Tamoxifen and ? fatty liver issue - advice please

I’ve been on Tamoxifen for just over 100 days now. I was told before my bc diagnosis that I had a fatty liver but it was nothing to worry about. However since stopping chemo I’ve gradually gone back to the ‘ache’ I had in my upper abdomen/low right rib area. (This stopped completely during chemo!! - weird!!!). I’ve read a lot on the internet about Tamoxifen induced fatty liver - has anyone out there had this problem and how where you treated for it? I’ve an appointment with GP tomorrow and will requests bloods and a scan but is there anything else I should do??

Thanks - Leigh

my mum was on a trial for tamoxifen, arimidex & femara during her first year of treatment and was recalled for deranged liver function test which is the blood test they will prob do to check… because of this she was recalled and had a liver CT… but was diagnosed with fatty liver.

now whether this was an incidental finding or related to tamoxifen we will probably never know as she has high cholesterol which is also a fatty deposits type disease so it maybe was just down to that.

she never had any pain or problems with her liver.

iv been on tamoxifen for almost 4 years but my liver function bloods are fine… just the cholesterol and thyroid ones that are a bit mental.

Lulu

Hi
My liver funtion is a little high now that i take aromasin and they said it was down to the drug. To start they kept asking me whether i drank a lot…

Hi Leigh, Just seen your post and can’t really help much except to reinforce the fact that you must insist on a scan as soon as poss. I had a mastectomy 18 years ago and the bugger came back in Jan this year in my liver and spine. I really, really am not writing this in order to scare you, I just want to make sure that you keep a check on that pain. I had the same pain after my inital dx and they couldn’t find anything at all, so I’m sure yours will be the same. Just make sure you get that scan and blood test. I wish you all the very very best for the future. Please let us know how you get on. Lots of love, Dianne x x x

I do know that fatty liver is a side effect of Tamoxifen. I developed it too…

Julie

I’ve recently been diagnosed with fatty liver as well… Last year when I had been on tamoxifen 6 months my liver function blood test was raised when i had my birthday check-up at my gp’s surgery (although i wasn’t told this as they were “just keeping an eye on it”) this year it was also raised and i started to develop pains in my side… my onc organised a nuclear bone scan first incase it was mets in my ribs and then an ultrasound which showed my liver was fatty and inflammed… I’ve got an appointment tomorrow to discuss the scan results with my gp as my onc said it wasn’t cancer and therefore not her area of concern… My liver function blood tests had always been fine before starting tamoxifen…

Theresa x

Here is a link to a thread I started when i first got my ultrasound results… breastcancercare.org.uk/forum/anyone-else-had-liver-problems-since-been-on-tamoxifen–t26502s25.html I went on holiday on June 4th - saw my gp after I got back but my hospital hadn’t sent on the scan results (despite saying they would…) which is why i am seeing my gp tomorrow to finally discuss them…

Theresa x

What sort of pain is it and where exactly is it? I am on Letrozole and recently have noticed a slight ache around the bottom of my ribs on the right-hand side when I sit. I put it down to too much slouching on the settee during Wimbledon fortnight. I did have it on occasions prior to dx. I am definitely not overweight.

Ann x

Hi everyone

Thank you all so much for your posts, its reasurring in a way to know you are not alone when confronted with these ongoing troublesome problems htis damn disease inflicts!!!

I saw my GP this morning and he felt the Tamoxifen isn’t causing a fatty liver problem. He has done a load of blood work, LFT, Thyroid, anaemia (as I am so tired all the time) etc. He examined me and as I am so tender around the lower ribs he’s also requested a chest xray to look for bone mets!!! Just great!!! NOT. I’m booked for Thursday and should have the results of this early next week. Another load of waiting…if any results show any abnormalities he will contact the Oncologist straight away…How I hate this waiting bit…:frowning:

However this afternoon I had a reflexology appointment/session and during the middle of my ‘footrub’ my ‘lady’ suddenly asked me if a certain part of my foot she was touching was hurting, which it was and she said ‘you have a problem with your gallbladder’. I hadn’t mentioned anything to her at that point about my low rib/upper abdominal ache!

