Tumor markers

GrandmaJ
GrandmaJ Member Posts: 209

 

Has anyone ever had an increase in tumor markers, (CEA-15) and what did your physician do ?  Mine are not abnormal, just increased since last 6 month check up.

 

thanks.

 

Judy

Comments

  • TraciInLA
    TraciInLA Member Posts: 1,994 Member
    Judy,

    My oncologist tests me for the CA 27-29 tumor marker every 3 months.  At one point last year, mine increased from one visit to the next, and the oncology physician's assistant who was seeing me started telling me this was very serious, we would have to send me for additional scans, and just generally scaring me to death.

    My oncologist walked into the room, and completely disagreed.  He said firmly that, as long as my tumor markers were still within the normal range, he wasn't concerned about some up and down fluctuations.  He said it's perfectly normal for them to go up and down, that there are many things that can cause fluctuations, and not to worry.  

    I recently asked my oncologist about my very first tumor marker test -- which he did before my surgery, when we knew I had cancer, small tumors in both breasts.  Apparently, my tumor markers at that time were NORMAL!  So I have to say -- I am not a medical professional in any way -- but I really take tumor marker tests with a grain of salt.

    Don't know if that helps?

    Traci

  • CypressCynthia
    CypressCynthia Member Posts: 4,014 Member
    I think a trend in markers

    I think a trend in markers can be helpful (they have been helpful for me at times).  But many oncs don't do them.  Currently, I have one who does them and one who doesn't. 

    Here is a synopsis of my experience.  When I was first diagnosed back in 1987, my markers were normal.  I had 3-4 rib fractures in 2005 and markers were still normal (markers not helpful).  Bone mets was confirmed with a rib biopsy (my scans had been inconclusive until 2009 when bone scan radiologist finally called it as bone mets).  In 2009 I also found out both my CEA and CA 27.29 were elevated for the first time.

    Since 2009, my CEA and CA 27.29 have mostly trended downward, but were not normal.  I had a big spike in the markers in early 2013, when my liver enzymes came back abnormal.  A PET, CT and biopsy confirmed liver mets. I had another biopsy and my treatment was changed (for the first time biopsy was her2neu positive).  Now, for the first time since 2009, my markers are currently normal.

    So, to recap for me, markers have not been very reliable in diagnosing, but I think they have been helpful in monitoring response to treatment.  My big caveat is that they have to be done regularly so a trend might (if you are lucky) be discerned.

    For you, I would not freak, just keep an eye on them.  One increase means little and they can go up because of smoking, inflammation, etc.  If they stay high, it would probably warrant another PET.

    Very confusing...lol.  Hope this helps!

  • disneyfan2008
    disneyfan2008 Member Posts: 6,583 Member
    I have had two lumpectomies ,

    I have had two lumpectomies , raditaion etc and out almost 6 yrs of treatment..but I have no idea what tumor markers are-no one ever told me , mentioned those words..but I hear most mention them.

     

    Denise

  • CypressCynthia
    CypressCynthia Member Posts: 4,014 Member
    Here is what ASCO says about

    Here is what ASCO says about tumor markers:

    "For monitoring patients with metastatic disease during active therapy, CA 27.29 or CA 15-3 can be used in conjunction with diagnostic imaging, history, and physical examination. Present data are insufficient to recommend use of CA 15-3 or CA 27.29 alone for monitoring response to treatment. However, in the absence of readily measurable disease, an increasing CA 15-3 or CA 27.29 may be used to indicate treatment failure. Caution should be used when interpreting a rising CA 27.29 or CA 15-3 level during the first 4 to 6 weeks of a new therapy, given that spurious early rises may occur. There is no change from the guideline published in 2000."  http://www.asco.org/quality-guidelines/american-society-clinical-oncology-2007-update-recommendations-use-tumor-markers

    Here is more explanation about what tumor markers are:

    "What are tumor markers?

    Tumor markers are substances that can be found in the body when cancer is present. Ideally, a tumor marker would always be found in the blood in higher-than-normal amounts, but only when a certain type of cancer is present. In reality, tumor markers are rarely like that.

    Some tumor markers are found in blood, but others are found in urine or other body fluids. Still others are found in tumors and other tissues. They may be made by the cancer cells themselves, or by the body in response to cancer or other conditions. Most tumor markers are proteins, but some newer markers are genes or other substances.

    There are many different tumor markers. Some are linked only to one type of cancer, while others can be found in many cancers.

    To test for a tumor marker, the doctor most often sends a sample of the patient’s blood or urine to a lab. Sometimes a piece of the tumor itself is tested for tumor markers.

    Tumor markers alone are rarely enough to show that cancer is present; they have many limitations (see the section, “The drawbacks of tumor markers”). Because of this, most doctors use only a few tumor markers. When a doctor looks at the level of a tumor marker, he or she will consider it along with the patient’s medical history, physical exam, and other lab tests or imaging tests.

