Benign reasons for TM'ers being elevated?

[Chelee]

Sorry to start another thread on this but I am just paralyzed with fear. My whole body hurts & I can't breath...major anxiety! Even my xanax is not helping. I wake up at night & can't get back to sleep.

As you all know from my 1st thread my TM'ers have slowly been rising over the last yr & 1/2. Started at a consistent 15 to 18 for a long time. Then creep up to 20, 23, 25, & last wk an all time high of 46. Retested last Monday & now in a wks time their 53. I looked up benign causes of TM'ers being elevated & couldn't find as much as I hoped for. But I did see it said seroma's which is a benign reason can cause an elevated rise in TM'er. I've had a large seroma since my 1st mastectomy that's never gone away. Has anyone had something else cause their TM'ers to rise other then the obvious?

Chelee

[Barbara H.]

Hi Cheele,
Any type of inflammation can cause them to rise.
Barbara H.

[Julie2]

Cheele,

You can try getting the Her2 serum marker. It will not have many false positives.

Julie

[ElaineM]

Don't forget that benign tumors and lymphdema can cause the tumor markers to rise too.

[Sheila]

Chelee
Have the TM's been accurate for you all along? As others have said, any infection, inflammation etc can cause them to fluctuate...mine were always normal even when I had progression.....they are not a definate marker for everyone.
Sending a big hug to calm your fears...you are in my thoughts

[Mary Anne in TX]

Chelee, mine went up and down for all kinds of crazy reasons...into the 40s and lover 50s. It was usually when my blood work had a quirk of some kind or when I was under extreme stress. I will confess that I worried about it a lot and it is mainly what drove me to fight for that 2nd year of herceptin!
But now it's 28 and I'm swinging from the moon!
Chelee, I'm hoping that yours is from other stuff too and that you will get some peace of mind soon by learning you're doing great! ma

[Joan M]

Chelee,

My markers have always been normal even though I've had lung and brain mets.

If you're taking other medications, they may be responsible.

As for Xanax, have you thought of switching to Ativan or Klonazepam?

Xanax works the fastest, but it doesn't work as long as other similar drugs, and therefore more is needed. Valium is next, followed by Ativan and then Klonazepam. The latter is the longest acting.

You might want to switch to Ativan or Klonazepam.

Joan

[Chelee]

I do know I've had fibroids that have shown on my scans since my 1st baseline PET/CT. I've also had a big seroma that was drained twice but has never absorbed. Its large...last "US" was 6.9 x 6.8 x 2cm. It does feel like it's changed...feels hard as a rock now. It was never this hard...causes discomfort big time.

I've always had these things since this entire nightmare started so I would have to wonder why it would elevate my TM'ers slowly over the last year & 1/2? And now instead of a slowly elevated rise...seems to be climbing faster now. :( I've been fortunate that I've experienced no lymphdema...well that I'm aware of?

Shelia my markers "seemed" to be accurate. They stayed in a low range throughout chemo & to the end of my Herceptin. Your question got me to look hard at my TM'er readings & now thanks to you I see my TM'ers started slowly rising not long after I finished Herceptin. Didn't notice that until now. I see my markers started creeping up exactly 4 months after I no longer received Herceptin. So now that makes me wonder if Herceptin was keeping "it" away...or if my markers are going to their new normal? I don't know what to think?

Chelee

[ElaineM]

I remember reading that cysts can cause the tumor markers to rise. I also wonder if steriod medications which increase inflammation can cause them to rise too?
People on some kinds of chemo take steroids. I also wonder if some kinds of chemo can cause the tumor markers to rise temporarily?

[Barbara2]

Chelee, this past spring I had the same concerns as you. My markers had consistantly been 18-22. Then it went to 23, followed by 45. My onc ran a bone scan to give me peace...it was ok. He wanted to see me in 3 months. I couldnt wait 3 months, so we did the TM again in 1 month. It was 16. I cried because I had been so sure...

More to the story:
Both my onc and his nurse had told me repeatedly that this was normal. That it happens all the time. Happens all the time? Then why, when I asked our Her2+ group, where an enormous amount of Her2+ people come for support and answers...why did I not get one reply from someone who had a large rise in TMs, followed by a "normal" test?? Why not? If this happens "all the time?"

Coincidence?:
I also knew that on the day of the high tumor marker, the CA27.29 machine broke down and the blood work had to be sent somewhere else that day. To this day, I believe, but cannot prove, that something happened with my bloodwork... that it didn't get chilled properly, or whatever, which resulted in a lab error. BUT, I continued to reason, if that was the case, then why weren't there more lab results from other patients, that were not in the normal range? I will never know for sure.

And also:
I have quoted Dr. Pegram a number of times on this very issue, so my appologies for the repeat, but this is what he had to say (2007) about tumor markers:

Question to Dr. Pegram: What is your opinion of having markers done?

I do them. They’re not very good, but I do them once in a while. It’s about like the barometric pressure. “How’s the weather today?” Oh its 760 millimeters of mercury today; well that’s one atmosphere, so that tells you maybe it’s not high or low but it doesn’t tell you the temp, clouds, precip. So that’s exactly the analogy I would make of the tumor markers. They’re a piece of a puzzle; by themselves they’re virtually worthless. But I still give them.

Question: My CA27-29 #s have been in the normal range, but went down a little more after completing Herceptin. Might that possibly show that Herceptin had an effect?

