Please explain how TUMOR MARKERS work

The doctor I used before did not discuss tumor markers. He always said it was not reliable. The new doctor I have does watch tumor markers. I don't really know how that works. Can you well informed ladies help me out? He told me my markers were elevated and gave the number 150 but I have no idea what the means. He explained that numbers are for individual use (can't compare to others) but rather a marker for how I am doing. How do you understand it?

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Tumor markers are used as a tool to determine the extent of cancer cells within a certain parameter. There are various markers used for various types of cancer. The CA27.29 is generally used for metatastic bone cancers. This marker should be in a range of 0-38. Anything higher is a concern for this marker. Each marker has its own range of what is considered to be acceptable. It is only one of the tools used to determine the extent of the cancer and is used to monitor the cancer along with other diagnostic tools ie MRI, CT, PET, blood work, etc. If you know which tumor marker your dr. is using, you can look up info on the web just google " CA .....".

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Well I have breast cancer with bone mets, so I am not sure what markers. He didn't explain that part yet. I'll ask next time. Thanks for the info!

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Hi Patpet7,
I have Stage IV breast cancer with bone mets and I had my first treatment 3 month review last month. My results were great (Thank God)...I have been on Femara and monthly zometa since diagnosis. My tumour markers are within the absolutely normal range and have been there since the beginning. My Onc says that this is not unusual and she puts little faith in their significance. Seems they are good indicators for some people and not for others. Just confirms how different we all are...there is no one hat to fit us all.
Good luck with your treatment!!! Happy Christmas.
Jo

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I have had similar experience, but in reverse order. The Oncologist I began with followed the tumor marker levels, as a guidleine to watch. I then switched to another Oncologist in research, who doesnt not follow them at all. He told me the same thing, they arnt reliable. That your level may be very low, but that itself can be misleading because we can still have alot going on.

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2xnow gave a good explanation of markers.... and they are not reliable for all of us. No onc would base a treatment decision on markers! When your marker is out of the 'normal' range - the actual number is not of importance.. it is the trend. That means if the number goes up or down. So.. if you go from 87 to 200 - that is the same as going from 87 to 100 - the trend in this case would be going up.. and that is not good for us. we want the trend to be going down. and as I said- for some, markers are totally unreliable. and.. ask your onc to explain how he/she uses markers and what they mean. We need to be our own best advocate- and that means that YOU understand what is happening in your body.. so ask! and if you don't understand.. ask again!

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My numbers have also always been relatively close to the "normal" range. My onc also says it's the trend, not the number. He does three markers each month, and the CEA is the only one that he has ever gotten very excited over.

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He has only done one marker so far, so there is nothing to compare it to at this point. we'll see what happens next time i go. thanks for the info ladies!

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Most of the oncologists I talked to say it's not reliable, only half of the people have their markers (their trend) follow their disease pattern. Mine have been spot on!

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My dr. at MD Anderson does watch the markers as do most of the drs. on staff, he places more importance on the trend. I guess everyone is different including the drs. Julieanne

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My oncologist "looks" at tumor markers but does not rely on them at all. We have talked about the fact that since I am in remission, not further growth at this time that if we could judge the growth with tumor markers then I could take time off until it changes. He says no way to determine that except with scans. Just another "problem" with handling our disease that others don't have. I would stick with the dr. that says they are not significant enough.

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My mom's onc has always watched her CA27-29 and they have been right on. When she was NED for a while she was in the normal range. They hovered in the 40 to 80 range depending how well her treatments were working. In the last 6 months they have skyrocketed from the 80's to over 1000 and she is currently very ill. She has lobular BC and it does not scan well so watching the trend of her tumor markers was helpful.

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I GOT A NOTICE THAT HE WANTS TO CHECK MY "CA15-3 AGAIN" SO THAT MUST BE THE ONE THEY DID FIRST. MEAN ANYTHING TO YOU? MY MARKER WAS 150 THEN. DO YOU HAVE TO WAIT FOR THE NEXT TEST TO SEE WHAT IT REALLY MEANS?

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My doctors do watch them, and I am made to understand that mine have also been spot on. This has caused me huge stress because they have been rising significantly. Sometimes, I wish I did not know.

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Well, I don't understand tumor markers, but many have written well above. I've been stable for over a year with tumor markers around 100. Then one month they skipped from 88 to 168. My doctor was concerned, but said let's seewhat happens next month. Then, indeed they were down to 88 again.
Obviously 88 is way above the 30 that is normal, but for an individual it can indicate a pretty stable state as long as it stays within 10 or 15 points each month. Or if the markers were over 1,000 that would not be a stable state but a deadly one.
Others know more about this than I; I'm just sharing my experience.

