Study on CA125 and risk of recurrence

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Hissy_Fitz
Hissy_Fitz Member Posts: 1,834
in Ovarian Cancer #1
This is a very interesting study on CA125 and risk of recurrence. http://annonc.oxfordjournals.org/content/20/2/294.full

Briefly, it says that women who experienced an absolute increase in CA125 of more than 5 points over their nadir value are more likely to recur. This number was achieved by subtracting the nadir CA125 from any post-treatment value.

For example, my nadir was almost 5 (4.8), and my most recent CA125 was 13. Subtracting 5 from 13 leaves 8. Since that is more than a 5 point increase, I am likely to experience a recurrence, according to this study.

Carlene

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  • poopergirl14052
    poopergirl14052 Member Posts: 1,183 Member
    #2
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    Let's hope they are wrong
    8 is still a good #..val
  • Cafewoman53
    Cafewoman53 Member Posts: 735 Member
    #3
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    Your nadir
    Is your nadir value your lowest Ca125 number ?
  • Hissy_Fitz
    Hissy_Fitz Member Posts: 1,834
    #4
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    Cafewoman53 said:

    Your nadir
    Is your nadir value your lowest Ca125 number ?

    Yes, CW. Nadir is the
    Yes, CW. Nadir is the lowest your CA125 drops during or after chemo.
  • Hissy_Fitz
    Hissy_Fitz Member Posts: 1,834
    #5
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    poopergirl14052 said:

    Let's hope they are wrong
    8 is still a good #..val

    Eight is a good number.
    Eight is a good number. Mine, however, is 13.

    Eight is absolute point rise, defined in the study as my current CA125, minus my nadir (lowest CA125). The study claims that any absolute rise over 5 points indicates the patient is likely to recur.

    Carlene
  • NCEllen
    NCEllen Member Posts: 115
    #6
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    Wacthful Waiting? Not again..
    Great article. I had my 1st recurrence Dec. 2010. My nadir after completion of my first round of chemo in July '09 was 2.1. I was on carbo/taxol but chose not do taxol maint. I needed time for my body to heal. My CT was clear, second look surgery to reverse my temp. ileostomy including tissue biopsies were also clear. My CA-125 numbers started to rise last June and were >50 in Dec. I was asymptomatic and felt well. A CT was done and confirmed multiple pelvic tumors.

    I started chemo this past Jan. and finished #6 out of 8 chemos yesterday (carbo/taxol again). My first CT scan after chemo #3 in April showed reduction of tumors and some had gone away completely - no organ involement. My CA-125 dropped to 31 after my first chemo. This week it's 3.12 and I still have 2 more treatments to go. BUT..at this point I will be watching the CA-125 more closly and insist on a CT scan when my nadir reaches that 5 point mark that the article refers to. I feel that I want to be on some type of maintenence something and stay on top of any type of re-growth - even if it's a low dose of taxol. Not sure if I can play Dr., but we all know our bodies the best and I know the little buggers are there - just a game of hide and seek. I really don't feel that my CA numbers are going to be reliable for me. I have another CT scheduled 5-27, so we'll see what's going on then. Someone get me some RAID!

    Will you be getting a CT soon or have you already had one? What is your Dr.s take on follow-up CT's?
    Thanks again for the reference work. Ellen
  • antcat
    antcat Member Posts: 270
    #7
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    Dear Carlene
    I'm sorry that there was a slight increase in your CA 125. It's always hard for a person when it goes up. I don't know how accurate a CA 125 really is and in the past my gyn/onc told me it's good to do it in conjuction with a HE 4 test. But, they don't do the HE 4 test at MSK, as I asked the oncologist. Thanks for always providing so much information.
  • Hissy_Fitz
    Hissy_Fitz Member Posts: 1,834
    #8
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    NCEllen said:

    Wacthful Waiting? Not again..
    Great article. I had my 1st recurrence Dec. 2010. My nadir after completion of my first round of chemo in July '09 was 2.1. I was on carbo/taxol but chose not do taxol maint. I needed time for my body to heal. My CT was clear, second look surgery to reverse my temp. ileostomy including tissue biopsies were also clear. My CA-125 numbers started to rise last June and were >50 in Dec. I was asymptomatic and felt well. A CT was done and confirmed multiple pelvic tumors.

    I started chemo this past Jan. and finished #6 out of 8 chemos yesterday (carbo/taxol again). My first CT scan after chemo #3 in April showed reduction of tumors and some had gone away completely - no organ involement. My CA-125 dropped to 31 after my first chemo. This week it's 3.12 and I still have 2 more treatments to go. BUT..at this point I will be watching the CA-125 more closly and insist on a CT scan when my nadir reaches that 5 point mark that the article refers to. I feel that I want to be on some type of maintenence something and stay on top of any type of re-growth - even if it's a low dose of taxol. Not sure if I can play Dr., but we all know our bodies the best and I know the little buggers are there - just a game of hide and seek. I really don't feel that my CA numbers are going to be reliable for me. I have another CT scheduled 5-27, so we'll see what's going on then. Someone get me some RAID!

