Chemotherapy and Liver Toxicity

You may have worries about your cancer treatment. That’s normal. While it’s true that chemotherapy can have side effects, remember that it’s also helping your body fight cancer.

Chemotherapy, or chemo, uses strong medicines to kill cancer cells in your body. Although chemo is good at killing cancer cells, it can also harm healthy cells and organs. That includes your liver.

What does the liver do?

The liver is an organ in the upper right part of your belly (abdomen). It has many important jobs, including:

• Helping with digestion by making bile

• Breaking down medicines

• Changing nutrients in food into substances your body can use

• Filtering and clearing harmful substances from your blood

• Storing and releasing vitamins and minerals into the blood when needed

Chemotherapy and liver toxicity

Damage to the liver caused by chemicals, including chemo medicines, is called liver toxicity (hepatoxicity). Chemo medicines can harm the liver when they pass through it. They may work the liver too hard, so it is less able to do its jobs. Some chemo medicines hurt liver cells (hepatocytes) directly.

Symptoms of liver toxicity

Symptoms of liver toxicity may include:

• Fatigue

• Yellowing of the eyes and skin, dark colored urine (jaundice)

• Itching

• Nausea

• Light colored stools

• Swelling in feet and legs

• Abdominal (belly) pain and swelling

Tell your healthcare team right away if you notice any of these symptoms.

How is liver toxicity diagnosed?

Your healthcare provider will do a physical exam. They will also ask you about your symptoms, lifestyle, medical and medicine history, and family history. They may do blood tests to check your liver function and to check for other causes of liver damage such as hepatitis. They may also use imaging, such as a CT scan, to rule out other causes of liver problems.

Protecting your liver during cancer treatment

If you have liver toxicity, your healthcare team may change the dose or type of medicines to lessen stress on the liver. In some cases, your team may give you other medicines to help your liver.

You can also take steps to protect your liver during cancer treatment, such as:

• Eating a healthy diet with lots of fruits, vegetables, and whole grains.

• Drinking plenty of water, unless instructed otherwise by your provider.

• Avoiding alcohol.

• Talk to your provider before taking any new medicines, supplements, or herbs. Some medicines, like acetaminophen, can harm your liver.

Take control of your health

Despite the risks, chemo can save lives. Your healthcare team should watch your liver health closely during chemotherapy. You can help protect your liver too. Through a healthy lifestyle, you can decrease your risk of liver toxicity.

Remember, your healthcare team is there to provide guidance and support. Speak up when you have questions or concerns.