CA 15-3 Jumping Around

Nissanz1

My wife had BC 20 years ago and has been very lucky, no chemo, stage 1, lumpectomy w rads. 3 years later another in the same breast, mastectomy, no meds no rads.i think second was different pathology. First was er + second er net but pr +. It has been 21 years since the second one.

So the onc had her coming once every three months for a year, then once every six months for 2 years, and then once a year since then, for about 15 years. Physical exam, bloods. And of course an annual mamo.

Well almost 3 years ago, her ca 15-3 jumped out of the normal range to, i think 35. So retest in 3 and it was i think, 42 or something, then in three months down to 38. So he spread out the testing and now it has been every six months for the last 2 years. It has been jumping around between 38-45, each time. Except this most recent visit, it was down to 33.

But the onc wants her to keep coming every six months for the "forseeable future."  I pushed back a little and asked, isnt 33 just the high end of normal, and is there a time at which we go back to once a year? He said it COULD be normal, but for now he wants to stick with every 6 months because he "doesnt want any surprises."

These visits are torture for her, she is under the covers for a week leading up to the appointmens. I admit, i dont particularly enjoy them either, but thats not relevant.

I am full of questions about this, but i guess what i am really wondering, if anyone else has had a similiar experience is this

1. after 2 years and 10 months with no other symptoms AND no sudden jump or trend upward, doesn't that indicate that this is nothing? Especially after so long.

2. Is the doc being too conservative here? Does 6 months intervals make sense?

3. Can smoking be a cause of the elevation? Unbelievably, she smokes, not heavy but she smokes. Maybe the cumulative effect of the years of smoking has caused the markers to elevate to a "new normal"?

I've asked my wife if she wants to go for another opinion to see if this is really necessary, but she doesnt want to start with an other onc. She said, we should just spread out the visits on our own. But i told her if we stay in his care, we need to listen to him, not be our own doc.

Would appreciate any thoughts, i'm a nervous husband.

momof3boys

I can understand that the testing is nerve wracking for the both of you. But, I also feel that your wife has a good MO that is actively trying to keep her NED.

My aunt passed away in August, 2011. She had BC and was eighteen years past treatment. She had UMX, chemo, radiation and was in on the first trial of Tamoxifin. She was beautiful, healthy, active and fit for eighteen years. About ten years after treatment ended, she and my uncle retired and moved south. Her new Doctor, learning that she was more than ten years out without a recurrence never did any testing other than an annual mammogram. Well, eight years later, her BC returned with a vengeance. It was everywhere, bones, liver, stomach... She passed away about twelve months later. We now know (from taking her to Johns Hopkins) that there should have been periodic tests and scans done that were not. So, I can see where your wife's doctor is coming from when he says that he doesn't want any "surprises". One thought... Can your wife get a prescription for something for anxiety for that time? That may help.

Nissanz1

Momof3 - thanks for your response. I guess i understand the docs wanting to keep on top of it. I was always told that after 20 years the chances of recurrence are very small.

The reason i am wondering if once a year markers are enough, is the fact that after 3 years no trend has emerged, and the "new normal" level has not increased at all, and in fact in the last test, was almost back to the normal range.