Monitoring for a Cancer Recurrence

takingcontrol58

I’ve seen many women on this site develop recurrences who are no longer with us, Stage 1 cancer patients who have developed recurrences, people who have survived five years, seven years, who then developed recurrences and women who want to know what to look for to watch for a recurrence. The cancer industry says there are no tests to predict for endometrial cancer, yet patients have many options. But you have to work with what is available to you today.

In this posting, I will focus on comprehensive blood testing.  I believe comprehensive blood testing is one of the best ways to monitor for a cancer recurrence. If any of the key markers were to get out of range and there were concerns with my ultrasounds, then I would perhaps move to a CT scan. No testing is perfect, so when you do blood testing along with your scans, you have a much better picture of what may be happening in your body.

 It is not about monitoring just for cancer but monitoring for the conditions that lead to cancer. You don’t want a recurrence, you want to prevent a recurrence.

 When you do regular blood testing, you can monitor the state of your body over time so that you can deal with any issues that arise before they get out of control.  Blood tests measure the state of your entire body and not just the state of your cancer. This is what you need to know as it is your body that grows cancer. Cancer is a systemic disease. So many people find out they have health issues they didn’t know they had when they finally get comprehensive blood testing, health issues that may have contributed to their cancer diagnosis (this was the case for me), conditions they may have been able to address to lower their risk of acquiring cancer. Oncologists do not perform complete testing to prevent recurrences. So you need to “takecontrol.”

 Unfortunately, there is no focus on cancer prevention in this country, whether it is an initial cancer diagnosis or a recurrence, so you will have to take matters into your own hands.

Below is a list of some of the blood tests I get on a regular basis to predict for a cancer recurrence. I get tested for 20-30 blood tests every four months. Some tests I get more frequently than others, as I have been doing this for five years now. The frequency of these tests can be determined between you and your doctor. Your doctor may want to add more tests, as there are plenty of blood tests available that are currently not being used in clinical practice. Once you have cancer, you can never let your guard down.  The blood shows everything.  It is the life of our body.

 

Blood Tests - be aware that the ranges for most blood tests are very wide- so even if a test result looks normal, it still may not be low enough or high enough for a cancer patient

 

Cell Damage
LDH (lactate dehydrogenase, an enzyme that rises in response to cell damage, lactate is consumed by tumor cells for their survival and also stimulates angiogenesis, it is considered a metabolic fuel for cancer)

Inflammation – these are also markers for heart disease, a risk factor for endometrial cancer patients
ESR SED Rate  -should be under 10
C-reactive protein - should be under 1.0
Homocysteine (better marker for heart disease than cholesterol)- high levels can be tied to low levels of B12 and folate

 

Metabolic Dysfunction
IGF-1 (measures insulin like growth factor, a key hormone involved in the growth of endometrial cancer, colon, breast, prostate and pancreatic cancer, it is made in the liver)- it is frequently raised before the diagnosis of endometrial cancer
Serum insulin (works with glucose, key driver of cancer)
Glucose (works with insulin) - made in the liver
Hemoglobin A1C (will advise if you are diabetic) – measures glucose levels for past 90 days
Adiponectin (higher levels are believed to indicate a reduced risk of endometrial cancer)- “each 1ug/ml increase of adiponectin indicated a 3% reduction in endometrial cancer” Circulating Adiponectin and Risk of Endometrial Cancer, https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4452093/ June 2015,
Leptin (high levels are tied to various female cancers and promote cancer growth, tied to obesity-leptin increases cell proliferation, inhibits apoptosis, promotes angiogenesis and can increase drug resistance, released by fat cells)

Key Vitamins
Vitamin D (most cancer patients are low in this important vitamin) – ideal level is 70
Vitamin B12 – (critical if you are using metformin, as metformin lowers B12 levels)- low levels can be tied to neuropathy and high glucose

Cancer Tumor Markers
CA125 (tumor marker for ovarian and endometrial cancer)
HE4 (for ovarian and endometrial cancer- good marker for recurrence of endometrial cancer)
CEA (carcinoembryonic antigen, used for colon, lung, breast, liver and endometrial cancer-I test this marker because I had metastases to my liver and outer rectum)

Iron
Ferritin (measures iron stores- cancer loves iron- it makes the cancer grow)- need to be below 100 
TIBC – total iron binding capacity (measures iron levels in your blood)

Other metals – if you have high levels of any metal you need to monitor to get to normal levels
Mercury, Lead, Aluminum, Arsenic

 Hormones – may be relevant if your cancer was hormone driven

Estradiol (measures estrogen)
Progesterone (needs to be in balance with estrogen)
Estrone (hormone that converts to estrogen)
DHEA-Sulfate (hormone produced by the adrenal glands- your adrenals still produce estrogen with your ovaries removed)
HCG (human chorionic gonadotropic, hormone produced by cancer cells and rises with cancer)
Cortisol – stress hormone

Standard Blood Tests – these tests I get every four months, along with the more specialized tests above
Complete Blood Count (CBC)
Complete Metabolic Panel
Lipid Panel

My goal is to prevent a recurrence and give me peace of mind.  Regular blood testing gives me peace of mind.

