Normal range for tumor markers?

[Greatday2]

Does anyone know the normal range for tumor markers - for breast cancer? Does everybody (including people without cancer) have some in their body or should it be 0 (zero)?

[HelenWi]

It doesn’t need to be zero. I think 0-38 is normal for CA 27-29.

[Greatday2 in reply to HelenWi]

Thanks!

[Lulis]

CA 15-3 says under 30 u/ml.

[Greatday2 in reply to Lulis]

Thank you

[friesianfan]

Agree with Helen, that “normal” ranges are expressed as < a particular value or, for example,as 0-25 or 0-31 which are two “normal” ranges I’ve seen for the CA (cancer antigen) 15-3 marker that our oncologist uses, along with some others. I believe some tumor markers can be present in people without specific cancers but that those markers can increase past those “normal” ranges when cancer is present and they increase or decrease in ways that are correlated with, or somewhat proportional to, the presence or progression of cancer. The tricky part is that other, non-cancerous things can also cause many of those markers to increase as well, which is one reason why most oncologists rely more heavily on different scans to make important decisions about changes in treatment. Tumor markers are usually much easier, quicker, and less expensive ways to estimate tumor burden, but they aren’t 100% reliable and can produce false positives at times.

Dave

[dyevooshka in reply to friesianfan]

Thanks for this answer Dave. Great question!

[Greatday2 in reply to friesianfan]

Thanks for your reply!

[Kerryd22]

CA15.3 will never be zero because breast cancer isn’t the only cause of markers. Breast cancer may not even elevate the marker. Normal is up to 35 according to the lab report. Mine is 19.

[Greatday2 in reply to Kerryd22]

Thank you! That's what I was curious about.

[love2golfwell]

My previous oncologist said that no one would have 0 for tumor markers, even if they did not have cancer. The normal range for CA27-29 in Illinois was 0 - 40. Here in Florida at their labs the normal is 0 - 38. Not sure why they are different.

[Mcangel11]

Below 30 is normal range and you can have a low number because other things can cause a slight elevation if yo don't have cancer. Hope your ok !Rox

[Hazelgreen]

Hi Great,

Since cancer meds are so hard on the body, I have wanted to take as small a dose as possible. Although all bodies may be unique, you may find my experience of interest.

When I took 40 mg of tamoxifen for a year, my CA (normal range in Canada is 0 -30) shrank from 73 to 49. My oncologist then refused to prescribe a double dose. During the following year on 20 mg of tamoxifen, my CA rose to 123. I then took no meds for two months, and my CA rose to 179.

My new oncologist prescribed ribociclib. When the dosage was gradually increased from 200 mg to 600 mg, my CA dropped to the normal range over the next year (2022). During 2023, I monitored my neutrophils as I wanted them to stay as high as possible (I'm78 years old). I found that I only needed to take 600 mg of ribociclib on week days to keep my CA in the normal range. This allows my neutrophils to remain at 1.6 or so which I assume gives my body a fighting chance against infections.

It is good to remember that ribociclib has a "half-life" of 32 hours, and lessening amounts stay in the body for up to 8 days. According to my husband's calculations (he was a physicist), this allows for an effective dose on a 5 days on/ 2 days off schedule. If there are any biochemists reading this, I would be happy to see their input. In any case, I keep track through regular blood work of what's happening with me.

Regards, Cindy

[Dragonfly2 in reply to Hazelgreen]

Hey Cindy, while on IBrance, I finally convinced my ONC that I would take my meds on a 5/2 schedule without a week off between rounds. That worked well for me…and my thinking was based on the half life of meds that build up in your body. My markers were all fine…until the meds ultimately stopped working . I’m curious if anyone is studying this dosage schedule for Piqray…as long as markers staying in line.

[Hazelgreen in reply to Dragonfly2]

Although I apparently have the PIK3CA mutation, I have stayed on ribociclib so have avoided the Piqray & fulvestrant combo. My current oncologist has not suggested I make any changes in my meds. Our healthcare system is currently much over-burdened. In any case, I would likely resist having to attend appointments to receive injections.

I asked for a change in oncologists when it seemed that the young fellow assigned to me wanted to change my meds simply to have me as a subject in an irrelevant (not related to specific mutations) study in which he was participating. That, of course, was unethical on his part!

I haven't found any studies other than the original Ibrance study which varied the dosage scheduling of breast cancer meds. You may have to act as your own control.

[HelenWi]

Interesting the most of the posts here seem to be managing doses based on markers and not on scans. My bone Mets have been stable on my scans for a year (on the max Piqray dose) … but markers are all over the place in the hundreds. We look at them as only one input and pretty much ignore them because scans are ok.

[hurricaneheather]

i have three tumor markers checked quarterly. each tumor marker (TM) has a different "in range." the range can be found on the report. "normal" does not mean zero. TMs are "substances in your body made by either cancer cells or healthy cells in response to cancer. Tumor markers may also refer to patterns or changes in your DNA."

[Greatday2 in reply to hurricaneheather]

Thanks for your reply. I was referring to the 15-3 tumor marker. Is yours ever zero? My was in the normal range but I was wondering if the goal is to get it to 0. Do people without cancer ever have zero? These are all questions I thought of after my appointment! And haven't been able to find these answers online.

[Kerryd22]

There’s some answers here 👉emedicine.medscape.com/arti...

’CA 15-3 levels are elevated infrequently in early stage breast cancer or completely absent from other breast cancers, making it difficult to detect early stage cancers or those tumours that do not express this antigen.’

As the test isn’t routine I think it’s safe to say zero isn’t the goal but the actual number of women who are zero isn’t known either. Apparently a lactating mother can produce the marker. I’ve only had one test and while I could easily get it done as often as I want, it’s also not indicative of anything in my case. But then again how do I know that if I don’t get tested regularly?

It’s a circular question but as it’s known to be unreliable on its own and even when used as part of a panel of similar tests it never reaches 100% reliability, I’m happy to continue to rely upon scans rather than a blood test.

Some people and some doctors do trust them and a friend who did believe they were reliable in her case expected to make treatment changes whenever they rose.

Those who do believe in it say it’s the pattern that’s important. Thirty percent increase over three tests minimum and you might have something to worry about but increases may also mean the medication is working because the test doesn’t differentiate between dead cells and live ones.