tumor marker fluctuation question (in normal range)

brandall

Everyone says that tumor markers can fluctuate up or down in the normal range, but it seems that the posts on here where I remember this happening, the ladies have found progression on subsequent scans.  Has anyone had tumor markers go up (but still in the normal range) and NOT had progression for a significant amount of time.  I need to hear those stories today if you have them!

Moderators

This Q & A could be helpful re. tumor markers....

http://www.breastcancer.org/symptoms/understand_bc/fears/ask_expert/2001_06/question_18

kayrnic

My tumor markers were up on my last round of blood work......went from 28 to 37.......but scan showed stable.

Gabpj

I have just come back from oncologist and he said don't get too hung up on tumour markers - they can be helpful and may show a trend but you need to bear in mind that you could have blood drawn 3 times on one day and the tumour markers would likely be different in each blood draw (sometimes even significantly so).

SonnyB

When I was first dx my markers were in the 60s.  After starting tamoxifen, xgeva and Lupron they slowly went down to the low 20s and stabalized.  Last February they were 29 and it made me nervous.  However the next scan was stable and subsequent markers have been back in the low 20s.  I hope this will be the case for you!

HLB

When I was NED for 8 years mine was usually in the upperr 20s with the lowest being 19 and highest being 29. When they went to 77 was when mets were found. I think it has to do with what is a normal range for you personally (if they work for you in the first place). I read a post awhile back where the persons tm was usually in the tenns and when she found mets it was when it went to 33. Still in the range but high for her.

brandall

Thank you ladies, I'm feeling a bit better today.  I got results yesterday and for the first time since I had them drawn, my markers were up 5 points.  Still well within normal (19), but after having them drop every other time, I got a bit scared  My next PET scan will be the beginning of June.

Warrior2014

I stumbled across this post....and am in the same boat. After having blood work done to check my WBC for new medicine, I looked at my TMs, which were all significant within normal range. I then went on to compare them to my last three blood tests, and two of the three TMs have gone up, but are still within normal range. I have called doctor and emailed...no response yet. Any updated responses to the original post from 2013 or to my post? Thanks. Blessings of health to each of you.

hope70

I am in the same boat with you,warrior24! Had my second after treatment follow up. My CEA markers are within normal but up since 3 mo ago. Dr told me she thinks I am fine and to reassure me she can repeat blood work in 1 month. I am very anxious even though it's a small change. From 1,3 to 1.

brandall

I'm the one who posted this originally. I posted this in May of 2013 freaked out because while still in the normal range, my tumor markers were rising. I can tell you that I did NOT have progression until February of 2014. So I think the answer is YES, you can have rising tumor markers still in the normal range and be fine. As I recall, my tumor markers did go down again a little bit and fluctuated quite a bit in the normal range.

My tumor markers are very reliable. When they started creeping above the normal range I had progression visible on scans very shortly afterwards.

Hope this helps!

ann273

I just saw this thread and am in a similar situation. After a recurrence in 2015, My tumor markers (CA-15-3) while in the normal range, went up from 20 to 25 between 2 tests. My doctor insists that it was because it was because of a flu that came on the day after my blood draw. It would be very reaassuring to hear stories of tumor marker fluctuations within normal limits.

Proparent

I'm very interested in this discussion. When I was diagnosed in July 2016 with a couple of bone mets to the rib and spine, I had a TM (CA 15-3) drawn in August. It was 174. One month later after starting Ibrance 125mg it went up to 202. A month after that and being switched to Ibrance 100mg because of low white and platelet counts, it went up to 327! Now I'm on Ibrance 75mg (again due to continuing problems with low counts) I'm very worried about the next time they draw the TM.

blainejennifer

Proparent,

Your baseline was 174, one month later, on Ibrance, it went to 202, and a month after that it rose to 327. I see on your bio that you are on Faslodex as well? Faslodex takes up to six months to quell the cancer, and the wait can be quite hair-raising.

If my TMs were behaving like yours (and they have), my MO would order scans to see if the blood work is confirming progression. Quite often, when beginning a new therapy, we can get "tumor flare", where the tumor is dying and casting off dead cells, but the TM test just checks for cells, not whether they are alive or dead. The scans can see if the tumor is active - that's the SUV count on your imaging report.

You have so many therapies available to you, as you are just starting this party. As a bone only, ER+ patient, your quiver is full, so fear not. If this protocol turns out to be a non-starter, you have many other options.

If you are experiencing a level of anxiety that is impairing your quality of life, you can speak to your MO about getting some anti-anxiety meds. Many of us here have benefited from these medications. They can be long acting, like the SSRIs, or short acting, like a quick hit of Ativan to withstand a medical procedure. You will not be the first patient your MO has seen with anxiety - trust me.

The received wisdom on TMs is to 1) Make sure that they are diagnostic for you. That's just watching them over time and seeing if they correlate with your disease volume. Some patients' TMs don't budge, even though they have a high disease volume, and some patients' TMs get crazy high with little progression (I'm one of those). 2) Having determined that your TMs are "diagnostic", no MO is going to get worried at one bad result. They follow trends. Usually, two highly increased TMs in a row indicates that some action should be taken (no one worries about minor variations). Most of the time, it is to scan first, then to alter or change the protocol you are on, wait three months - while following TMs - and scan again. Until you are stable, you will probably be scanned every three months. My TMs have been as high as 3,000. Now they are in the low 20s, thanks to Halaven and CMF.

You also have the right to ask your MO what she thinks. You could call her right now! I've never been a fan of waiting in fear, and have made myself a bit troublesome every now and then to the patient and loving staff at my MO's office.

Let us know how you are doing. Managing cancer is no fun, and I'd have lost my mind if it weren't for the amazing ladies here.

Jennfier

Proparent

Well I had another blood test done the day before Thanksgiving and the TM was up to 602! So they scheduled a bone scan and a CT scan Dec. 6th. Turns out I have extensive bone met progression now on the skull (3 areas) all up and down my spine, several different ribs, my upper arm bone, femur just above the knee, pelvic bones and hip socket! So they stopped the Ibrance/Faslodex combo and I am now on Xeloda. I'll have a blood draw in the next couple of weeks to check everything and a scan when done with my 2nd cycle of Xeloda.

blainejennifer

Proparent,

Xeloda did great things for me. It's a pretty easy therapy, just make sure to keep your hands and feet moisturized to prevent the skin peeling that Xeloda can cause, especially in winter.

Sorry about the progression, but in Stage 4 land, we play whack-a-mole with the cancer. If you are in pain, is your MO good with making sure you have adequate medication?

Jennifer

Proparent

Hi Jennifer, yes my MO is good about providing pain relief. I don't have too many areas of pain, just a couple spots in the ribs that hurt like heck. but the meds they prescribed me seem to do the trick. I hope the Xeloda goes easy on me! I only just started my first cycle on Dec. 26th. Time will tell I guess.

blainejennifer

PP,

Hoping that the Xeloda does well for you. I loved the stuff. In fact, I am kind of revisiting it, as I am on the CMF protocol, which was the infused version of Xeloda, and am getting a good response.