 Each of us has different health issues, though we all have a human body so these are some of the key markers tied to endometrial cancer, and many conditions that develop from some of these markers are the reason our cells mutate. You need to test basic blood tests then add specific ones that may be more relevant for you. There are so many blood tests that you can get, but you need to start having conversations with your doctor, most likely your internist or a doctor of functional medicine or integrative medicine, so you can dive further into the state of your health. You need to focus on keeping yourself healthy so cancer has no need to form.

Takingcontrol58

 

oldbeauty

Interesting

Thanks for this, takingcontrol58.  As usual, thought-provoking information.  I'm going to share this with the newest member of my team, a practicing physician who is taking course-work in advance of sitting for board certification in functional medicine.  This physician is intrigued by my case.  I am curious, though.  If you are willing to share, has any test shown a definite tilt "to the dark side," and if so, what were you able to do that produced a satisfactory response?  Like others here who are prodigious researchers and share the info with us, you are an asset to this forum.  Best wishes, Oldbeauty

takingcontrol58

Oldbeauty

What do you mean, "has any test shown a definite tilt to the dark side?"
That the test was at a level indicative of an issue?

Takingcontrol58

oldbeauty

Sorry. Too cute for my own good!

Yes.  I'm curious, if you wish to share, whether in the years you've been monitoring your health you've had to respond to any issues where the blood work was out of the normal range, and, if so, what corrective action was taken.  Best wishes, Oldbeauty

takingcontrol58

Old Beauty

I can give you 2 examples-
1) Last year, I noticed that my glucose levels (which had been in the mid 80s to low 90s) started to go up over 100-
I thought that odd as I was on metformin and don't eat much sugar. I started thinking about what had changed in
my regimen.  I realized that I had started to take Vitamin B3 (niacinamide) to reduce my risk of skin cancer. I had
3 basal cell carcinomas before I was ever diagnosed with EC, and am at high risk for melanoma.  I looked up more
about B3 and discovered that it can raise glucose levels. So instead of taking a capsule every day, I started taking 3 capsules
a week. My glucose dropped back to the mid 80s.  Our blood markers move all the time. But when you check your
blood more frequently, it is easier to remember what changed in your life or what drug or supplement you starting using.
The good news is that I haven't had any more skin cancers since my diagnosis of EC.

2) It is very important to test for metals in your blood.  Metals cause free radicals and lots of damage.  I had very
high ferritin levels when my cancer metastasized. it is a blood marker that I believe caused the aggressiveness of my cancer,
as it is tied to two of my mutations that control iron homeostasis.  It was tested by my integrative doctor in Feb 2015 and
the level was 334.  It should be below 100 - ideal is about 30-60.
I looked back at my past blood tests and only one doctor had ever tested it- back in 2006- the number was 93, still normal at the time.
I did stop seeing that doctor for certain reasons but no doctor ever ran this blood test on me from 2006 -2015- Obviously, it was
during those years that the number kept going up.  I had no idea how important it is to have the right level of ferritin in your body
as no doctors every discussed this with me and I had no idea it is a key food for cancer. I've watched two people die in the last
year with excessively high ferritin levels that their doctors thought was not a problem. Looking back, I know what probably caused
my levels to rise so much, but since I never knew about ferritin and what it does to the body and nobody was testing it, I continued
on with my bad lifestyle habits.

If any of my doctors were monitoring my ferritin levels, I could have radically changed my diet then to eliminate what was most likely
raising my ferritin levels (I ate too much meat, drank lots of fruit juice with Vit C-vitamin C makes your body absorb iron),
and drank alot of red wine. (alcohol is full of iron). I could have started taking the supplements I use today to keep the levels in a normal range. 
This is one blood test that I diligently monitor every four months. I know how damaging ferritin can be.

I saw you posted about your most recent recurrence, with a very small lung nodule. As an example, lung nodules are common in
people and most are benign. If you don't smoke, the nodule is small and is full of milk of calcium, then it is most likely benign.
Two things that can cause lung nodules are inflammation (which is a key driver of cancer and many health issues) or an infection.

I would recommend you get your blood tested for ESR SED rate the hs-CRP to see what you inflammation levels are. This is an 
example of a blood test that perhaps could be tied to your nodule- perhaps it was lower in the past but increased as the nodule formed.

On a positive note, metformin targets the Nf-KB pathway (the inflammatory pathway). So perhaps the metformin is keeping it stable by
lowering your inflammation levels-if I was in your position, I would start monitoring these levels on a regular basis.  Another option for
you is to start taking a low dose aspirin each day- aspirin is the best known anti-inflammatory and lowers the risk of all cancer by 25%.
That is if you have no stomach issues. Aspirin targets the COX-2 enzyme, which drives inflammation.

