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Old 12-31-2006, 03:31 PM   #1
StephN
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Location: Misty woods of WA State
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Question New Tumor Markers Test Method

Hi Everyone -
I got my labs last week from earlier in the month and there was a big asterisk in the boxes containing my CA 27-29 and CEA (Carcinoembryonic antigen) tumor marker results.

CA 27-29 says "by Bayer Centaur. NOTE: New test method effective 12/01/2006" The result is the same as I usually have with the old (Tosoh) method (same reference range).

CEA says more: *By Bayer Centaur *NOTE New Test Method effective 12/01/06. The Bayer Centaur method results are approximately 50% of those obtained by the previous Tosoh method. NOTE New Reference Range effective 12/01/06. Bayer Centaur CEA Reference Range: [0.0 - 0.2 Normal] [2.1 - 4.0] Indeterminate] [ >4.0 Abnormal]

I am mentioning this as the new CEA number may indicate a rising CEA for me if this really does not correlate to the old method. The lab at the U of W would not give me any information as they are not supposed to speak with patients. My onc is on holiday and all the oncs were supposedly given an info packet on this according to the woman in the lab.

Just wondering if this new test method is "out there" for any of the rest of you, and what you may know about it if you have been using tumor markers as a guide during your treatment or measuring NED (like I have).
__________________
"When I hear music, I fear no danger. I am invulnerable. I see no foe. I am related to the earliest times, and to the latest." H.D. Thoreau
Live in the moment.

MY STORY SO FAR ~~~~
Found suspicious lump 9/2000
Lumpectomy, then node dissection and port placement
Stage IIB, 8 pos nodes of 18, Grade 3, ER & PR -
Adriamycin 12 weekly, taxotere 4 rounds
36 rads - very little burning
3 mos after rads liver full of tumors, Stage IV Jan 2002, one spot on sternum
Weekly Taxol, Navelbine, Herceptin for 27 rounds to NED!
2003 & 2004 no active disease - 3 weekly Herceptin + Zometa
Jan 2005 two mets to brain - Gamma Knife on Jan 18
All clear until treated cerebellum spot showing activity on Jan 2006 brain MRI & brain PET
Brain surgery on Feb 9, 2006 - no cancer, 100% radiation necrosis - tumor was still dying
Continue as NED while on Herceptin & quarterly Zometa
Fall-2006 - off Zometa - watching one small brain spot (scar?)
2007 - spot/scar in brain stable - finished anticoagulation therapy for clot along my port-a-catheter - 3 angioplasties to unblock vena cava
2008 - Brain and body still NED! Port removed and scans in Dec.
Dec 2008 - stop Herceptin - Vaccine Trial at U of W begun in Oct. of 2011
STILL NED everywhere in Feb 2014 - on wing & prayer
7/14 - Started twice yearly Zometa for my bones
Jan. 2015 checkup still shows NED
2015 Neuropathy in feet - otherwise all OK - still NED.
Same news for 2016 and all of 2017.
Nov of 2017 - had small skin cancer removed from my face. Will have Zometa end of Jan. 2018.
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Old 12-31-2006, 04:59 PM   #2
Heart Sutra
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Hi Steph,

I don't have an answer for you, but congratulations on the sharp lookout.

nice catch!

Hope the New Year brings the best.
__________________
---Kevin and Sue---

Dx'd 10/06 IDC grade III/III
Er- pr- HER2 3+
MRM right breast 12/5/06
nodes negative
same day reconstruction started
(implants)
Stage II (2.2 cm tumor)
fairly extensive DCIS
Ct and Bone scans clean
Port placement 12/26/06
AC (4 cycles DD)to begin 1/2/07
Taxol/Taxotere (4 cycles DD)
Herceptin for one year

"There is no distinction between the one who gives, the one who receives, and the gift itself."- Hahn
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Old 12-31-2006, 05:39 PM   #3
StephN
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Wink My Med Onc's Reply

Gee - Even on a Sunday afternoon before New Year's Eve!
Here is what she says:

"We will need to follow the new tests for a while to "reset" a patient's baseline. Although the averages for large groups of patients are about the same for the new CA27.29 test, and about 1/2-2/3 the previous value for the new CEA test, some people's numbers will go up and some will go down. The tests are not meant to be sensitive or specific enough to detect significant changes within the normal range, so even if your CEA fluctuated between 0-4, we would not react."

I would think that if my CEA has been steadily below 1 and heads up toward 4 in a relatively short time, I would be seeking a reaction! This is not the case as it is still low with the new test.

My concern comes as my brain mets seems to make CEA a good marker indicating tumor activity or not. In any event my markers are drawn with every Herceptin tretment and I will have the new pattern established soon.
__________________
"When I hear music, I fear no danger. I am invulnerable. I see no foe. I am related to the earliest times, and to the latest." H.D. Thoreau
Live in the moment.

