Blood Count Question

[Angela]

I have blood work done everytime I go to the onc. but it only seems to be white and red blood cells they look at. Do they only monitor CEA after a reoccurance?

Thanks,
Angela

[Lolly]

I think some oncs do follow-up tumor markers if you're considered high risk for recurrence, and I believe they're usually ordered as part of the re-staging scans if you develop symptoms of recurrence. After one is diagnosed with recurrence, if one or more of the markers have been elevated, then you usually are monitered with the marker to track response to treatment. After reaching stable disease or NED, some once continue them routinely and some wait for symptoms before ordering the markers again. This has been my observation, anyway. Hope this is helpful.

Love,
Lolly

[JoJo]

While I was on initial chemo treatment, I was never ordered for tumor markers, but when I once recurred, they tested me for only CA27-19, but not CEA. My CA 27-19 results showed a number in the normal range, despite that I was officially stage 4. They have not tested me again since then.

Tumor markers are considered very controversial, as the study data has indicated that numbers were not reliable, regardless of your stage. So, now it just depends on the onc.

Based on past record, some numbers were 'off' due to elevated enzyme levels, but those enzyme levels didn't mean that you had active cancer.

Angela -- perhaps, you test only for RBC & WBC, because you are on chemo treatment, are you?

[Barbara]

Angela:

Since I was diagnosed Stage IIB January 2004 my oncolgist does a CBC, Complete Chemistry panel and CA 27-29 at every visit. Now that I am on Hereceptin only off label, I only see my oncolgosit once a month and he continues to run all three. Actually, I wish he would also run a CEA as I understand that the CA 27-29 is fairly reliable for bone and liver mets, CEA is more reliable for regional reoccurrences and lung and brain mets. But then I am a worry wart so to speak.

From what I have read the tumour markers often rise two to three months before symptoms are present. The chemistry panel is done each time to watch the liver enzymes and alkaline phosphatase. Alkaline phosphatase will oten go up before the tumour maker in bone mets and the liver enzymes will often go up before the tumour makers rise in liver mets.

There can be false rises in the liver enzymes, alkaline phosphatase and tumour markers if you are on Nuelasta or another white cell stimulant. I had this happen as have other pateints. That is why some oncologists do not run tumour markers during chemo.

My oncologist is very understanding and knows my personality type which is I want to be doing something even if it is just close monitoring.

[Angela]

Hi JoJo,

No, I'm not on chemo...I finished 4 rounds of A/C in Oct of 2003. I just had a bone scan and ultrasound of the liver based on systoms but all was clear. I was just surprised...I asked the dr. when he ordered the test on my liver if my blood work showed any problems with my liver and he said no, all your blood work is normal. So I requested a copy of my blood work before I left the office..just for my records and I realized that all he ordered was a CBC. Where in that does it tell that the liver is ok?

Angela

[Ginger]

Very good questions Angela. I am having the same questions myself and same situation. I think some women assume they are getting a blood test for cancer in their follow=ups when it is actually just a CBC. I figured that out finally and when I asked to be tested for cancer markers was told I didn't have any symptoms and if I wanted that then I would need to go somewhere else. I'm glad you asked and people have taken the time to respond and explain ... it seems like you are ignored unless you have symptoms of recurrence.