hello everyone- just curious to see if your CEA tumor markers get checked with your oncologists.
My dads tumor markers have been fluctuating between 2.7 to 2.1 to 2.9 2.8 and now this month it’s 3.5. Does this seem concerning? His BMP results look good (liver and kidney function, etc). Just awaiting the CA-15-3 marker to come back which was 19.8 last month. Any calming words would be greatly appreciated. Last scan in January 2023 was NED.
Hi Jennifer
No my oncologist doesn’t test for tumour markers as she feels that they aren’t accurate for breast cancer although they are in ovarian cancer in her experience.
I was curious though so I asked my GP to check CA15.3 and it was 19 and under 35 was considered normal. One number doesn’t mean anything as it’s the trend that’s more important. So you need to see at least three tests each one 30% higher than the last to be concerned about the individual numbers.
Individual numbers don’t tell us anything. And numbers can rise and fall for reasons other than cancer which is why they aren’t considered integral to our treatment unless there’s compelling evidence i.e. a scan to confirm that a rising tumour marker is related to progression. And for some people their results do indicate progression but for many others it doesn’t.
I wouldn’t worry about this small change. If it’s trending upwards at 30% or more over at least three months then you might have cause for action which would be a scan not a change of treatment.
All the best
Kerry
thank you so much.
three tumor markers (TMs) have been checked with both the initial and mBC dxs. it was the significant rise in the three TMs in July 2015 that led to the discovery of mBC. CEA was back in range in Oct 2015, CA 15.3 in Dec 2015, and CA 27.29 in Jan 2016. beginning in 2016, TM's are checked quarterly. NEAD since March 2016. i am grateful that the TMs all are "low." they do minimally fluctuate. i am not concerned with minimal fluctuation, nor is the onc.
thanks so much for your reply. I just messaged you
This doesn't seem bad at all. It is a little up. Mine bounce around between normal one month, a little high the next, back down to normal range. CA 15-3 went up into the 40's two months ago. I was concerned but the oncologist wasn't. This month down into 30's, normal range. When the oncologist is concerned because there is a consistent trend of going up (say to 50's), she orders a PET.
I believe that, for me, the CA 15-3 is most diagnostic, but I don't know that is a fact. It is the one that goes up the most. The others stay normal. I get three TMs every month. As someone else said, it is the trend: up, up, up? Time for a scan, but only if it consistently above normal, by more than 10 points or so, and increasing. You -- your father -- is fine.
thank you so much! I am waiting his CA-15-3 marker to still come back this was just his CEA. do you get your CEA tumor marker tested?
I get 3 tumor markers tested monthly: CEA, CA 15-3, and CA27-29. I don't remember the difference in what they measure, and I understand that 2 of them are redundant. I just randomly opened one test record. Turns out it was my first, starting treatment, and it was 80! I knew nothing then. I hadn't remembered it was ever that high. It went down over a few months, and has remained normal or just above for the next 4 years.
Here is what it said then: Cancer Antigen 27.29
The CA 27.29 assay is intended for use in monitoring: 1) disease
progression and/or response to therapy in patients with metastatic
disease, and 2) disease recurrence in patients treated previously
for stages II or III breast carcinoma who are clinically free of
the disease.
makes sense thanks so much. Do you know what your CEA consistently hovers at?
My CEA is checked monthly and is <1, which is normal for non smoker. <3 is normal for smokers. My understanding is it is elevated when other (not breast) cancers exist. My oncologist began ordering it in response to my concern that scans (CT, Bone and PET) elevate risk for other cancers. I've had mBC for 18 years, and lots of scans. My 15.3 and 27-29 are > 1300, trending up over the past3 years. I've been on a several different med regimens with progression in bone, skin and dermis, but nothing that is debilitating. I feel fortunate
According to my dad's lab, less than 3.8 is normal for non smokers 
Wow, 18 years! Can you talk a little bit about your lines of treatment/ type of Metastatic breast cancer you have?
I'll try to keep this short. 2005 age 54 L mastectomy ER+ Progesterone + HR-, 4.5 cm tumor, met to bilateral ribs and foci in liver by PET, chemo with Adriamycin and Cytoxin, NED by PET after 3 mos, CA 27-29 30, commenced Anastrozole. NED for 10 yrs. Enlarged lymph nodes in L clavicle area removed, + for BC, 2015. Commenced tamoxifen as I was resistant to letrozole. 3.5 years later endometrial CA attributed to tamoxifen, total hysterectomy 2019. I took med vacation for 15 months, ended up with tumor + for BC in skin in L clavicle area 2020. Met to bone and liver also, CA 27-29 130, commenced Ibrance and letrozole, continued with small increase in markers over 2 year period to 247, no big changes in scans. Switched to Kisqali and fluvestrant for 5 months during which time markers increased to 900s (both CA 27-29 and 15.3 since 2020 have trended the same). No Kisqali for 1 month, fluvestrant injection only, prior to Liver biopsy on 5/4/23 which reveals very weakly ER+ (1%), down from 68% in 2020, still HR-. Path ahead less clear. Commenced Xeloda at low 1000 mg dose bid qowk in May with no side effects, will increase to 1500 mg bid qowk next week. Feeling fairly optimistic that my BC has progressed slowly.Hope you have the best path forward possible Jennifer.
Thank you Flowerfriend for taking the time to let us all know your situation. I am amazed to know how our dx can changed with es/pr +/- and or the actual her2, also. I was on my markers were at 70 in 2019 then dx with MBC. 600 in Feb of this year with managable pain w/o pain meds. Vinorelbine then dropped my 15-3 to 250 about in April and then shot up to 800 in just a month, which is crazy. Doc says enhertu is next, if scan shows and the blood markers from last week confirm progression. You said yours are >1300 and you are still going strong and look GREAT! You my firend give me hope. I am 57 and I hope I have many more years too. Blessings
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