    Recently, doctors have begun to develop newer types of tumor markers. With advances in technology, levels of certain genetic materials (DNA or RNA) can now be measured. It’s been hard to identify single substances that provide useful information, but doctors are now beginning to look at patterns of genes or proteins in the blood. These new fields of genomics and proteomics are discussed in the section called “What’s new in tumor marker research?” "  http://www.cancer.org/treatment/understandingyourdiagnosis/examsandtestdescriptions/tumormarkers/tumor-markers-what-are-t-m

    All of this is clear as mud, right?  Lol.  Like I said, they have sometimes been helpful to me, sometimes not and your onc may or may not test for them.  They can be a tool in a large toolbox, but they are not to be used alone and can result in confusion. Wink

  • GrandmaJ
    GrandmaJ Member Posts: 209

    I think a trend in markers

    I think a trend in markers can be helpful (they have been helpful for me at times).  But many oncs don't do them.  Currently, I have one who does them and one who doesn't. 

    Here is a synopsis of my experience.  When I was first diagnosed back in 1987, my markers were normal.  I had 3-4 rib fractures in 2005 and markers were still normal (markers not helpful).  Bone mets was confirmed with a rib biopsy (my scans had been inconclusive until 2009 when bone scan radiologist finally called it as bone mets).  In 2009 I also found out both my CEA and CA 27.29 were elevated for the first time.

    Since 2009, my CEA and CA 27.29 have mostly trended downward, but were not normal.  I had a big spike in the markers in early 2013, when my liver enzymes came back abnormal.  A PET, CT and biopsy confirmed liver mets. I had another biopsy and my treatment was changed (for the first time biopsy was her2neu positive).  Now, for the first time since 2009, my markers are currently normal.

    So, to recap for me, markers have not been very reliable in diagnosing, but I think they have been helpful in monitoring response to treatment.  My big caveat is that they have to be done regularly so a trend might (if you are lucky) be discerned.

    For you, I would not freak, just keep an eye on them.  One increase means little and they can go up because of smoking, inflammation, etc.  If they stay high, it would probably warrant another PET.

    Very confusing...lol.  Hope this helps!

    Tumor markers

    Well my oncologist wants a CT Scan with contrast (won't do it cause I'm allergic to Iodine), and a bone scan on Mon.   My liver enzymes were off too, but that happened before and then went back to normal.  Since I have bad arthritis in both knees and was on Advil, Aleve and percocet at different times, they believed that was the cause.  But now I am fearing liver mets.  Are you in treatment for this ?

    My first oncologist left me for a job in Texas and I was assigned my current oncologist.  Having just lost my mother 3 weeks ago, I pretty much got hysterical when he started talking about bone scans and CT scans.   He was very unsympathetic, left me in the room crying.  I came home and called the office and told them I wanted a different oncologist, one I wanted before but she wasn't taking new patients at the time. 

    In July it would have been 5 years cancer free, but I guess I don't know that yet.  Really, really scared. 

     

    Judy

     

  • GrandmaJ
    GrandmaJ Member Posts: 209
    TraciInLA said:

    Judy,

    My oncologist tests me for the CA 27-29 tumor marker every 3 months.  At one point last year, mine increased from one visit to the next, and the oncology physician's assistant who was seeing me started telling me this was very serious, we would have to send me for additional scans, and just generally scaring me to death.

    My oncologist walked into the room, and completely disagreed.  He said firmly that, as long as my tumor markers were still within the normal range, he wasn't concerned about some up and down fluctuations.  He said it's perfectly normal for them to go up and down, that there are many things that can cause fluctuations, and not to worry.  

    I recently asked my oncologist about my very first tumor marker test -- which he did before my surgery, when we knew I had cancer, small tumors in both breasts.  Apparently, my tumor markers at that time were NORMAL!  So I have to say -- I am not a medical professional in any way -- but I really take tumor marker tests with a grain of salt.

    Don't know if that helps?

    Traci

    Tumor markers

    Thanks for answering. It does help... my oncologist scared me to death with the way he was talking and ordering tests left and right.    Last month I lost my 89 year old mother from a heart attack and my 68 year old brother in law to pancreatic cancer.  Needless to say, I was not ready for bad news and I sort of lost it.  He walked out of the room and left me there crying without any sympathy or concern for me.    He is no longer my oncologist.  

  • camul
    camul Member Posts: 2,537

    Here is what ASCO says about

    Here is what ASCO says about tumor markers:

    "For monitoring patients with metastatic disease during active therapy, CA 27.29 or CA 15-3 can be used in conjunction with diagnostic imaging, history, and physical examination. Present data are insufficient to recommend use of CA 15-3 or CA 27.29 alone for monitoring response to treatment. However, in the absence of readily measurable disease, an increasing CA 15-3 or CA 27.29 may be used to indicate treatment failure. Caution should be used when interpreting a rising CA 27.29 or CA 15-3 level during the first 4 to 6 weeks of a new therapy, given that spurious early rises may occur. There is no change from the guideline published in 2000."  http://www.asco.org/quality-guidelines/american-society-clinical-oncology-2007-update-recommendations-use-tumor-markers

    Here is more explanation about what tumor markers are:

    "What are tumor markers?

