Dont know if I should panic or not

Pat634

My chemo doc considers tumor marker scores from 0 to 40 to be "normal". I get labs taken every 3 months and finished up treatment on Aug 3rd of this year. 6 months ago and again at 3 months ago my tumor markers were 37.5 and this last one went to 40.5

I had a bad reflux episode last monday morning that left me coughing up phlegm and I had my labs last Friday. Doc isnt worried about .5 over normal and wants to see if there is a "pattern" but of course I'm terrified.  Also they claim 1 liver enzyme test is slightly elevated but the other liver tests are normal.

Anyone more versed in this type of thing out there who can explain this to me?  Thanks!

mawhinney

Generally, a slight elevation in a test score is not a big concern.  I would ask how reliable the testing method is and what might cause a score elevation.  I do not know exactly what test you had but have heard that some blood marker test are unreliable.

TenderIsOurMight

Please don't panic, Pat.

It's a doubling of the tumor markers within a specific time period (usually 2 to 4 weeks) which is considered a pattern as I've been told. My oncologist has done tumor markers from my first visit on (I'm eight years out and still get them). They always frazzle me.

There is between test variability, and that seems to be what you're doctor is reassuring you on. For each test, and this one appears to be the CA 27-29, their exists a bell-shaped or Gaussian curve, broken into standard deviations of norms. So there will be high values on tests which extend out to the upper limit of normal, and low values. Since the test in your case was done 3 months apart, inter test variability is introduced which limits the chance of the exact same value being obtained again. In fact if you run a blood tumor test on the same blood three times on the machine in one day, there would be intra test variability suggesting slight difference.

These markers take strong guts unless your emotionally made of steel, which I'm certainly not. The wait is one thing, and then splitting hairs over the result in your mind is another. But the big point of the trend is not just up, but defined typically as a doubling over two draws. At least that's my understanding.

I'll have mine tomorrow so I fully understand your post. Hope this helps, Tender.

ps: liver enzymes notoriously go up and down. One slight elevation is not uncommon. I'm sure a repeat test will be done in time. I've had this happen too. It resolved.

mmm5

Pat
I ditto everything Tender said about tm's and have had myself in a tizzy many times about them.

I wanted to weigh in on the liver enzymes too. I work for a lab and know that there are several tests that look at liver function. If it was your ALT that was elevated I would not be concerned as it can up and down and meds totally impact this count. Normal is usually under 45 (depending on lab) and mine went to 75 once then came back down to 30 next time. I was on a bisphos, Femara etc.

Also natural supplements can elevate liver enzymes, basically any med that is processed in the liver including melatonin.