Tumor Markers

Marion · Experienced user Joined: 28 Nov 2004 Posts: 60

Can anyone help me understand a little more about tumor markers? Last fall I had 4 treatments of A/C followed by 30 rads and now have completed 2 of 4 Taxotere. The onc is extremely good about monitoring everying with blood test, WBC, etc each treatment which is reassuring. I just learned that the onc has been looking at tumor markers since the first treatment last fall and I was able to see the results. In trying to help me understand, he indicated they like it to be below 39. When I started first chemo I was at 27 then next blood count it was 35 and then has continually reduced now down to 14. I've read all the reports and studies and understand that by itself tumor markers are not necessarily reliable but "perhaps" only an indicator of how successful treatment is. And having looked at the studies I see it is only 50%+ accurate and can give false positives. Knowing all that, perhaps the doctors can help me understand:
1) what would have caused the spike from 27 to 35 in a two week time period from the time of first treatment to the second treatment -- would that be because the chemo started and basically "disrupted" all the cancer cells into a frenzy?
2) if I was at 27 and now down to 14 does that indicate that at least the chemo treatment is working and doing what they expected and
3) is the idea to get it to 0 or just low and then to watch for a change upward that could indicate something in the future?

In any case, I take it as reassurance that the onc is watching and testing all things for my best treatment and it is a positive sign that things are progressing in the proper direction -- always looking for the encouragement to wake up to another beautiful day! Very Happy

Marion
_________________
Age: 48
Dx 10/14/04
lumpectomy 10/26
1.6 cm
Stage IIA
SN biopsy 10/29
1/14 nodes +
4 A/C
30 Rads
Taxotere complete
Tamoxifen for 5 years

Muttsmom · Posted: Sat Apr 16, 2005 8:06 pm Post subject: Re: Tumor Markers

Hi Marion,
I've written you 3 times and then deleted them. TM's and oncos go from one extreme to the other. A friend of mine before she had her biopsy, had the CA 27-29 done and it was normal, but she had a 9cm tumor and 11+ nodes. Needless to say, they didn't do anymore tumor markers on her. I think they are better at detecting reoccurences then initial dx. I didn't have my 1st one until I was NED a year and my onco did them at each of my 3 month check ups for a year, to see what was normal for me. My last one was in Oct. and my next one will now be in Oct. I'm definately not a doc and I'll let one answer you with more definate answers but wanted to give you a little info that I learned based on my onco's views of TM. He said he would not do any on me during treatment as so many things can cause false positives, as well as false neg. and with the chemo, which is obviously a foreign body going in, he just wouldn't do them. The reason he waited a year was he wanted to be as sure as humanly possible that I was NED, then he could see what the norm was for me. The labs they do, tell a big picture, more then I even realized until recently. Of course the liver enzimes obviously keep an eye on the liver. Calcium levels, tell a lot about the bones, as far as mets go. Some oncos never do any TM. Mine doesn't do the CEA because everything can cause those to go up and down.
I know easier said then done, because I freaked when mine went up 5 points and it was still in the low normal and the next time went back down. I was running a fever and that's more then likely what caused the slight change, but to me it was a huge change since they had always been almost identical each time. Try not to think about the TMs, especially at this point. You're getting the chemo regimine that your onco feels is best for your type of cancer and radiation and getting good care. I think a good onco is half the battle and it sounds like you've got one that is very good and truly cares about you as a person, not a number. You're already considered NED because the obvious cancer is gone and this is to get any stray little suckers that might be floating around, so you're on your way and before long, you'll be celebrating your 1 year NED. I don't know what is standard after treatment care, but mine did another CT Scan of my chest after treatment and a year later, did a bone scan (that was because I was hurting in places I hadn't hurt before) and that was fine. The way mine told me was if my tumor markers went up and continued to go up, he'd start checking to see IF it meant the cancer was back somewhere and on the other hand, if I was having problems, like I did when my lower back hurt so bad, that I just knew I had bone mets (he said it was a disk) and even though the TMs were normal, he did an MRI of my lower back and it was a herniated disk thank God. I hope this makes sense because I can confuse myself sometimes.....lol
Hang in their girl, you're doing great and before long, you'll be done with treatment and starting your new life after cancer.
Hugs
Nancy
_________________
Nancy
2/14/02 ILC 43 - 5.5 cm 9+/16 nodes
Stage IIIA er/pr+ Her2-
2/02 MRM
FECx6 radsx33
Tamoxifen - Arimidex (chemo induced menopause)
4/03 SM w/bilat. recon.
9/03 expanders removed
5/04 repair reconst. disaster
10/04 Actonel for bone/joint pain from Arimidex
NED - 5 years
3/07 Diabetes
In memory of Kim 12/1/04

Marion · Experienced user Joined: 28 Nov 2004 Posts: 60

Hi, Nancy. Thanks for the information. To be honest, the TM are not a concern for me. Just trying to understand what role they play. I look at them as just another piece of the puzzle, and the more knowledge that I gain the more I'm in control of this battle. It also offers me the ability to ask intelligent questions of the onc. I find the more knowledge I have and can ask relevant questions about my own treatment, the more likely he is to not treat me as a number.

Thanks again.

Marion
_________________
Age: 48
Dx 10/14/04
lumpectomy 10/26
1.6 cm
Stage IIA
SN biopsy 10/29
1/14 nodes +
4 A/C
30 Rads
Taxotere complete
Tamoxifen for 5 years

Muttsmom · Posted: Sat Apr 16, 2005 11:11 pm Post subject: Re: Tumor Markers

Hi Marion,
It sounds to me like you have a good, knowledgable (sp) head on your shoulders already. Smile

Hugs
Nancy
_________________
Nancy
2/14/02 ILC 43 - 5.5 cm 9+/16 nodes
Stage IIIA er/pr+ Her2-
2/02 MRM
FECx6 radsx33
Tamoxifen - Arimidex (chemo induced menopause)
4/03 SM w/bilat. recon.
9/03 expanders removed
5/04 repair reconst. disaster
10/04 Actonel for bone/joint pain from Arimidex
NED - 5 years
3/07 Diabetes
In memory of Kim 12/1/04

leo · Owner Joined: 23 Sep 2004 Posts: 1574

Hello

Tumor markers are well established for following prostate, colorectal and ovarian cancers. For breast cancers the tumor markers are not so well studies that they can be relied upon as it is with the above-mentioned tumors. That's why there is so much variation as to why some doctors follow them whereas others don't.

Personally, I would rather not use them since it does not add any information, but some (including many that know much much more than I do) prefer to use it, so basically it is up to the particular physician.

best regards,
Leo
_________________
Leonardo F - Webmaster Cancer Forums
Disclaimer: this information is for informational purposes only. It is not medical advice.

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