Tumor markers rising when it has to be the other way around

danzk

Hello all, I need your advice and your opinions. My mother's CA 15-3 is gradually rising and I can not understand why since it has to be the other way around. Short story: April 2017 she had her ovaries removed, the surgeon saw mets on her intestines and colon. Biopsy came positive for cancer mets on the ovaries. Back then her CA 15-3 was around 100 points. She did CT scan which was clear, but doctors agreed that CT scan can not show intestines, colon and stomach, but it was good news to us, because there were no other mets. Then she started alternatives and FEC chemo. During FEC chemo + alternatives her CA 15-3 was around 120 points. Then the doctor decided to switch to Docetaxel. After first Docetaxel infusion it went up to 150 points. Since then I stopped tracking her marker. Then on her last day of Docetaxel infusion her CA 15-3 was 200 points. One month and a half after chemo was over it is 275 points, so almost 300! She did a PET scan recently which showed: A FEW SMALL LESIONS on her peritoneum of which the largest one is 7 mm and maximum SUV is 2.1. Her oncologists are not even certain that these lesions are cancerous. They said that it might be damage from her surgery or some kind of infection since SUV is very low. But even if these are cancer mets they are now less, because the surgeon who took out her ovaries in April 2017 said that he saw MANY SPOTS MUCH LARGER THAN 7 MM and the PET scan showed only a few, single lesions. So to me it looks like a shrinkage and I can not understand why her CA 15-3 is rising. Any ideas? In my opinion after she started Docetaxel her CA 15-3 went crazy, but I do not understand why almost two months since she stopped it her CA 15-3 is still going high.

txd

Hi danzk,

my mother has mets to bone. For most of the time, her tumor markers were not tracking with the PET-CT scans either. The SUV of her bone tumor went down a lot (from 9.2 to baseline) while her tumor markers 15-3 is higher than when she discovered the bone tumor and 27.29 is double the value when she discovered the tumor. I don't get it and feel the frustration too. I'm not sure if this is helpful but I just want you to know I feel frustrated by this as well. solidarity.

danzk

Thank you very much. It's very helpful! And also encouraging.

Just to be sure that I understood you correctly, but your mother''s PET/CT scan was showing shrinkage or was stable, but her CA 15-3 was rising at the same time?

HLB

Danzk, my marker was always very accurate and indicated if something was going on, however when I started Ibrance/Faslodex it just went up every month, but scans showed improvement. I was on it for 16 months and at the end it was 5000! I used to get concerned when it went to 100! Even when I did have progression and had to switch, it only showed the same Mets with more activity, no new Mets. Now I'm on xeloda and the marker is going down by the thousands. I asked the onc what he thinks of the high number, could something be going on that's not showing up? He said he doesn't think so, and with bone disease it's harder because you have healing areas that are hard to differentiate from active areas. I feel fine so I decided not to worry.

zarovka

danzk - it's important to plot cancer markers over time in a graph, noting the treatment and the scan results. only with that type of analysis and considerable time can you figure out, with time what the tumor markers might mean for your mother. and even then TMs are hard to interpret because cancer changes ... a cancer that released a certain TM at one point can be entirely replaced by a cancer that does not release that TM.

also, cancer markers do rise with cancer growth but sometimes they rise with cancer death. the later is known as a flare reaction and is typical with certain drugs when they start working. in general the scans are ground truth and you interpret what the TM's mean based on the scans. if and only if you see patterns with time do you start extrapolating what the scans will be based on the TMs. many ladies here have been at this a long time and really have a good idea of what the TM's predict. i am still figuring it out but so far it seems CA 15-3 and CA 27-29 are useless. CEA seams like it might be meaningful, based on correlation with scans so far.

but scans are tricky. i recently had a PET scan done with a CT so poor it hid massive progression even though the PET scan was clear. in addition, scans don't pick up ILC type cancers well. how much you can believe a scan depends on the type of cancer how definitive the cancer is. if you want to roll up your sleeves and understand the diagnostic tools driving your mom's treatment, start by sitting down with a nice radiation oncologist and reviewing each scan. you need to understand what they report and what they don't and what the terminology they use in the report really means for you and your cancer.

our cancer diagnostic tools are really weak and i believe that we need to improve these tools before we can improve cancer care.

>Z<