    Will you be getting a CT soon or have you already had one? What is your Dr.s take on follow-up CT's?
    Thanks again for the reference work. Ellen

    Ellen....
    I had a CT done in
    Ellen....

    I had a CT done in Jan, prior to starting the vaccine trial. It is required by MSKCC to affirm remission. It was clear. I had another one done last month. It was also clear.

    MSKCC does CT scans every 3 months, as long as you are on the vaccine trial, so I will get another one in July.

    My local gyn/oncologist does a CT scan at the end of first line treatment, then one a year later. I'm not sure what his protocol is after that. I think it's negotiable, though. He would not normally do a CA125 on me more than every three months, but we compromised on every other month.

    Carlene
  • LaundryQueen
    LaundryQueen Member Posts: 676
    #9
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    antcat said:

    Dear Carlene
    I'm sorry that there was a slight increase in your CA 125. It's always hard for a person when it goes up. I don't know how accurate a CA 125 really is and in the past my gyn/onc told me it's good to do it in conjuction with a HE 4 test. But, they don't do the HE 4 test at MSK, as I asked the oncologist. Thanks for always providing so much information.

    The research results were published back in 2008 with the hope that early recognition of disease progression and treatment would be of benefit. Regarding early return to some type of chemo, the more recently published research does not support that approach.

    Perhaps someday the ovarian cancer vaccine or one of the biological therapies rather than chemotherapy would be indicated for early progression/recurrence.

    I am hoping someone will look into the benefit/risk of CT scans for routine follow up.

    Colleen: Technically speaking, because you are in the ovarian vaccine trial, these research results may not apply to you. Perhaps the vaccine trial that you are in will prevent recurrence for you. :)

    (((HUGS)))

    LQ
  • Havehope2
    Havehope2 Member Posts: 22
    #10
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    Also,,
    My onc told me that since my CA 125 was normal (6) after my 3rd chemo treatment I am not considered a high risk for recurrance. Unfortunately, I cannot qualify for vaccine trial, either. I am also going to MSKCC in NYC.
    My CA 125 back in 2009 was 11, before having ovca. Shoulddn't that be my Nadir instead of what I will have after finishing chemo? Just curious.
  • Hissy_Fitz
    Hissy_Fitz Member Posts: 1,834
    #11
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    Havehope2 said:

    Also,,
    My onc told me that since my CA 125 was normal (6) after my 3rd chemo treatment I am not considered a high risk for recurrance. Unfortunately, I cannot qualify for vaccine trial, either. I am also going to MSKCC in NYC.
    My CA 125 back in 2009 was 11, before having ovca. Shoulddn't that be my Nadir instead of what I will have after finishing chemo? Just curious.

    No, I think the 11 would be
    No, I think the 11 would be your benchmark. The nadir is always the lowest CA125 achieved, post-treatment.

    You are fortunate to have a benchmark. Most of us have no idea what our "normal" was, pre-Cancer.

    I am in the vaccine trial at MSKCC. I should remember to ask Dr S why they added that stipulation about the CA125, mid-treatment. I'm guessing that their desire was to rule out, as far as possible, women who would not have recurred, even without the vaccine.

    My CA125 did not drop to normal until after my 4th round of Carbo/Taxol. My nadir was 4.8, and that was 2 months post-treatment, while I was on Taxol maintenance.

    Carlene
  • Havehope2
    Havehope2 Member Posts: 22
    #12
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    Hissy_Fitz said:

    No, I think the 11 would be
    No, I think the 11 would be your benchmark. The nadir is always the lowest CA125 achieved, post-treatment.

    You are fortunate to have a benchmark. Most of us have no idea what our "normal" was, pre-Cancer.

    I am in the vaccine trial at MSKCC. I should remember to ask Dr S why they added that stipulation about the CA125, mid-treatment. I'm guessing that their desire was to rule out, as far as possible, women who would not have recurred, even without the vaccine.

    My CA125 did not drop to normal until after my 4th round of Carbo/Taxol. My nadir was 4.8, and that was 2 months post-treatment, while I was on Taxol maintenance.

    Carlene

    Explanation
    I asked my onc why I would not qualify and she said that they will not know for sure if the chemo or the vaccine "cured" the ovca.But I would like to know Dr S. opinion as well.
  • Unknown
    Unknown
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