CT SCAN avastin/taxol...need your advice

[judiek]

Hi Everyone,
My doctor's nurse called to give me my ct results...they were much better than I feared.

This is after 24 tx (8 months) of taxol and avastin trial

CT of brain-negative.
Chest-stable, lung mets and plural effusion still gone...no new lesions.
Liver-Slight improvement in hypodense lesions in the liver, otherwise minimal change...no new lesions. He metioned 4 locations, 3 had shrunk, 1 was stable. Does this mean 3 are completely gone? August ct showed 7 total.

I know it all sounds wonderful and I am very pleased!!. This is where I need your help.

In Feb my ca27.29 was 66.1, and the CEA was 23. These numbers slowly came down every month. August 9th the CA.27.29 was 22.3, and the CEA was .8. It took 7 months to get to this point.

Sept 7 the CA27.29 was 33.6, CEA was 1.5
Sept 20 the CA27.29 was 39, CEA was 1.4
Plus liver enzymes are both elevated

I am to see the dr next Tuesday and they will do complete labs. My tm's could be elevated more or possibly stable. What would you do at this point? Change tx because tm's are up, but ct didn't reveal any growth? I know that many doctors don't believe in these, but tm's have been very accurate for me...unless this is a fluke. I'm not sure what the doctor plans to do. I don't want to change treatment if it is still working. I also don't want to continue if there is new cells circulating just waiting to land! Should I request a pet scan at this point? Appreciate any input...thanks. I appreciate all the prayers and well wishes. If the numbers started to decrease I would be elated!!

Warmly,

Judie

History

Discovered lump Sept. 2002 (mammo didnÃâ€*t pick it up)
Dx Oct 2002-just turned 41
IDC and pagets disease, stage 2B, grade 3/3, nottingham scale 9/9
3cm, lumpectomy,clean margins
er/pr-pos, her2 neg, 2/25 nodes w/cancer
Nov 2002-March 2003-FEC (5fu, epirubicin, cytoxen)
March 2003- started tamoxifen
May 2003- finished rads (33tx)
June 2003-CT/PET Scan- clear
Started 3 month check ups w/lab
Dec 2003-complete hysterectomy
Jan 2004-extensive mets, both lungs & liver(labs normal)
Jan 2004-stopped tamoxifen
Feb 2004 CEA-23 (0-3 normal) CA27.29-66.1 (0-38 normal)
Feb 23to current-clinical trial, taxol & avastin
April 15th, 2004-CT-significant shrinkage on all tumors/plueral effusion gone
June 8th 2004-CT-all liver lesions decreased in size/lung mets gone
Aug 9th, 2004-CA27.29 is 22.3, CEA is .8)
Aug 9th, 2004-Brain-CT neg, lung mets/pleural effusion still gone, liver mets had slight shrinkage. Largest hypodesne lesion is 2.1cm, 6 others 1cm or less.
Sept-Tumor markers on the rise
Sept 13th-bone scan negative, mri revealed herniated disc.
Sept 27- Ct of brain, negative/lung mets/plueral eff, still gone/liver tumors, minimal shrinkage.

[Ruth]

Yipee!!!

Sorry that I don't have advice since my Onc. doesn't do the marker test for me...however, since they have been accurate before maybe a petscan would be a good idea. In my own little opinion, I'd really think about changing chemo regiments to get to that wonderful spot called NED. I would definitely discuss this with him unless he thinks that it is still possible to get to it with the current meds.

I am SO very happy for you!

Ruth

[anonymous]

Never change treatment based on a number. Scans, though not perfect, are far more substantial than a marker. Markers waiver, go up and down. I would wait until your scans clearly show progression or you have some clear symptoms of progression.

Good luck

[Christine]

Judie
Tumor markers are affected by inflamation, such as what is going on in you liver I presume. It is in my opinion that the most important tm is CEA. IT WAS THE BEST INDICATOR IN MY CASE. It seems to be in the normal range now and may show promise as you continue your trial. It is rather a slow tx. which is probably why your liver is nagging you to get off. If you want to stay on the trial to completion, ask the onc for more comparison CT scans and keep a close watch on the liver enzymes.I did experience the same liver high enzymes during triple chemo's CMF and had liver pain which led me to refuse any more at the very end of that protocol. 14 yRS LATER abd after dx / Stage 4, My liver is still going strong. Liver does regenerate. Ask your Onc to explain the Tm delema more. Hope this helps
Warm hugs
Christine
NED SINCE 2000