They’re all in the normal range. It doesn’t mean a thing. Any bouncing around in the normal range doesn’t mean a thing. I don’t get impressed unless those things double on 2 separate occasions, back to back, a month apart. To impress me it would have to go from 20 to 40 to 80, then I’d say maybe something’s going on. That just means it’s time to take a look with some tests, but it’s not alarming. But 20 to 40 even, doesn’t get me excited. 40 doesn’t mean anything; 38 is the upper end of normal. So if it doesn’t double twice, then I’m unimpressed.[/I]

Me again:
And finally, are there benign reasons for tumor markers to elevate? I asked my onc and he really would not give me specifics, but he said, "Yes, there are many reasons that tumor markers can elevate. If they would get to 100, then I would want to do more testing."

When searching for "answers" I also came across this:
1: J BUON. (javascript:AL_get(this, 'jour', 'J BUON.');) 2007 Oct-Dec;12(4):487-92

Zervoudis S (http://her2support.org/sites/entrez?Db=pubmed&Cmd=Search&Term=%22Zervoudis%20S%22%5BAuthor%5D&itool=EntrezSystem2.PEntrez.Pubmed.Pubmed_ResultsP anel.Pubmed_DiscoveryPanel.Pubmed_RVAbstractPlus), Peitsidis P (http://her2support.org/sites/entrez?Db=pubmed&Cmd=Search&Term=%22Peitsidis%20P%22%5BAuthor%5D&itool=EntrezSystem2.PEntrez.Pubmed.Pubmed_ResultsP anel.Pubmed_DiscoveryPanel.Pubmed_RVAbstractPlus), Iatrakis G (http://her2support.org/sites/entrez?Db=pubmed&Cmd=Search&Term=%22Iatrakis%20G%22%5BAuthor%5D&itool=EntrezSystem2.PEntrez.Pubmed.Pubmed_ResultsP anel.Pubmed_DiscoveryPanel.Pubmed_RVAbstractPlus), Panourgias E (http://her2support.org/sites/entrez?Db=pubmed&Cmd=Search&Term=%22Panourgias%20E%22%5BAuthor%5D&itool=EntrezSystem2.PEntrez.Pubmed.Pubmed_ResultsP anel.Pubmed_DiscoveryPanel.Pubmed_RVAbstractPlus), Koureas A (http://her2support.org/sites/entrez?Db=pubmed&Cmd=Search&Term=%22Koureas%20A%22%5BAuthor%5D&itool=EntrezSystem2.PEntrez.Pubmed.Pubmed_ResultsP anel.Pubmed_DiscoveryPanel.Pubmed_RVAbstractPlus), Navrozoglou I (http://her2support.org/sites/entrez?Db=pubmed&Cmd=Search&Term=%22Navrozoglou%20I%22%5BAuthor%5D&itool=EntrezSystem2.PEntrez.Pubmed.Pubmed_ResultsP anel.Pubmed_DiscoveryPanel.Pubmed_RVAbstractPlus), Dubois JB (http://her2support.org/sites/entrez?Db=pubmed&Cmd=Search&Term=%22Dubois%20JB%22%5BAuthor%5D&itool=EntrezSystem2.PEntrez.Pubmed.Pubmed_ResultsP anel.Pubmed_DiscoveryPanel.Pubmed_RVAbstractPlus).
Breast Department, "Lito" Maternity Hospital Athens and Ioannina University, Greece. szervoud@otenet.gr
PURPOSE: To analyze, study and interpret the increased levels of tumor markers in breast cancer patients without recurrence or metastasis. PATIENTS AND METHODS: We studied a series of 400 patients with stage 1 breast cancer during a 3-year follow-up after primary treatment. Follow-up included frequent serum estimation of CEA, CA 15.3, CA 125, CA 27-29, TPA and TPS tumor markers. RESULTS: Of 358 patients being continuously disease-free, 18 (5%) cases showed false-positive levels of tumor markers, associated with benign conditions and not to cancer recurrence or metastasis. These conditions included ovarian cysts, thyroid disorders, hepatitis, renal stone and sarcoidosis. CONCLUSION: The value of increased tumor markers should be interpreted cautiously because it doesn't always imply disease recurrence. Tumor markers may increase in many benign conditions.
PMID: 18067207 [PubMed - indexed for MEDLINE]

Peace to you. You are in my prayers.

[Chelee]

Barbara, Your story does sound similar to mine. The only difference is my markers have slowly over a yrs time been gradually increasing & now a jump. Like you I hoped to find several other woman on this board that ran into the same thing but it would turn out to be nothing. So far I'm not seeing that. :( Yours is the 1st post that experienced almost the same problem.

My onc ran my TMers again last Monday just to see if it was a fluke...but it jumped up again by 7 points in a wk. It just keeps going up. Now there not as high as I've seen lots of other peoples...but it still scares me since my TM'ers have always been so stable. Four months after stopping Herceptin they have seemed to go up. Not sure if that's a coincidence or what to make of it?

But your post does give me some hope...and hearing Dr. Pegrams thoughts on TM'ers helps alot! He's the man...along with Slamon and a few others. My markers were rising slowly every 3 months. Then the last time it was 6 months apart & it doubled. Quite a jump for me. That got my attention. I've also seen people like Brenda (hutchibk) TM'ers be a very good indicator of progression when they went up gradually like mine. If I would see mine drop just one time I'd feel so much better about this. I'm praying so hard for one of those "benign" reasons they go up.

Thank you so much for sharing all that with me...it helps! My FSH & Estradiol has had a big change finally...I wonder if that could play a part in this? Didn't think to ask my onc that at my last visit. Can't wait to get my PET/CT done.

Chelee