MY STORY SO FAR ~~~~
Found suspicious lump 9/2000
Lumpectomy, then node dissection and port placement
Stage IIB, 8 pos nodes of 18, Grade 3, ER & PR -
Adriamycin 12 weekly, taxotere 4 rounds
36 rads - very little burning
3 mos after rads liver full of tumors, Stage IV Jan 2002, one spot on sternum
Weekly Taxol, Navelbine, Herceptin for 27 rounds to NED!
2003 & 2004 no active disease - 3 weekly Herceptin + Zometa
Jan 2005 two mets to brain - Gamma Knife on Jan 18
All clear until treated cerebellum spot showing activity on Jan 2006 brain MRI & brain PET
Brain surgery on Feb 9, 2006 - no cancer, 100% radiation necrosis - tumor was still dying
Continue as NED while on Herceptin & quarterly Zometa
Fall-2006 - off Zometa - watching one small brain spot (scar?)
2007 - spot/scar in brain stable - finished anticoagulation therapy for clot along my port-a-catheter - 3 angioplasties to unblock vena cava
2008 - Brain and body still NED! Port removed and scans in Dec.
Dec 2008 - stop Herceptin - Vaccine Trial at U of W begun in Oct. of 2011
STILL NED everywhere in Feb 2014 - on wing & prayer
7/14 - Started twice yearly Zometa for my bones
Jan. 2015 checkup still shows NED
2015 Neuropathy in feet - otherwise all OK - still NED.
Same news for 2016 and all of 2017.
Nov of 2017 - had small skin cancer removed from my face. Will have Zometa end of Jan. 2018.
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Old 12-31-2006, 06:37 PM   #4
Adriana Mangus
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Hi

Dear Stephn: I have nothing to add regarding the new method as I will get my test done in a week, but I just wanted to say that I really love your new picture!!!

Have a Happy and Healthy 2007.
__________________
1994 - rt brst, .lump, underarm node dissection,chemo+rad 1.2 cms, Grade 3.
28 nodes neg
Er,Pr, Positive HER2 status unknown
2003- Recur to rt lung.July 16 ( B-Day!)
Her2+++ Er,Pr, Negative
2003 - Aug04--Navelbine + Herceptin
2004- 2007--
NED - Herceptin, only
2007 Feb-April Xeloda added to hereceptin
2007-May Back on Navelbine+Herceptin
2008-Feb-Mar 15 Ses Rad to Rt. Lung
2008- Oc 17 Add Tykerb to Herceptin
2009- June-- Discont Tykerb
2009 July 7--Current Taxol + Herceptin
2009 Dec--Discontinued treatment due to progression. Looking into cyberknife.
2010-Aug Accepted to TDM1, no SE, except liver count went up.
2010-2011 September got kicked out of the trial, due to a small spot found on lung.
2011- 2012 September thru early 2013 on Herceptin
2013- March Bone density shows small spot on 5th rib.
2013 - April 4th appt with onc. will post after discussing course of treatment.
2013-March-April Cyber knife to brain and radiation to rib. Chest --base line before chemo-CT-Scan stable for lung issue. CA2729 Normal.
2013 April Herceptin- TDMI
2013 Sept Herceptin + Perjeta . CA2729 within normal range. Brain and Pet scans October 31st. will post results.
2013 October Brain MRI- mixed response. Will see Onc/rad on Halloween.
2013 October/November Brain-MRI nothing new. Repeat MRI next year in May.

2013 December Continue Herceptin and Perjeta. Stable at the moment.
2014 February Brain MRI -clear!
2014 January Added Taxotere to Perjeta+Herceptin.
2014 March Stopped chemo-chest ct-scan next.

2014- March Scans shows tumor's larger, CA2729 higher. Discontinue Herceptin.
2014 April Perjeta+ Halaven
2014 April CA2729 went down 60 points after one cycle. Cough does not want to go away.
2014 June Continue on Perjeta + Halaven-- no more cough. Stable
2014 June Back on Herceptin + abraxane
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Old 12-31-2006, 07:42 PM   #5
TriciaK
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I love the new photo, too, Steph! You look great! And thanks for giving us a heads-up on the markers tests. Have a wonderful new year! Hugs, Tricia
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Old 12-31-2006, 08:34 PM   #6
heblaj01
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Stephn,
If you get a look at the following study comparing test methods for various markers you surely will be surprised as I was by some of the wide variations in a number of test results:
http://www.wadsworth.org/labcert/cle...evaluation.pdf

To me this means that in those cases the markers should always be tested by the same process & that they are only valid as trend indicators if they move up or down but are not good indicators of the absolute status of the disease especially if they are relatively stable & not far off normal values.
A case in point I am personaly aware of regarding CEA is when it failed to predict or confirm a primary reccurence of a 3 cm tumour by staying around 5 to 6 for over a year as it was growing.
Some members of the Forum have reported the reluctance of their onc to rely on markers prefering clinical symptom, biopsies,X-Rays or scans.
I have even met an MD (not an onc) who is himself a cancer patient & who completely disregards CEA as valid marker.
I think he may be going a bit overboard but he is not totaly wrong.
The fact that blood tests are fast, relatively inexpensive & non invasive accounts for their usage.

Last edited by heblaj01; 01-01-2007 at 01:05 AM.. Reason: Adding omitted last paragraph
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