Routine marker poll

[AlaskaAngel]

Would you prefer to be offered periodic routine marker testing so that you can decide whether or not to have them done (either presently, or at some point down the road)?

[Mary Jo]

Hello,

I'm not quite sure how to respond. My doctors do not do tumor markers to me. I'm not sure if that's because I'm an early stager or not, but they do not. I know they have explained to me that tumor marker testing is a very unreliable test to determine cancer recurrence. I know from coming to this site that that is true for some and untrue for others.

Now, that being said, I am happy that tests like that are not routine for me. I don't like tests of any kind as I'm always very fearful of "cancer" for almost anything BUT I do think it should be offered to you as an individual so you can make that decision for yourself. We're all different and we all "need" different things to get through this journey.

Mary Jo

[cafe1084]

Tumor markers are drawn routinely every 3 months in the office where I go. For me, it seems to an accurate representation of the cancer in my body. It started out at 44 and have progressively dropped since last November to 15 at this time. Athe the conclusion of taxol, they had dropped from 29 to 17. I don't know if they are reliable, but I like the way they've gone so far, so as long as they want to draw them, I will oblige.

[madubois63]

Tumor markers have never been accurate for me...but I still get it done every six weeks.

[mke]

I don't know how to answer either. On balance I would prefer to have a choice in everything, but doubt that I would go for the tumour markers at their present level of accuracy. Certainly I've never been upset about not being offered them.

[Yorkiegirl]

Every 3 months when I see the Doctor and have my blood work, tumors markers have always been part of that blood work.

[Alice]

My Onc does markers for stage 4 as a part of the overall picture. She says that they are unreliable accept as a piece of the big picture. I had markers done at the time of diagnosis and they were normal and as I turned out to be stage 3b I do not have much faith in them. I think they can be useful in being an indicator as to when to start looking deeper but if they were normal at stage 3 I would not count on them.
Alice

[StephN]

Alice - The markers are picking up cell sheds in our blood. At diagnosis, unless we are stage IV at that point, most of us will have a marker in normal range. This is because the cancer is confined to the primany tumor site and perhaps a few nodes. There is probably more in our lymph than in our blood at dx. (Maybe someone can correct or confirm that last statement.)

So an early marker will not necessarily be indicative of what is to come. It is a starting point or base line. If one has a high grade type and takes a chemo that is not effective (me, for example), the only way to know how we are doing is by checking markers and having scans.

Being staged IIIb is not the same as IV. There are various reasons for a person's staging from tumor size to number of involved nodes. But the cancer is still considered "in check." A normal range number would be considered accurate for stage III.
Perhaps with the advent of successful use of Herceptin, the thinking is turning away from using the present tumor markers for early stage AND hormone positive.

[hutchibk]

Steph. You are a twin soul for me. You and I agree exactly regarding the value, purpose and application of markers. Thanks for your clear and succinct explanations for those who ask...

[Alice]

I think even though my onc only does routine tumor markers for stage 4, she would not deny doing them if I asked. I think everyone should have the oportunity if they would like. So I voted yes!
Alice

[AlaskaAngel]

A quick interruption --

The term "markers" can be confusing. Some here who are stage IV and more likely to be getting the tests specifically designed for shed cells (Bayer HER2 serum test) may not realize that "markers" refer to other types of blood tests, such as the CA 15-3, CA 27.29, CEA, and CA-125.

The CA-125 is generally used for trying to detect ovarian cancer, and so those who not only are at risk for recurrence of bc but also ovarian cancer would get the CA-125 regardless of HER2 status or hormonal status. It too is not infallible, but can be helpful in that group. As Becky mentioned in another thread, it in conjunction with annual transvagional ultrasounds has more accuracy.

The CA 15-3 and the CA 27.29 are both used for general bc and some docs use them for all stages and some don't. Some docs may consider them more useful for HR- patients and/or HER2 patients early on. If they are aware that HR+ risk extends out indefinitely, they may consider them useful for HR+ patients farther out in time as well.

The CEA is used mostly for other cancers, and less often used for bc.

The Bayer HER2 serum test is not used for early stage bc.

And ALL of these "markers" are not used in isolation, but are considered along with other lab test results, physical exam results, history, scans, etc. So if you have lots of red flags being raised, even at stage I, hopefully you would be more likely to be getting markers; if everything else is fairly benign, you would be less likely to be getting markers routinely.

AlaskaAngel

[jones7676]

I do not know how to answer - I guess I would prefer to have the markers done just in case. They have not consistently proven to be a reliable guage for my recurrences or increases in activity. But they have proved to be helpful as a confirmation after I have expressed concern about other symptoms I was experiencing.

[Bev]

Yes. I would like that choice. BB

[sarah]

I get routine marker tests every 3 months but honestly they don't help me with my cancer. when they knew I had invasive cancer and where it was my blood tests for CA 13,5 was the lowest it has ever been - 10! so I don't really think it works for me. also at that same time they couldn't "see" the cancer in either a mammo or sonogram despite knowing exactly where it was because of the biopsy!! so tests for me are not reliable or reassuring but I still think it's the best of what we have.

