favorable!

Reply # - February 20, 2013, 08:58 AM

meli80
Posts: 24

Thank you both for your time and kind replies. I will hope that LDH is due to tumor death, since my mom is feeling fine (actually nothing changed for her since her diagnosis apart from the diagnosis awareness...) and is all active and also other blood values are normal (e.g. even the c-reactive proteine is in the normal range).

But again, I know that only a CT scan will show the real picture. Still, hoping is sometimes living...:-)

Off the topic, I was so excited to read that Dr. West was quoted in one online article in the renowned German weekly magazine "Welt "on the topic of a robotic lung cancer therapy prescriptions. We are all so fortunate to have Dr. West's and his team's incredible support and advises here on a daily basis and in a such a human approach.THANK YOU!

http://www.welt.de/gesundheit/article113778848/Supercomputer-Watson-arb…

Kind regards,
Meli

Reply # - February 20, 2013, 11:17 AM

catdander
Posts:

Meli, Your mom sounds like she is doing very well...except for the knowledge of the diagnosis of course. That's no small point! You're right about the hope too. We had a member who left us with an abundance of wisdom; Simon said there is always hope that tomorrow will be a better day. For you and for my husband and me hope is that your mom and my husband continue to do well under the circumstances.
Fear and hope have been common themes among dare I say all our members. It does seem to be a logical combination of emotions, ones no good without the other.

Thanks for the link, I wish I could read it but maybe Dr. West will point us to its meaning. I think this may be it from the photo of the game show with a computer as a contestant. http://cancergrace.org/cancer-101/2012/12/13/dr-watson-as-oncologist/

And you're right, I know I'd be a different person without Grace for the past 3 1/2 years. There's nothing else like it and he has assembled a group of sharing professionals who are the best in their field.

I look forward to hearing about the good results from her next CT (conjecture, a form of hope :wink: ) . Best to you and your mom,
Janine

Reply # - February 20, 2013, 12:16 PM

catdander
Posts:

Not a big game show fan so here is wiki's definition. It's been around a long time...ah wiki says since 1964 so it has quite a bit of appeal to the trivia buffs.

"Jeopardy! is an American television quiz show created by Merv Griffin. Like most programs of its genre, it features trivia in a wide variety of topics, including history, language, literature, the arts, the sciences, popular culture, geography, and wordplay; however, it has a unique answer-and-question format in which contestants are presented with clues in the form of answers, and must phrase their responses in question form." http://en.wikipedia.org/wiki/Jeopardy!

Reply # - February 20, 2013, 01:28 PM

Dr West
Posts: 4735

Thanks for that info about being quoted in Germany...news to me. I also shared some comments with a reporter from Medscape, an internet-based US medical news group, very recently on the same subject. It could be that some of my comments were picked up from that story.

-Dr. West

Reply # - February 21, 2013, 10:16 AM

meli80
Posts: 24

Certain Spring, you are right - the article was about "Dr. Watson".

You are very welcome, Dr. West! You were quoted on your statement that you believe that a computer will never replace a human doctor (the article was about this new project, Dr. Watson, where the computer decides on the patient's therapy). Which is also my personal opinion - I would find it very scary to have a therapy prescribed by a machine, with all due respect to the technology nowadays... but it is a bit like the movie I-Robot...

Catdander, I can only fully agree with what you have written. As long as my mom and your husband feel well and can go after their daily activities without pain or any other constraints, we have all the reasons in the world to stay positive and hopefull. Despite the knowing that this stage might as well change quickly. But, what is the point in being sad today over something that has not happened (yet)?! It only takes that one and only prescious moment away that we can call ours - the "now". And at the moment - "now" feels like the good old normal, thank God!

My mom will have her "big" CT scan on 12/03/2013. Please, keep her in your thoughts, she is very anxcious about it. I will post here the results afterwards.´

All the best,
Meli

Reply # - February 21, 2013, 01:41 PM

catdander
Posts:

Will look forward to hearing good news about your mom's scan.
It's amazing to see our lives beginning to look like something normal. I didn't think we'd have the opportunity and must admit it feels like pretend. A lot has changed but that's probably a good thing, there's no pressure to make it look like it used to.

As for hope, I think as long as we exist we have hope. It must be a part of the living experience. There's more to hope than hoping for a good scan. It's relative to where you are at any given time I suppose.
As you can imagine I've given this some thought and couldn't let my partial explanation stand. 8-) so there.

All the best hopes, always,
Janine

Previous PostNext Post