My husband has spent most of this evening goggling gallbladders issues and I seem to have most of the symptoms - its also done a lot to help me keep thinking about the bone mets issue!!!

Will keep you posted - and I’m printing off the info ablout Tamoxifen and fatty livers so I can show him when I go for the results of my tests - am keeping fingers and everything else crossed it is not bone mets - everything else I can cope with but I know that news like that…

Thanks again all - Leigh xx

Your gall bladder sits just under the liver so that could explain the pains.Isn’t it strange how gall bladder stones would be a welcome diagnosis???
Fingers crossed for you
Dot
xxx

hello
I had 5 years of tamox and a year or so into got a lot of ‘gall bladder’ type pain. saw GP and had scans which showed nothing, but felt much better on low fat diet so took that up very successfully. the same has happened this time - now 10 weeks into letrozole, so going to do the same thing and see how it feels.
somehow, as long as its not secondaries, anything is OK, isn’t it?
monica x

monica - I found this article on gallstones. I am not suggesting you, or I, have them but it could explain the discomfort. I have no idea about the credentials of the author, though.

second-opinions.co.uk/gallstones.html

I also found this in another article:-

“If you eat a low-fat diet, you have enough bile trickling out from the liver to deal with breaking down fat, but if you have a particularly rich meal the gall bladder contracts and squeezes out a large amount of bile into your small intestine. The problem comes when this bile crystallises and forms into stones.”

I was interested to learn that you are taking Letrozole. I have been on it since November but have only recently had this problem and I would have thought it would have occurred earlier if the drug been the cause.

Anyway, I have just taken a glass of bicarbonate of soda. That was always our household remedy for anything liver related:-) Too early to say if it will make a difference. If I wasn’t on medication, I would take Milk Thistle but I can’t take the risk that it will clear out the Letrozole as well as any toxins!

Hope you are feeling ok today.

Ann x

well I’m a picture of biliary colic!!

Well, good news is all my blood work appears normal (LFT, thyroid, anaemia), bad news my GP will not get results of chest xray for bone mets for 2 weeks. I’ve subsequently spoken with my Oncologist and he now wants me to have a bone scan (booked for 30th) - tummy seems to have settled abit on eating rice and wheat/gluten free bread only!!! Still hoping its my digestive system that is the cause of all the problems but I have to say my lower ribs are particularly sore all the time. Anyone got any info re.bone mets?. My husband has decided not even to talk about the possibility of the cancer returning and what it all means and I’m slowly going crazy inside with worry…

Leigh

Hi there cleesyB

We have an information bookelt on bone mets which you may find informative.

Here’s the link:

breastcancercare.org.uk/upload/pdf/SBC_BONE_2010_FINAL_for_web.pdf

I hope you find this useful.

Kind regards

Louise
Facilitator

Hi Leigh, Good to read that your bloods appear ok. I know the waiting for the results from the x-rays is awful. (2 weeks seems a long time though) I have spine mets as well as liver. I didn’t even know I had them until I had the bone scan. They are three ‘hotspots’ top, middle and bottom of my spine. However, the onc doesn’t seem particularly worried about them and put me straight onto Bondronat which is a daily tablet. That was six months ago and I’ve had no trouble with them so far. (It’s the liver that gives me some stick!!!)

I know this is probably a silly thing to say, but please, please try not to worry too much. My oh also hated the idea of the cancer returning after 18 years in my case. It was horrifying at first, but I’m used to it now and doing ok at the moment. I wish I could help you more, just don’t know what else to say. Why don’t you come onto the thread called ‘Feeling Low’ There are several of us on there and we have all become great ‘cyber friends’ and we help and support each other every day. I realise that you may not want to come onto a thread where we all have secondaries, but if you feel like it, just have a look at the posts.