[Brenda_D]

I have CA 27-29 blood draws, along with CBC, and CMP every 3 months or so now. I voted yes, just because I'd like the choice to have or not.
So far, my CA27-29's have never been high, so I'm not sure they work for me, but I'd still like the option to run the test every so often.

[Patrice]

I've been given the choice to have tumor markers run (initially every 3 months and now every 6 months - 2.5 years after diagnosis) - and decided to have them. This was after full discussion with my oncoligist as to the pros and cons and so, I look @ TMs the same as I would a worrisome symptom - if they raise a potential concern, then the doctor can do scans to ascertain whether there is anything going on. I did have one instance near the end of my Heceptin treatment when my nurse mistakenly ran them and they were slightly elevated. My onc treated it the same way she did when I had severe pain in my rib - she did scans to see what was going on.

Patrice

[dhealey]

My onc has not ordered the markers on me, but the doctor I work for has. I see him for my blood pressure and various other things. We are using them as a baseline. He also has ordered follow-up MRI's on the pineal cyst which is in my brain and has ordered a PET scan due to a lump in my neck which has not shown up on CT scan. He feels it should be biopsied and my onc does not. Anyway I feel if one misses something the other will not.

[Jackie07]

I've been wondering about my 'tumor marker' since it has been mentioned quite often on the board. AlaskaAngel explained it well on her post and I thought I would bring it up so others (new comers like me?) can see. My oncologist has never mentioned it to me so I thought I would ask for one. So I asked the Nurse practioner to give me a 'tumor marker' test. She arranged a blood test for me. Then I saw the oncologist. He said the blood test was perfect and he checked on my chest muscles around the scar and explained to me the bumps I felt were the joints of my ribs. He also mentioned that since I had had mastectomy, my rib cage had changed position and most of the strange feeling I felt when touching the area is due to the changes in my chest wall.

I was glad to get my questions answered. My oncologist also encouraged me to continue to be vigilent. He's the same one that diagnosed my 'diastasis recti' (pulled my belly muscle when learning Yoga - only went 3 times and had to stop) and quelmed my worries. I am so glad I got on this board to learn so much from everyone. Hope this post might bring some interest to some new comers like me.

[tousled1]

Regular tumor markers have been unreliable for me -- never went over 15.3. What my oncologist and I are doing is relying on the HER2 serum test which seems to be particularly sensitive in my case. A slight rise in the serum level indicates something is going on. I know everyone is different. Tumor markers for some are the first indication that something is amiss. I don't see any reason why doctors don't run marker tests as it is certainly non invasive and can offer a lot of women peace of mind.

[Ruth]

OK...feeling like I should know these things but I don't think I have had markers done? Is that possible? I go in every six months and get CBC and liver functions tests done. Is that markers? They draw two vials of blood. I ask him if it is ok and he says everything is good. Was this done almost 5 years ago too? Or are marker tests more common now?
Thanks! Ruth

[DonnaD]

Hi Ruth,
Read AlaskaAngels post on this topic about 9 up from your post. Tumor markers are different than the routine blood tests you seem to be getting. Look at your blood tests results for CA125, CEA, CA 15-3. Many onc's. do not offer them unless there is an issue and rely on symptoms rather than tumor markers.

I was not getting them but developed several small nodules in the lungs (pretty sure they are from radiation) 13 months out. Now I will have markers done every 6 months. Still not sure how I feel about them. They came back fine the first time. Getting them done again in June and I am already concerned about the results.

I am sure others with more knowledge than I have will also answer your post and explain it better.

Sounds like you are doing great. What cute kids!
Donna

[Joanne S]

Alaska http://smileys.smileycentral.com/cat/15/15_3_36.gif (http://www.smileycentral.com/?partner=ZSzeb001_ZNxmk788MNUS),

Thanks so much for your very informative response. http://smileys.smileycentral.com/cat/3/3_3_20.gif (http://www.smileycentral.com/?partner=ZSzeb001_ZNxmk788MNUS)



http://smileys.smileycentral.com/cat/23/23_13_3.gif (http://www.smileycentral.com/?partner=ZSzeb001_ZNxmk788MNUS)
Jo

[hutchibk]

Ruth, markers would be a blood test that is separate from the CBC and Chemistry(which includes liver function) - it is usually called the CA 15.3 or CA 27.29... some doctors choose not to follow tumor markers, especially if you have not had recurrence.

My doc follows my CA 15.3, and it is staying 100% stable for the last 9 months... I am thrilled, because my TMs are always a very important indicator for us when I have had new activity.

[Ruth]

Ladies ~ thank you so much! I went and read Alaska's post. I guess my Oncologist is one of the ones who relies on symptoms. I was tested so much the first two years with scans and things I didn't question about blood tests other than was I good to have chemo? I did always ask about CBC results. This site is truly the best one out there.
Two of the kids are welcome additions with my new hubby. We are just loving having such a full house although I tell you the food bill has gone through the roof!
Hugs ~ Ruth

[harrie]

Ruth, your CBC and liver function tests are not the markers they are all talking about. See AlaskaAngels's post in this thread to see a discription of the markers.

harriecanarie

[ElaineM]

Definitely YES.

[jenniferz]

My new onc. orders them, and even thought they may not be that reliable, I still will have it done along with my other lab work. Why not?