CA27,29 to CEA

Initially, the tumor marker for my breast to bone cancer was CA27,29. Tamoxifen then anastrazole caused the CA27,29 to decrease from 250 to the 30's, where it plateaued. CEA started to rise, doubling every month for several months to a high of 1400 or so. My oncologist felt I was working on a second primary, but colo/endo didn't produce any concerns. Had lab this week and both the CA27,29 and CEA are on the rise...both up about 30 since last month. My oncologist said it was odd that the tumor marker went from CA27,29 to CEA when that happened and he's perplexed again that both are now on the rise. Has anyone here had that happen and what was the outcome?

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Colon/Endoscopy? Did you have scans too?

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Yes, I had colonoscopy and endoscopy in December of last year because my oncologist felt the CEA was indicating GI cancer. Nothing was worrisome on the endo/colo. I had a PETscan in August of last year which showed improvement in some areas, no new areas...basically unchanged overall. I haven't had any other film studies since August and my oncologist isn't going to order one at this juncture because he said the markers are, roughly, where they were in August.

Mostly it's the change in marker and the rise in both CA27,29 and CEA that I was hoping to pick someone's brain about as it perplexes my oncologist so I'm perplexed too!

Thanks!

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Wish Greg were here....just saying.
Again, I know I sound like a broken record but.....PET SCanS, BONE SCANS don't work for me. The only thing that really works for me is tumor markers (trends) and MRI's with and without contrast. I don't know why they don't do that. I get them every few months and they don't have radiation and they picked up a growth in my kidneys and tumor on the underside of my spine that wasn't picked up by other scans.

Can you ask for a chest/abdominal/pelvic MRI? It's worth a try and it's safer than the other scan as they work on magnetism, not radiation.
Good luck
(hugs)
Frenchy

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Thank you both. My oncologist hasn't been conservative with film studies and I believe would have ordered an MRI to help sort things out if he felt that would be beneficial. I did ask him about repeating the PETscan because that has reflected what the tumor markers were indicating, but he said the tumor markers were about where they were when I had the last scan so he wouldn't expect to see anything new.

I'm really interested in others who had the tumor marker change from one to another, particularly CA27,29 to CEA, and who later had both markers start to increase after a months long plateau. My oncologist made it sound as though that's pretty unusual so I don't know if others who have experienced this would be visiting inspire, but I'm hoping!

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PET/CT have never shown my mets. To compare my PET/CT to my MRI................My MRI shows severely, diffuse, widespread bone mets,.......whereas my PET/CT looks absolutely normal (Go figure?). My markers are pretty reliable, so far.

FYI............an Endoscopy & colonoscopy only show the tissue that is in the length of the scope (the entire intestine is not visualized). There are so many places in the abdominal cavity that MBC can hide.

Have you had your head scanned??

If those markers are not accurate, make sure with a MRI. Guessing and/or planning treatments on an assumption, is not the way to go.

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Yeah, warrior1...that's odd that PET doesn't reflect your disease as it's my understanding that's kind of the gold standard. Weird.

Except for the rising CEA, there hasn't been a hint that something might be wrong with my GI tract which I'm grateful for!

No, never had my head scanned as I've been asymptomatic of anything concerning in that regard.

I believe the markers, at least I have no reason not to at this point. I just wondered if anyone else had breast primary transition from CA27,29 to CEA as a marker. Also wondered if someone else had both CA27,29 and CEA rise after a plateau and what the finding was.

My oncologist has been in the business for quite some time and this marker thing, the transition from one to another and then both rising after a period of stability, are perplexing.

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My tumor marker is the CA 15-3. Has been very predicatable for me and only recently did 27-29 "catch up" to where it was (was always low before). We all know that tumor markers are unreliable but for some they work well, so if they have been predictable for you in the past, chances are good they still are. When my 15-3 continued to rise even with some heavy duty Gemzar, one theory that we considered was that treatment was actually working and, as the tumor dies, it becomes necrotic from the inside out. Therefore, it is possibly shedding more cells as it is dying, which explains the increase in markers with no change and/or decrease in PET scans (for me it was from August to November). Having said that, I did switch treatments in December and have been doing Xeloda and radiation with good results. Both tumor markers have come down 10 points since the week before we started. Anyway, I would run that by your onc. Some of this cancer stuff is as much experience and "art", as it is science.

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Hi Could some one please explain to me more abour the blood markers and how they determine the cancer in the body .

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i meant "about " typing error.

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This is my understanding after talking with several oncologists and doing my own research. Different tumor markers track different cancers. Some are more reliable than others (e.g., CA-125 for Ovarian cancer & the marker for prostate cancer). For breast cancer, they can vary widely from person to person as to whether they are effective measure or not. The three that I know of are CA 15-3, 27.29 & CEA. Essentially, they measure the amount of epithelial cells that a tumor throws off. All cells have epithelials, but tumors throw off more generally because they are growing faster than normal. I think most oncologists don't use them much with a primary diagnosis of BC, but once it has metastasized, there is better evidence that markers can be used as one measure of how treatment may or may not be working. As I said before, for me, the CA 15-3 has been very sensitive. It shows cancer for me at very low (or just slightly above normal, which is anything above 30). When I was first diagnosed in 2008, it was at 69. This was with known cancer present in my body. In July, when the metastasis was discovered, it was at 56. I knew when I saw that number that I had cancer again. For other women, it shoots up into the hundreds before cancer is detectable. This is one of the reasons it is not very reliable or a good predictor of primary BC. I hope that helps.

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Thank you, Crisc.

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