    Tumor markers are substances that can be found in the body when cancer is present. Ideally, a tumor marker would always be found in the blood in higher-than-normal amounts, but only when a certain type of cancer is present. In reality, tumor markers are rarely like that.

    Some tumor markers are found in blood, but others are found in urine or other body fluids. Still others are found in tumors and other tissues. They may be made by the cancer cells themselves, or by the body in response to cancer or other conditions. Most tumor markers are proteins, but some newer markers are genes or other substances.

    There are many different tumor markers. Some are linked only to one type of cancer, while others can be found in many cancers.

    To test for a tumor marker, the doctor most often sends a sample of the patient’s blood or urine to a lab. Sometimes a piece of the tumor itself is tested for tumor markers.

    Tumor markers alone are rarely enough to show that cancer is present; they have many limitations (see the section, “The drawbacks of tumor markers”). Because of this, most doctors use only a few tumor markers. When a doctor looks at the level of a tumor marker, he or she will consider it along with the patient’s medical history, physical exam, and other lab tests or imaging tests.

    Recently, doctors have begun to develop newer types of tumor markers. With advances in technology, levels of certain genetic materials (DNA or RNA) can now be measured. It’s been hard to identify single substances that provide useful information, but doctors are now beginning to look at patterns of genes or proteins in the blood. These new fields of genomics and proteomics are discussed in the section called “What’s new in tumor marker research?” "  http://www.cancer.org/treatment/understandingyourdiagnosis/examsandtestdescriptions/tumormarkers/tumor-markers-what-are-t-m

    All of this is clear as mud, right?  Lol.  Like I said, they have sometimes been helpful to me, sometimes not and your onc may or may not test for them.  They can be a tool in a large toolbox, but they are not to be used alone and can result in confusion. Wink

    My orig onco did not believe in tumor markers to determine

    Whether I had cancer, but he did do the CA125 along with treatment to see if there was a drop or rise. Said that along with scans and how I was feelinv gave him a better picture. When I asked why he didnt do regular markers, he did not feel they gave an accuate reading, and said most who use them do so to see if a treatment is working. The onco I see now who had me on Femara also used markers, for 2 months on Femara there was a slight decrease in the levels. After being off Femara for 5 weeks, the tumor marker showed a decrease of 300 which put me at 129. On Monday , he is doing bone scans head to toe along with ct scans, one from thigh to abdomen, and the other from nose to abdomen to see if there is a reduction in the tumors. U am on Aromasin now, but once the muscle pain from Femara decreased, my bone pain in the lower spine and thighs has increased, as well as my ribs, so he is not at all certain that the markers are givung a true picture, hence, all the scans. He said the same thing my orig Dr. said, that he uses them as a guude along with treatment, but dies not take fluxuations as concrete. But he didnt even mention the first 2 because they were not significant enough to make him belueve trratment was working. And the big drop does not go along with the increase pain.... I wouldnt gbe too worried if the onco isnt, especially if you are within normal ranges. I have not been in normal range since mets were duagnosed, so I dont get too excited. When I was first diagnosed in 2002, my tumor markers were normal. The first time the CA125 was elevated was with mets in 2010. Best of luck to you, and CCthanks for the information, I didnt even know what tumor markers were until I came to this board.

  • camul
    camul Member Posts: 2,537
    GrandmaJ said:

    Tumor markers

    Well my oncologist wants a CT Scan with contrast (won't do it cause I'm allergic to Iodine), and a bone scan on Mon.   My liver enzymes were off too, but that happened before and then went back to normal.  Since I have bad arthritis in both knees and was on Advil, Aleve and percocet at different times, they believed that was the cause.  But now I am fearing liver mets.  Are you in treatment for this ?

    My first oncologist left me for a job in Texas and I was assigned my current oncologist.  Having just lost my mother 3 weeks ago, I pretty much got hysterical when he started talking about bone scans and CT scans.   He was very unsympathetic, left me in the room crying.  I came home and called the office and told them I wanted a different oncologist, one I wanted before but she wasn't taking new patients at the time. 

    In July it would have been 5 years cancer free, but I guess I don't know that yet.  Really, really scared. 

     

    Judy

     

    Judy,
    YOu are so righ, the thought of cancer coming back is scary. This disease is scary. Each time we have to go thru scans, we know that the results may change our lives forever.
    I dont think my sons are too hopeful with this set of scans! One is off for spring break(high school teacher, and the other took the day off to be there. My ex today mentioned that I seem like everything is getting harder and the pain increasing.... I think they all are thinking this is it!
    I really am glad they will be there. I love this board and feel so fortunate, yet sad, that everyone has been here and really does get it (usually). It gets hard to always feel that I have to console family/friends when news is not good.
    I love knowing everyone is here for each other and they get me.
    Please let us know how your scans go. I'll be thinking of you going thru the same Monday! Wish you the best!

    Hugs,
    Carol