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i have stage IV breast cancer i was stage II in 08 it changed in 2010, lung mets, MY TUMOR MARKERS HAVE NEVER BEEN OUTSIDE NORMAL LIMITS so that ought to tell you how reliable they are, they arent alot of Drs will do them in case they show up but they are not reliable they dont work for me at all!

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I'll chime in more or less in the vein of others. I originally had my post-chemo 35 radiation treatments at MSKCC in 1999. My MD there told me they don't use the CA27-29 in follow up.

However, my med-onc in NJ does use it. For 11 years of follow-ups, mine was always below 38. Then in March 2010 it was 48. We reapeated the test and it was 56 a week later when I also had scans that showed mets to the bones and lymph nodes. My doc said we caught it very early. I started on Zometa and Faslodex and had scans in June which showed stabilty in the bone mets and smaller lymph nodes. So I continued. Then in Sept the scans showed more mets in the bones and growth in the nodes. All the while the CA-27-29 was increasing monthly, 58 to 64 to 72 to 84 to 102 to 122. In Sept I went off Faslodex and added Avistan and Abraxane. My CA27-29 continued to go up to 148 then 175 in OCt. The latest Dec 14 was the first reduction---down to 120. My Nov. scans showed signficant reduction of lymph node sizes and stability in the bone mets.

My med-onc seemed hapy to tell me about the lower CA27-29 number now. Earlier as the number was rising he told me that he treats patients not numbers. He said that when treatments start the CA-27-29 may go up as there are more (dead?) cancer cells the blood. (Not sure if I have the correct explanation of this). My laywoman's take on it is that he is happy to see the CA27-29 in sync with the scans and did not want to rely on them while I was on the hormonal treatment but needed the scans for the real proof.

He also said to me that I cannot compare my numbers with anyone else's--- ie that there is no relationship between my 100 and someone else's 1000. As others are saying it must be your trend that is significant.

Is the CEA test more reliable?

Be strong, hang in there!
carzur

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I posted what I thought was an explanation of tumor markers but when I discussed this with my LE therapist, she looked at me and said "if it is counting tumor cells in the blood then it is leukemia". Made sense to me so I found an explanation on the internet for Lab results of CA27.29. What is actually in the blood that relates to the count is an antigen. So I looked up antigen and found that it is any substance that causes the immune system to produce antibodies against it. An antigen can be a foreign substance from the environment (chemicals, bacteria, virus, pollen) and may also be formed in the body as with bacterial toxins or tissue cells. An antibody is a type of protein the body's immune system produces when it detects harmful substances, called antigens. This makes more sense. I also read that increased values (counts) can be caused by non cancerous events such as cysts of ovary, uterine fibroids, intestinal/colonic problems, medications, tb, chronic hepatitis and/or cirrhosis of the liver, sarcoidosis or systemic lupus erythematosus. None of the tests are 100% reliable and depending on the type of cancer diagosis the dr. selects which CA test(s) is used. Sometimes they use more than one but I also learned that you cannot compare tests from one facility to another because of the testing methods used by the pathologist at the facility. Does this make sense to you.

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I really don't think they know for sure the whats and whys of cancer, especially breast.
I was reading a few chapters of Susan Love's BC book & she was saying many scientists feel BC is hormone related.
First child under 30, 1st menstrual cycle, whether you breastfed or not, estrogen levels, HRTS, menopause. She also said low bone density people have a lower risk of breast Ca& higher density have a higher risk. Osteoporosis is from low estrogen. Then she names studies in which BC patients that were est. Pos. were given small amts of soy or estrogen to bring them back to an 'estimated' hormonal level& they did well.
She also talked about anti-angiogenisis. DCIS supposed by many docs is not considered a real cancer, but when it produces a protein that makes a blood vessel that comes to the tumor and makes it spread. Thes proteins keep getting called on by the tumors& more spreading. If not for the blood vessels and the method used to spread the cancer, the cancer couldn't survive. I then looked up anti-angiogenisis foods & sure enough, studies were done on those foods, fruits, etc & they either slowed down the angio process or eliminated it. No blood vessel to feed the tumor, no tumor. Sounded believable to me. It also showed if we eat these foods on a regular basis, we prevent cancer alot.
The 2nd article was from a Dr. William Li on Ted.com. They even had videos to watch what they were saying. It was very interesting, IT even said diabetics& heart patients lose the angio process , so they don't get enough blood supply and don't do well.
ANyone ever hear of anything like this? I have a link somewhere if interested.

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My first marker number was 150. The next time I went it was 300. He stated he was concerned and if they get to 450 we would do something different. Here's hoping the Femara starts working and doing some work on getting that marker number down. CA 15-3 test.

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