Anyway, it may turn out to be absolutely nothing and I will keep everything crossed for you. Take good care of yourself, sending lots of love and hugs. Dianne x x x

When I saw my onc two weeks ago , he said I had an "inflammed liver ", which he said he noticed before I started on letrozole .I´m waiting now to have an ultrasound on it .
However , knowing me , it´s proberbly just a fatty liver to match my fatty a… !!
Good luck to all awaiting results .
Kris

Just a quick update - still awaiting chest xray result re. bone mets (hadnt been reported on to date!!) Spent all of Monday in A&E as pain was just intolerable - ‘quickie’ ultrasound ruled out aortic aneurysm (Thank god!!!) and Registrar could not see anything untoward in gallbladder but when I said great - she said she wasn’t qualified well enough to not rule out gallstones!!! May need to look into that further but in the first instance they booked me for intravenous urogram for kidney stones which I had today and guess what - normal!!!

All my bloods are clear as well including cancer markers which is a huge relief as you an well imagine but they still want me to have bone scan to be on the safe side!!! (surely any cancer would show in bloods???)

So currently I’m up to the eyeballs with Cocodamol and Ibuprofen which takes a fair bit of pain away I admit and I’m now left with option of a more in depth ultrasound to see if it is gallstones or dare I say it - bone mets. And I also cannot help but worry as my Dad died last year of cholangiocarcinoma originating in his gallbladder before it spread to his liver - 5 months from diagnosis to his death April 09 (I was diagnosed on October 09)My stepdaughters wedding is in 5 Saturdays time and I’m fed up with feeling rough, worrying and hubby just does not seem to be getting it!! Rant over, sorry ladies - feeling sorry for myself when I shouldn’t…

Leigh x

PS. When I ask about fatty liver and Tamoxifen everyone squashes that suggestion straight away but could it be a fatty liver? Thank you all for your posts - feels a bit less lonely

Hi Leigh, I have been on Tamoxifen since July 2008, I have a variety of side effects, hot flushes, joint pain and odd sleep patterns and very hot feet!!! very strange. Anyway Jan 09 I had blood tests which showed raised liver levels, had to have liver scan etc and CT scan, I had an odd thing on liver but is noral/ abnormal but all ok and they showed me I had gall stones, no pain though. Anyway I looked it up and on lots of sites there are links to gall stones and tamoxifen, but on the Memorial Sloane cancer hospital in the states site, which is brilliant for info and advice it says that lots of cancer patients have gallstones, did they have them before or poss from the medication they take. Also again this year I had high liver levels all tests were repeated, and showed I have fatty liver, very very low chloestrol etc and everything else good, def got to be from Tamoxifen, even says on NHS advice site, think its CKS or something, it says can cause fatty liver so good to print out and take with you.
I have also had joint and rib pains, had scans and no probs, they said just side effects of tamoxifen!!!
Ask anything you want and ill help if I can,
Good luck,
Hope you get it sorted out soon,
Keep us informed,
take care
Dawn xx

Hi Dawn

Thanks for sharing your experiences and info - will definitely be looking up the sites you suggest and print off the info.

Still awaiting CXR result GP requested re. bone mets!!! And to hear about appointment for gallstone ultrasound. I’ve lost 7 lbs in 10 days and have no appetite at all. The pain is definitely exacerbated if I attempt to eat even a rice cake! Have stopped painkillers also as the laxative I was told to take, because of the constipation they were causing, gave me such a bout of diarrhoea and abdominal pain on Wednesday (from the little I had consumed) I have opted not to take anything - just the Tamoxifen. I cannot tell you how much I am hoping this is all gallstone related - if its mets… well…??? Just about managing to hold it together at the mo - roll on 30th when bone scan is booked.

Call me an idiot as well but I have also scared the poop (s’cuse the pun) out of myself re. some of the side effects of Tamoxifen especially with regards to it causing liver cancer - can it be possible from only being on it 120 days???

Will keep you updated Leigh xx Thanks for caring