Tumor Markers

[Cal-Gal]

HI everyone--reaching out for advice--

I am a bit freaked out that my tumor marker CA 27.29 went up 7.3 points in one month--although it is still within normal range---normal being 0.00-38.60

Here is my tumor marker history--

Jan-27.2--ten days after surgery
March-46.4--about a month into chemo
April-41.9
May-63.5--a week prior to last chemo(5/28)
July-34.0
Aug-28.8
Sept-26.1
Oct-27.2
Nov-34.5

I have another one done in a few weeks---I am freaked out--should I be????

Thanks so much----

[suzan w]

Hi Cal Gal My onc always told me not to worry too much about fluctuating tumor markers, as long as they stay in the normal range. She says it is the big jumps to watch out for, and even then it could just be 'nothing to worry about' (ha!easy for her to say!!!) Hope it is nothing! It is so hard not to freak out about everything, eh??!! XO Suzan

[Cal-Gal]

Thanks Suzan--I know that it is still within normal---but a jump of 7 points seems high--and higher than pre-chemo--that is what worried me--pre-chemo was 27.2---even though it is within normal---it is so hard not to see something like that and get worried---
thanks for the note--I feel better--

[hutchibk]

I am one who TMs are very sensitive and have always alerted us early to progressions.

My onc looks for increases over 3 or more labs. If it is bouncing around under or in the normal ranges, we don't worry. Mine pretty much stay under the top end of normal at all times, but if they increase incrementally over 3 to 4 consecutive three week labs then we usually do a PET/CT for starters to see if anything shows up. Even though mine stay relatively low and under normal, they have always indicated my recurrences.

[Cal-Gal]

Thanks for the insight--

-I tend to agree and will see how the labs on 12/11 go--if it is still increasing--I will speak to ONC about a CT--just had one though 4 weeks ago---it is close to the time for my PET--which is in Jan--so if it is again increasing--we will have that conversation--

but honestly--after my experience w/mammograms not being able to detect my ILC--thank god it did detect the DCIS which led to the MRI--I dont know if the CT catches all there is to detect--

Thanks again for your time---

[Rich66]

Well..it's basically the same as July. Maybe something to watch over time, as Hutchi says.

Came across this:

Limitations of tumor markers

Tumor markers are not foolproof. Usually doctors need results of other tests, such as x-rays or biopsies, to determine whether a higher level of a particular tumor marker is a cause for concern. Other limitations of tumor markers include the following:

An elevated tumor marker level may indicate conditions or diseases other than cancer.
Some tumor marker levels may be high in people without cancer.
The level of the tumor marker may vary, making it hard to obtain consistent results.
The measurement of a tumor marker may not rise until a person's cancer is advanced, which is not helpful for early detection or screening.

[Cal-Gal]

Thanks Rich--

[margiermc]

I am tumor marker sensitive. Recently I had the her2serum marker test. The tumor marker's fluctuate - When my cancer was found in my liver it was around 120. I get nervous every time it's tumor marker time, every 2 months. It's stressful, i'm in your shoes and understand. I have a cancer survivor friend, 19 years out of stage 4, and she said, back when she had the cancer in the liver, there weren't any tumor marker test, so, she said, she wished there was because it would have been a red flag something is going wrong. Years ago, they just gave chemo, hoped for the best.


margie

[Cal-Gal]

Thanks Margie and Happy Thanksgiving--

[Lien]

Hi Cal-Gal,

My tumor markers were normal when I was diagnosed and didn't change after surgery. So we never did them again. Here in the Netherlands we are always told they are very unreliable. They are used sometimes to see if tx is having an effect, in people who appear sensitive to them.

Have a Happy Thanksgiving!

Jacqueline

[Cal-Gal]

Thanks Jacqueline

[Jackie07]

Found this on the BC Q&A Board at Johns Hopkins:

"...doing tumor markers today is becoming rarer and rarer because it is such an imperfect test. it can go up for no known reason. how you feel is the best marker to use... try not to dwell on this. also, risk of recurrence is greatest during the first 2 years..."

[10/25/2008]

[Chelee]

Cal-Gal, I see you were due to have TM'ers ran again on 12-11-09. Have you found out what they were yet?

Jackie is right that tumor markers aren't very reliable...and many onc's won't run them. But for people like Brenda, myself and so many others I know of...they work really well. My markers slowly creep up for a yr and thats when we found my recurrence. I know for me TMs are very reliable. In fact after I had my first loading dose of Herceptin after my recurrence...my TM's were down instantly. So for some they work great...and others they are worthless.

Let us know when you get your labs back. I hope all is well. There are many benign reasons for them to climb...so hopefully it's nothing.

Chelee

[Cal-Gal]

Thanks Jackie and Chelee---

Spoke w/my Oncologist's nurse today, my TM was at 32.5
so it went down 2 points--so bizarre that it was up Sept-Oct-Nov-(in Nov it was up 7 points)---and now down 2--but still above my lowest on 9/18/09---noted in my first post--

I am thankful that I am within 'normal' range--but plan on watching this--I think it can be valuable for some people---guess, I am finding out if I am one of those or not----

Thanks for all the support---

[Hopeful]

Here is a link to the thread I posted in the Meeting Highlights forum for an abstract presented at SABCS evaluating the accuracy of CA 27.29 in a German study: http://her2support.org/vbulletin/showthread.php?t=42886&referrerid=1173

Hopeful

[Cal-Gal]

Hello Hopeful-
Thanks for this study--really interesting---

Am I reading it correct---the German's feel that greater than 31 U/ml is a positive reading?

Right now, as you know standard here in the US is greater than 38.60 U/ml.

Let me know if I am reading that correct? I will surely speak to my Oncologist about that, if that is correct--he is very open and may already have seen this.

[Hopeful]

Cal-Gal,

31 is the cutoff they used for the purpose of the study. That number could be where the dividing line was for determining relevance of the factors they were evaluating. It is difficult sometimes to get all the info you need from an abstract - you need a poster or a full paper to fill in the gaps.

The main take-away I got from this is that the marker was a better indicator for larger tumors, along with positive nodes. The investigators do say they need to evaluate their results over a longer period of time to be conclusive.

Hopeful

[Cal-Gal]

Thanks Hopeful for this explanation--

I am due for my 1st PET scans post chemo in January--I ended chemo and starting Herceptin about 6mo ago and have only had 2 CT scans and 3 echocardiograms--so no PET until Jan--this will be about 1yr anniversary of my surgery and when I started chemo--

At this point--with my cancer ILC--not showing in a mammogram--it was found on an MRI--I will take all the information that I can get and use to stave off any more cancer!!!!

Have a wonderful day--

[WolverineFan]

Sorry for such a delayed response. There definitely seems to be two schools of thought on tumor markers. My onc won't even do them because she does not think they are reliable. While they may be for some, as it appears is the case with Brenda and Chelee, my onc said they can go up for no reason and create a lot of unwarranted stress. I wasn't sure if I bought it all, and as a result, researched a lot on the web, and found a lot of doctors who believed the same as my onc. I do think that seeing a pattern is an important indicator and also believe it works great for some, but not for all. Good luck and continue to keep us posted.

Hayley

[Cal-Gal]

Thanks Hayley--

Yes, a mixed bag on these tumor markers--I am going to watch mine--and try not to get stressed out when they go up--unless it is over the baseline---

Happy Holidays!!!!