Unfortunately, our medical system treats you after the fact- it would have been ideal for you to have been taking aspirin and metformin since
your initial cancer diagnosis. The metformin would have treated your metabolic syndrome.  I had both metabolic syndrome and insulin resistance.
This is what I mean about treating the root causes of your cancer.

Regards,

Takingcontrol58

 

 

oldbeauty

takingcontrol58 said:

Old Beauty

I can give you 2 examples-
1) Last year, I noticed that my glucose levels (which had been in the mid 80s to low 90s) started to go up over 100-
I thought that odd as I was on metformin and don't eat much sugar. I started thinking about what had changed in
my regimen.  I realized that I had started to take Vitamin B3 (niacinamide) to reduce my risk of skin cancer. I had
3 basal cell carcinomas before I was ever diagnosed with EC, and am at high risk for melanoma.  I looked up more
about B3 and discovered that it can raise glucose levels. So instead of taking a capsule every day, I started taking 3 capsules
a week. My glucose dropped back to the mid 80s.  Our blood markers move all the time. But when you check your
blood more frequently, it is easier to remember what changed in your life or what drug or supplement you starting using.
The good news is that I haven't had any more skin cancers since my diagnosis of EC.

2) It is very important to test for metals in your blood.  Metals cause free radicals and lots of damage.  I had very
high ferritin levels when my cancer metastasized. it is a blood marker that I believe caused the aggressiveness of my cancer,
as it is tied to two of my mutations that control iron homeostasis.  It was tested by my integrative doctor in Feb 2015 and
the level was 334.  It should be below 100 - ideal is about 30-60.
I looked back at my past blood tests and only one doctor had ever tested it- back in 2006- the number was 93, still normal at the time.
I did stop seeing that doctor for certain reasons but no doctor ever ran this blood test on me from 2006 -2015- Obviously, it was
during those years that the number kept going up.  I had no idea how important it is to have the right level of ferritin in your body
as no doctors every discussed this with me and I had no idea it is a key food for cancer. I've watched two people die in the last
year with excessively high ferritin levels that their doctors thought was not a problem. Looking back, I know what probably caused
my levels to rise so much, but since I never knew about ferritin and what it does to the body and nobody was testing it, I continued
on with my bad lifestyle habits.

If any of my doctors were monitoring my ferritin levels, I could have radically changed my diet then to eliminate what was most likely
raising my ferritin levels (I ate too much meat, drank lots of fruit juice with Vit C-vitamin C makes your body absorb iron),
and drank alot of red wine. (alcohol is full of iron). I could have started taking the supplements I use today to keep the levels in a normal range. 
This is one blood test that I diligently monitor every four months. I know how damaging ferritin can be.

I saw you posted about your most recent recurrence, with a very small lung nodule. As an example, lung nodules are common in
people and most are benign. If you don't smoke, the nodule is small and is full of milk of calcium, then it is most likely benign.
Two things that can cause lung nodules are inflammation (which is a key driver of cancer and many health issues) or an infection.

I would recommend you get your blood tested for ESR SED rate the hs-CRP to see what you inflammation levels are. This is an 
example of a blood test that perhaps could be tied to your nodule- perhaps it was lower in the past but increased as the nodule formed.

On a positive note, metformin targets the Nf-KB pathway (the inflammatory pathway). So perhaps the metformin is keeping it stable by
lowering your inflammation levels-if I was in your position, I would start monitoring these levels on a regular basis.  Another option for
you is to start taking a low dose aspirin each day- aspirin is the best known anti-inflammatory and lowers the risk of all cancer by 25%.
That is if you have no stomach issues. Aspirin targets the COX-2 enzyme, which drives inflammation.

Unfortunately, our medical system treats you after the fact- it would have been ideal for you to have been taking aspirin and metformin since
your initial cancer diagnosis. The metformin would have treated your metabolic syndrome.  I had both metabolic syndrome and insulin resistance.
This is what I mean about treating the root causes of your cancer.

Regards,

Takingcontrol58

 

 

"Food" for thought!

Thanks, again.  I appreciate your willingness to share info, as well as your recommendation.  I will share this with my functional medicine physician.  One of my oncos had been following my ferritin and we did the various blood tests you recount.  My iron was very low (I think it was because I had uncontrolled diarrhea for a year that I think was related to chemo damage.  After repopulating my gut biome with a pre- and pro-biotic for many months, the diarrhea is gone). I am going to ask my doc to recheck these values as I continue to take Iron and Vitamin C daily (even tho' my ferritin is good now bc I am frugal/thrifty/cheap and I still have some pills left).  I know it is dangerous to have Iron levels too high.  Best wishes, Oldbeauty