Herceptin and CA 27.29 tumor marker

[Cal-Gal]

Does anyone know how Herceptin makes the CA 27.29 tumor markers react?

I get everyone is different--but my understanding with chemo is that it elevates this marker--and that after chemo it is suppose to come down--my question is.....

Does Herceptin elevate tumor markers?

Thanks----

[Chelee]

Cal-Gal,
All I can tell you is my personal experience with Herceptin & TMs. When I recurred last Sept. all I could start on was Herceptin since I was going to have surgery on my femur. My markers had been climbing slowly for almost a yr. (Which I now know TMs are very reliable for me.)

After my first loading dose of Herceptin my CA27.29 instantly dropped. I was relieved to see how well Herceptin works for me. The Herceptin kept my TM'ers down quite a bit until I could start on chemo. I have never heard of Herceptin causing TM's to be elevated? In fact when I was first DX a bit over 4 yrs ago I did a complete yr of Herceptin. The only time my markers jumped up once was towards my 5th cycle of TCH which I was told could be tumor flare. (Dying tumor cells.) After that one small jump I finished the entire yr of Herceptin with my CA27.29 staying between 15 & 18...they never moved from that until I recurred. (Which was 3.5 yrs.) Hope this helps?

Chelee

[Cal-Gal]

Hi Chelee-
Thank you and Bless you for answering my question--you are such a bright light on this forum.



Here is my tumor marker history-thus the reason for the question-they dropped after chemo and initial Herceptin-but have not dropped lower than 26.1 and are up to 35.1 a few weeks ago--





CA 27.29 Tumor Marker History Range 0.00-38.60


1/28/09 27.2—one week after surgery—two weeks prior to chemo
3/13/09 46.4
4/23/09 41.9
5/21/09 63.5—Chemo complete 5/28/09
7/10/09 34.0
8/14/09 28.8
9/18/09 26.1
10/16/09 27.2
11/14/09 34.5
12/11/09 32.4
1/08/10 33.0
2/5/10 27.7
3/5/10 35.8
4/2/10 35.1

[weety]

I'm no doctor, but from looking at your results and comparing them to my experience, I would just say you are one to come in with high-normal values. Your markers tend to bounce around in about the 28-35 range, which is still considered normal. My onc says that it is the upward trend that they worry about, not a single fluke reading here and there or even a high-normal that stays consistently high-normal. My numbers were 27 before surgery, went up to 48 during chemo and now have been slowly going down (38, then 34.9 and now the most current at 32.6) but they still haven't gotten back to my first score of 27. This has been freaking me out as well, but I'm really trying to believe it has to be remnants of the chemo still, since it has gone down each time just a bit more. My onc only does them every 3 months now that they've gotten back into the normal range. I think my next one is in May.

[Cal-Gal]

Thanks Weety-

I think you are right--that I have 'high-end' normal values-or at least I hope you are on the right track--

I dont have my marker pre-surgery-just post surgery/ pre-chemo which was also 27.

Looks like we are in same boat--my chemo completed about 6 mo prior to yours-I am still on Herceptin as well--

I am looking forward to ending Herceptin in 8 weeks and seeing if they drop even further--

Thanks for taking the time to reply--

[Chelee]

CalGal,
After seeing all your TM'ers results I would not be concerned at all. Your markers were on the higher side to start with. I see the only time they had an upwards trend was during your chemo & that does happen. One thing I'd like you to note too is that TM'ers are not reliable for everyone. For some ppl they just do not work at all. But when they do work...you want to look for a slow or rapid increase. (Like mine climbed very slowly for a yr & not once did they go back down.) I see your TM'ers bounce around a bit. I wouldn't be worried at all if my markers were like yours...honestly I wouldn't. That seems to your "normal" range.

As long as your markers continue to bounce around in consistent range like they are...I would rest easy. Again, remember that TM's don't work for everyone. TM'ers can be stressful as you know...and since they aren't always reliable many onc's refuse to even use them. Why stress the patient out. I hope this helps.

Chelee

[COOK12151]

Hi, my ca 27.29 marker was 33, and I didnot get any treatment.
Can you tell me what does that mean.


Cookie

[COOK12151]

Hi, Can you tell me how you handled all the stress and anxiety? I am only 10 months out of surgery, and had my 1st mammo, and I am a wreck waiting for the results.

Cookie.
You can email at bmmargie@yahoo.com if you like.

[Cal-Gal]

Hi Cookie-
I just saw your post--

To answer your question, I just take one day at a time--but also being human I go to and fro--Faith and Fear--I try and stay in the 'Faith' mode--when that ugly dog Fear raises it's head--I pray for the 'faith'---

As far as treatment--as you know, BC is not just one disease--it has many sub-types--and for my sub-types I had a very aggressive treatment plan--

Good Luck

[Char]

My Oncologist at unc Chapel said that when starting a chemo drug it can elevate your blood markers but it's not to be concerned with the numbers until you give time for the chemo treatment is further into it's course of treatment.
I've been on Tykerb for 2 months and now my blood markers are just begining to come down.


