Monthly Blood Tests, CA 15-3 & CEA

Anonymous

Monthly Blood Tests, CA 15-3 & CEA

Faith_Hope

Hi, I am new to the MBC community, initial diagnosis in June 2015 with Stage IV breast cancer (ILC, ER/PR +, HER2-), left breast that spread to lymph nodes under armpit and bones in my back. I had 10 radiation treatments, am taking 1mg Anastrozole (Arimidex) daily and monthly infusion of Zometa.

Every month I take a blood test so my Oncologist can monitor CA 15-3 , CEA and misc other (WBC, etc.). The tests that appear most important in knowing if treatment is working are the CA 15-3 and CEA. Initially my CA 15-3 marker was improving starting at ~1600 in June, lowered to 660 in July, 333 in August, 220 in September, 236 in October, and 240 in November. CEA level continues to go down, August 121.7, September 65.9, October 48.0 and November 38.3.

The monthly blood test has me on the edge of my chair every month. I had hoped the CA 15-3 level would drop this month like it did in the initial 3 months.Has anyone had a similiar experience with CA 15-3 staying relatively the same/slightly elevate, did it drop later later?

Thanks in advance for reply!

sandilee

Hi Faith Hope!

Sorry you had to become a part of our community, but stick with us. I think you'll find it helpful.

It looks to me like your numbers are dropping very quickly! I think once they become lower, like in the two-digits, it's common that the drop is less dramatic. But look, in five months you have gone from 1600 to 240! That's great! And your CEA has dropped as well. It sounds to me like the drug you're on is working.

My CEA is a good marker for me, and mine dropped quickly with Faslodex, although not as quickly as yours. And yes, it can stay the same for a few months and then drop. But yours has continued to drop each month.

For some people the tumor markers don't really help them that much. The scans are really more reliable, in general. It looks like for now, anyway, your tumor markers are showing that your cancer is responding.

Faith_Hope

Hi sandilee,

I much appreciate your reply, very helpful!

New to this (five months), I look to monthly blood tests to let me know I'm okay. My oncologist does not want to do a scan due to recent (Jun/Jul) radiation treatments. Your response put me at ease.

Thank you much!!

Faith_Hope

Hi suersis,

Your response put a smile on my face/made my day!! New to MBC diagnosis, I am still dealing with emotions & fears. The monthly blood test is something I look forward to that tells me everything is okay. I hope to not be in a situation where I should have been doing something different... that's what got me here in the first place

Thanks much!

GG27

FH, I get monthly tumor markers & they fluctuate slightly from month to month. You're lucky that they seem to work for you as they do for me, but for many they don't show anything.

When I started treatment they fell quickly & then tapered off. I now have a scan every 3 months & now that I'm stable am hoping that it will be a bit less often. Sounds like your treatment is working well & hopefully when you have a scan that will confirm.

Good luck, GG

Faith_Hope

Hi GG,

Thank you much for reaching out. We have similiar dx and treatment, very helpful to hear of your blood test results. I am going to ask for a scan my next Oncology appt (January), I think it would give me better piece of mind.

I have another question for you... Are you taking brand or generic Arimidex? I am taking generic, wondering if brand better.

Thanks!

Cafelovr

Faith, welcome to the club (unfortuantatley,)

I have been living with MBC for 6 years, 5 of which have been NED. My TMs hover between the 25-35 mark. I doubt they will ever go lower than that...

Faith_Hope

Hi Cafelovr,

Thank you for your msg. It's encouraging to hear of stories like yours. My hope is I too will get to double digit TM (currently at 240) and will be NED. I am grateful my TM has dropped since DX. I was hoping this month It would have fallen further .

Thanks

GG27

HF, I take generic anastrozole (brand name, Arimidex) but the main ingredient by law has to be the same in both brand name & generic. It's the fillers that can be different & can be a problem. If you're not having any side effects, I wouldn't worry about which you're taking.

