HER2 Support Group Forums - View Single Post - Routine marker testing and recurrence... worth it?

AlaskaAngel · 10-23-2007, 11:02 PM

The debate has been difficult at times, but the issue is one that is hard to understand. I think it is worthwhile.

I don't know what criteria the people used who created this particular guideline, but it is hard for me to agree that this guideline would provide more help than horror for those who are continuing on difficult, uncomfortable, expensive treatments that they are hoping are keeping them NED throughout the time that markers might have helped them to know that what they were doing wasn't helpful. If I read your argument correctly, these patients are better off kept in the dark based on the judgment of the people designing the guideline (who are not, after all, the ones directly dealing with cancer themselves). This guideline then would be based primarily on extending survival and not at all on QOL, since obviously QOL is worsened in this case by being kept in the dark. It seems like they are somehow measuring the value of hope against the hardships of treatment, and how do they manage to do that with any accuracy?

I also think the perceptions about doing markers would be somewhat different depending on whether the guideline is intended to address the UNreasonableness of doing routine markers for everyone who has had bc -- for example, including those diagnosed at early stage whose labs and all other indicators are wonderful and who have been NED from the getgo -- versus those at the other end of the scale, those who have recurred once and are NED. If the guidelines are meant to say that those who have recurred but are NED don't benefit from routine markers, then we do disagree. The guidelines discourage the routine use of markers, but don't say not to use markers altogether. But what would be the guideline definition of the non-routine use for markers?

A.A.

10-23-2007, 11:02 PM	#65
AlaskaAngel Senior Member Join Date: Sep 2005 Location: Alaska Posts: 2,018	The debate has been difficult at times, but the issue is one that is hard to understand. I think it is worthwhile. I don't know what criteria the people used who created this particular guideline, but it is hard for me to agree that this guideline would provide more help than horror for those who are continuing on difficult, uncomfortable, expensive treatments that they are hoping are keeping them NED throughout the time that markers might have helped them to know that what they were doing wasn't helpful. If I read your argument correctly, these patients are better off kept in the dark based on the judgment of the people designing the guideline (who are not, after all, the ones directly dealing with cancer themselves). This guideline then would be based primarily on extending survival and not at all on QOL, since obviously QOL is worsened in this case by being kept in the dark. It seems like they are somehow measuring the value of hope against the hardships of treatment, and how do they manage to do that with any accuracy? I also think the perceptions about doing markers would be somewhat different depending on whether the guideline is intended to address the UNreasonableness of doing routine markers for everyone who has had bc -- for example, including those diagnosed at early stage whose labs and all other indicators are wonderful and who have been NED from the getgo -- versus those at the other end of the scale, those who have recurred once and are NED. If the guidelines are meant to say that those who have recurred but are NED don't benefit from routine markers, then we do disagree. The guidelines discourage the routine use of markers, but don't say not to use markers altogether. But what would be the guideline definition of the non-routine use for markers? A.A.