My History updated below:

Oct 07 R Mastectomy 17 of 21 POS lymph nodes at Camp Lejeune NC.
Referred to Oncologist in New Bern NC. for Treatment of ER+PR+ Her2+
Oct-Nov 2007Adinmycin/Cytoxin (A/C and Taxotere 8 Weeks
2008 Radiation 33 days
Herceptin 1yr Aprox Date: early 2008-2009 started Arimidex
Jul 09,1st Pet Scan showed tumor L scapula bone Started Monthly Zometa (zoledronic acid)
Oct09 pain in groin area, MRI report stated pubic bone looks suspicious for tumor. Oncologist said it was arthritis but the word arthritis was not on the MRI report)
Feb 2010 Blood markers values went from 89 in Nov 09 to 187 on Feb 11, 2010 so a PET SCAN was done Feb 2010 Pet Scan confirmed the suspicious MRI back in Oct09 on the pubic bone, another tumor.
Radiation to the pubic bone and the L scapula bone reduced the size and relieved the pain.

My husband with 26 years in Navy Medicine, told the oncologist that he was upset about the Doctor saying back in Oct 09 the MRI just showed arthritis and we will not have anymore appts with him.
Now we go to UNC Chapel Hill.
Taking Tykerb and Zometa and my blood markers are coming down. I feel great. Thank the lord.

[weety]

Hi Cal-gal,
I was one of the ones who responded to you a few months ago when you were worried about your tumor markers bouncing around near the top of normal. Of course, at the time, my advice was to not worry. But now, I'M WORRIED about mine, and it is soooooo much easier to give advice than to follow your own! Here are my markers ( they seem really similar to what yours did-that's why I'm hoping you will let me know what to do!)

Before chemo/surgery: 27
After surgery/before chemo: 29
During chemo: 48
After chemo: 44, then 41, then 38, then 34, then 30, then 26.
Now they've been going up again!
June 2nd--28, June 28th--30, and now on July 13th--34!

I'll put it in a list so it's easier to read--I just realized that wasn't very easy to read above.

27 before surgery/chemo
29 after surgery/ before chemo
48 during chemo
44 1 month after chemo
41 2 months after chemo
38 3 months after chemo
34 4 months after chemo
30 5 months after chemo
26 5 1/2 months
28 6 months
30 6 1/2 months
34 7 months

What ever happened to yours? I am assuming you stopped worrying about them since I couldn't find any new posts about it! Do they still bounce around? What do you think about mine? I HATE CANCER!

[Cal-Gal]

Hi Weety,

So sorry you are going through this worry--

You can see since my initial worry in April that the following month the marker went down almost 6 points--it seems mine like yours tend to bounce around that same area.

I finished Herceptin about 6 weeks ago--and funny you should ask about this now--I was freaked out only about a week ago-after being off the Herceptin about 5 weeks, my marker jumped to 42.2--the Onc had me retest 2 days later and it was back within normal range--but still at 34---

I have read that the 38 normal set point is just that a set point and that some Onc's think it should be lower.

All I know is that if mine is within normal my Onc doesnt freak out--

As for ME--I am just making sure that I am diligent about reporting pains etc-and making sure I have all my scans on time!!

Don't know if we can do anything else?

Good luck--Hugs,

CA 27.29 Tumor Marker History Range 0.00-38.60
1/28/09 27.2—one week after surgery—two weeks prior to chemo
3/13/09 46.4
4/23/09 41.9
5/21/09 63.5—Chemo complete 5/28/09—Started Herceptin June 12, 2009
7/10/09 34.0
8/14/09 28.8
9/18/09 26.1
10/16/09 27.2
11/14/09 34.5
12/11/09 32.4
1/08/10 33.0
2/5/10 27.7
3/5/10 35.8
4/2/10 35.1
4/30/10 29.7
5/28/10 32.3 -completed Herceptin 6/4/10
7/14/10 42.2
7/16/10 34.4

[COOK12151]

Hi, Ididnot get any treatment except surgery. Was the right decision?

[COOK12151]

Hi,
I didnot get any treatment and my tm was 34. Is that bad?


Cookie
bmmargie@yahoo.com

[Cal-Gal]

Hi Cookie-

All breast cancers are different and treatment options and decisions are best decided between the patient and the oncologist.

I only talk to my situation-and I think that is all we can ever talk to is our own unique experience-

Your TM is within normal range---

Hugs,

[weety]

Hi Cal Gal,
It's been a while since I visited this thread, but I was just wondering if your tumor markers ever started behaving better??? Mine still bounce around a bit, always at the higher end of normal. Still freaks me out, but onc doesn't seem to be concerned.

[Cal-Gal]

Hi Weety-
Thanks for checking in--

I go in every 2 months now--due to go in this Monday--11/22-
here are my markers since July--I still have not been able to get it under my initial marker right after surgery which was 29 or so--

7/16/10 34.0
9/15/10 30.1 (3.9)

It does freak me out sometimes that I cant get it lower--but my Onc doesnt seem concerned either---

Hugs to you and thank you for checking in--
Good Luck to you--

[weety]

Yours are almost exactly like mine!
Mine was 34 in July and now 28 in Nov. I wonder why they fluctuate so much?
What is the (3.9) next to your last reading?

[Cal-Gal]

that is how I track the numbers--it is ()=minus 3.9 from the month prior---

[weety]

Ahhh. . . that makes sense now.