I honestly don't remember what my numbers are anymore & because I have to get them done at the hospital through my port, I can't look them up online. When I go to see my onc, she always just tells me that they are fine, same as they were last time, which is all I really want to hear anymore.

I'm sure that a scan will be suggested when you go in January. They don't want to scan too often because of the radiation but also to let the drug do what it's supposed to do & if they scan too often they can't see any changes, either good or bad.

Take care, GG

Faith_Hope

GG,

I take Anastrozole too. The only side effect is joint achiness/stiffness which I understand to be a normal possible side effect. I am okay with this so long as I know the treatment is working.

Hearing about your experience with blood work and scan is very helpful; it gives me peace of mind. I expect to sleep better tonight .

Thank you much, have a great weekend!!

Anonymous

FaithHope -- Just be aware that the tumor marker numbers are very relative. I have a good friend who had a recurrence at the same time I was diagnosed. Her tumor markers were much higher than mine (1600)but she actually had much less (2 tiny lesions no bigger than 1cm) active cancer than I did (7-10 lesions with largest 5.6 cm) with a much smaller number (140). What really matters are the trends of going down, up, or stable in comparison to your scans in seeing if your tumor markers are going to be reliable to use as a good screening tool. Also, remember that tumor marker tests measure both live & dead cells with no distinction between the two so sometimes you see little spikes when the meds are working. From what you've posted, it looks like your tumor markers will probably be a pretty reliable tool which will be helpful in the long run. Just don't put too much weight on the actual number itself unless it gets in the normal range.

Faith_Hope

Hi nbnotes,

Thank you much for sharing your experience with tumor markers, very helpful and comforting

Question related to your last sentence, what is the normal range?

Thanks again!!

Faith_Hope

suersis - thank you for your answer/clarification re normal range. I am feeling more at ease knowing that as long as TMs are going in the right direction, down or stable, treatment is working. I much appreciate your replies, very helpful.

ShetlandPony

Hi, Faith. ILC here, too. My experience has been different from what suersis describes, in that my TMs (CA 27-29) are indeed in the normal range even though I am stage iv/metastatic. My TMs did what Faith's did--started out high and went steadily downward with treatment. If you want to know what normal range is, it should say on your lab report. (Be aware that the range might not be the same for another lab.) And yes, TMs don't have to get to normal for you to be doing well; stable is good, too.

Faith, why do you say that you should have been doing something different and that's what got you here? Do I have to stop this car and give you a talking to?

Landaffqueen1

Landaffqueen1 

Hi Faith, 

My breast cancer was ductal and lobular estrogen positive with 2 positive nodes, chemo and radiation and tamoxifen and then arimidex...metastasis occurred about six years later to my liver.TM was 2900 with major sudden pain. Have been on xeloda (capacetapine ) since diagnosis in Feb 2013 .TM have gone down nicely and have been in the normal range (25) for several months ...probably almost a year.last month showed a rise to 29 ....from a low of 22 in the summer...I feel well, plenty of energy and so on...am dealing with the side effects ...doc says he will switch to another drug when the xeloda reaches about 40

It is unnerving to see that number every three weeks or so..

He predicts he can keep me alive for about five years from diagnosis...February 2013

Faith_Hope

Hi ShetlandPony, thank you for reaching out . My reference to what got me here in the first place is the oversight of changes in my left breast, dimples on lower side and drooping nipple. I learned after DX that my physicians and/or OB/GYN should have recognized this to possibly be BC... had this been DX'd sooner it may not have been an initial diagnosis MBC. I'd like to not have this happen again, something that should have been DX'd/treated sooner than later, thus the initial question about TMs.

Faith_Hope

Hi Landaffqueen1, thank you for sharing your story/experience. It's sounds like treatment is working well, and good to hear you are feeling good. If all is going well, how can your doc make such a prediction?

