Tumor marker question

[Tri78]

Has anyone has elevated CA 27 & CA 15 go up without progression.

Or does it always mean progression and a change needed in tx?

Thanks

[Hidden]

Hi Tri78 -

Tumor markers often increase with no progression.

For some people they're not very accurate. I think this is linked to how many mets, where the mets are, and just our individual bodies. You and your doc may have already determined whether or not they're accurate for you. Mine are accurate...

On my first treatment my markers mostly increased very gradually, sometimes stable for long periods with occasional spurts followed by a plateaus, for almost four years. They kind of mirrored the change in "heat" in the PET scan but as long as I had no new mets *on a scan*, no change was indicated. I would estimate that they doubled over the course of that treatment before I needed to change, based on scans/new mets.

Where are your mets? If they're in the bone, the Alkaline Phosphatase on your lab report is also a good indicator and is, I think, more concrete, i.e. it measures something "real" that indicates bone destruction, as opposed to the tumor markers, which measure our body's response to the cancer (*I think this is an accurate description*). If you have liver mets, I understand that there are enzymes/similar on the labs that can give a good indication.

If I were you, I wouldn't necessarily sweat this too much. There are many people who prefer not to scrutinize their labs specifically because it can be stressful. But I think if you keep them in perspective, they can be useful...

Please do let us know how you make out...

Best,

Lynn

[stardust1965 in reply to Hidden]

Hi Lynn, you have calmed my racing mind with this timely response. My markers are accurate but have just increased by about 75% from just above normal. Unfortunately my blood results were not back before my oncology telephone appointment so I phoned the Macmillian nurse to get them yesterday. All she said was they’d be worried if they had doubled! It is the first real increase in my tumour markers but I have been a little stressed recently. I will have to wait until my next monthly oncology appointment to discuss this so I was reassured by your post, it was just what I needed to read just now.🙏😊💕

[Snallygaster in reply to Hidden]

Thank you Lynn for your calming words. I too have rising tumor markers and that makes me worry even with my latest scan showing no progression. I remind myself every day about how good I feel and how active I am. It is good to hear from someone else not to focus on the markers but the bigger picture.

[Hidden in reply to Snallygaster]

Oh, gosh, Snallygaster, thank you, but I can't claim to not focus on the tumor markers!

I'm pretty obsessive about them, actually (!), but I know from experience and from what my docs have told me that a) they can jump around a bit (I worry more with a multi-month trend) and b) they can increase quite a bit before progression shows up on a scan.

But at the same time, they are accurate for me. In the spring, I had several consecutive months of pretty significant (for me...) increase, e.g. 10-20% each month, so I was not surprised when the scan in June showed a bit of progression. Part of why I like to focus on them is so that I'm no when and when not to worry/prepare myself.

I do understand why some people prefer not to focus on them, though....

Lynn

[Tri78 in reply to Hidden]

Thank you so much!!

Mets are liver (January) and the tm’s were high but dropped to normal range on the treatment with good response.

Do you think it has anything to do with the timing of the lab in the cycle?

They’ve crept up over the high range the past 3 monthly labs.

I have a 3mo PET scheduled soon.

My MO doesn’t talk about them but I study my labs (maybe too much!)

ALT/AST liver counts have stayed in the mid normal range with little if any fluctuations.

[Hidden in reply to Tri78]

So sorry for the late response; I've been distracted by other matters...(all good)..

But I've wondered the same thing over the course of my disease re: does the timing matter? Early on, I actually tracked the timing of my labs vs. TM's, i.e. to see if # days into Ibrance cycle correlated to the results. I did not see a clear relationship...

So I've loosely concluded "no", except...*except*...I have a new hypothesis re: exercise possibly affecting that day's/the next day's tumor markers? Here's why:

When I "beat back" (yes, there's bravado in this statement....it helps me mentally!) progression in June through exercise, the first couple of months my TM's were quite low (for me). After that, the TM's were higher, but the ALP (measure of bone destruction) was still low. So I sort of told myself that the cancer itself was reined in, but the TM's - measuring my body's response - were increasing. Here's the thing - the first couple of months I was very gung-ho and would exercise prior to going in for labs, i.e. that same morning. Part of this was because it was summer in Dallas so if I didn't get out early, it was unlikely to happen (oppressive heat). Since then, I actually have slacked off just prior to labs, kind of thinking "the die is cast". I actually pondered this during my workout today.

Why do I think this might matter? Because of the Swedish study I've referenced re: some chemical the muscles produce during intense exercise "harming" (not sure of the right term...killing? ) cancer cells 10-15%. In a test tube, I think. And the author speculated that, yeah, 10-15% might not matter too much, but day after day, it adds up. So is it like literally that chemical harms/kills cancer cells in that moment, but it's fleeting, so you have to like keep doing it? **BTW, this is why now I push myself for time with "burning muscles" vs. other measures when exercising.

So, my next labs are on Monday...I plan to workout prior and also the day before to see if the TM's respond? I'll try to remember to let you know (the muscles are doing great; the brain? not so much!!!).

Much too long an answer, but just a glimpse into how much I obsess about this stuff! *Just trying to understand and stay alive*

Best,

Lynn

[Pbsoup in reply to Hidden]

Just a nerd question—if the TM go down from exercise is that just a blip or is it really effecting long term healing? Especially if you exercise right before your labs—is that kinda cramming for an exam so you get the good grade. but you don’t retain the knowledge long term? Not judging your efforts—or study skills, just trying to find the analogy.

I am fairly active but have had a bit of progression recently. You are inspiring me to do even more.... 💪

[queeneee]

In the UK they no longer use tumour markers for progression as they were found to be unreliable.

[hdhonda]

Hi Tri,Tumor markers are not always reliable. If you have the sniffles, stressed, etc. can cause them to rise. Also, you can get a bad lab read. Best wishes. Blessings, Hannah

[Tri78]

Sure enough I had some progression

[Tri78]

I had 3 monthly labs - each a little higher. I show progression on the scan so since it’s been in the liver the TM’s have been accurate.