Anonymous

FaithHope -- Just a little correction to what SuerSis stated, even in stage IV your tumor markers when NED CAN get in the normal range. I am currently NED, but I have a PTscan Wednesday to see if that is continuing (knocking on wood as I type this), and yes, my tumor markers were still in the normal range as of three weeks ago and have been for the 2 1/2 years that I've been NED. I may be more of the exception than the norm, but it can happen. You would need to ask your doctor or look at your labs chart for what they consider the normal to be as it can vary slightly lab to lab, etc. Right now, you don't need to worry about normal so much as the right trend though of being stable and/or of moving down.

AnnE16

Faith,

So sorry you have had to join this club. This March marked my 10th year from my original diagnosis and this October was my 7th year living with Stage 4. I had a priest tell me I would be dead by Thanksgiving 2009. Looking forward to Thanksgiving this coming week and I am no longer Catholic! My doctor has me do the CA 27-29. Do any of you ladies know what is the difference between that and CA 15-3? He doesn't do my CEA. What is that for? He does CBC and CMP monthly. Faith, were you having back pain or any other symptoms or was it the dimpling in your breast that started to cause you concern?

ShetlandPony

Yes, Faith, your doctors should have known that those breast changes warranted investigation. I have some of those what-if thoughts too, and it is so hard because we can't go back in time. (For example, what if for the first diagnosis they hadn't caused me so many delays in treatment because of their scheduling issues?) I don't know what to do with that except say that stage iv might have happened anyway, and that all I can do is take it from here. It's hard. Well, the other thing I have done is move my care to a place where I have more confidence in the institution and in my oncologist.

And so far, so good. My TMs are reliable, and like you I find that very reassuring each month. During my initial stage iv treatment the TMs kept getting cut by half each month, though with smaller numbers the difference didn't appear as dramatic. Now they have small fluctuations each month, a few points up or down.

GG27, I am going to scan less often now. For the first time since the stage iv diagnosis, I am having my scan after four months instead of three. I figure three per year instead of four per year will be less radiation, less expense, less inconvenience. Of course if I have symptoms or rising TMs, we will scan sooner.

Landaffqueen1

Hi faith,

My Onco. Doc made it clear from the beginning that the usual pattern for Xeloda is that it would be effective for a period of time ...two to three years ...it will be three years in May and it is beginning not to work as evidenced by the lab tests...I'm my case he is doing the CA 15-3 and a at scan done last week.

However I have feeling well with plenty of energy and dealing ok with the side effects.

The plan is to switch to Ibrance and Fasoldex combination in several months when he predicts my TM will be about 75....it is 40 now ....up from a low of 22 in last August. 

That combination if it works for me. Should be effective for about a year or 18months...

I did not discuss further tx after that...I figure it will be curtains

More concerning to me these days is that fact that my husband has Alzheimer's

And my life is upside down...knowing he cannot care for me going forward and I will not be here for him....

RonnieKay

Ahhh...I just saw this & it interested me. Shetland cracked me up with her message to Faith :-)

I am one that has experienced normal TMs from about 1 month into mets dx tx..a liver FULL of tumors & a thought that I wasn't going to be around too long! With all 3 dx, my TMs told the story quite clearly, so my onc says they "show fidelity!"

I'm confused since my center is dropping 27/29 & going to 15/3...when I saw so many w/15/3, I asked my onc why I didn't get it (just had Cea & 27/29)..I understood my tumor didn't express 15/3. It'll be my question next week at my mtg.

jobur

Landaffqueen1, I am so sorry to hear about your situation. You got the double whammy. In some ways I think Alzheimer's is even crueler than cancer, so my heart goes out to you both. Take care of one another as long as you are able, but this is probably the best time to get a plan in place for when that is no longer possible. I hope you have children or friends nearby that can help when needed. And don't write yourself off too quickly, some women get lots of years from Faslodex and there are other treatments too. Wishing you and your husband many more good days together.

Hi Ronnie, When I asked my mo the opposite question, why do we do CA15-3 and not 27-29, she replied that they were different ways of measuring the same thing. I'll be interested to hear what you doc says. My CA15-3 has always been in the normal range and CEA only slightly elevated, even when first dx'd with diffuse bone mets to spine and pelvis.