CA.27.29 reliable for you? + question about liver mets

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livingwithit
livingwithit Member Posts: 39
edited June 2017 in Stage IV/Metastatic Breast Cancer ONLY

Hey guys! First off thank you all for always being here . ..it's so comforting to read stories and know that I'm definitely not alone. Someone has always "been there, done that" when I have a question or feel scared.

Today my question is about CA 27.29 levels. When I was first diagnosed with bone mets in August 2015 my tumor marker came back as normal at 28. MO said that since the tumor marker "didn't work" we would not be using them, instead relying on more frequent scans.

My original MO retired and somehow CA 27.29 has been added back to my monthly blood work. I've had a total of 4 tumor markers drawn: Aug 2015 was 28; Oct 2016 was 31; May 2017 48 and today June 1, 2017 53.

Blood work today also showed elevated liver enzymes for the first time. I had my gall bladder removed nearly 20 years ago so it wouldn't be related to that.

Because CA 27.29 and liver enzymes are elevated the Nurse Practitioner I saw today ordered a CT (last one was less than 3 months ago).

I am trying to understand if my CA 27.29 numbers have any meaning. I've read posts by other women who had levels in the several hundred range. At 53 mine is higher than normal but doesn't sound so bad. But at 53 that's 90% higher than it was in August 2015. And then I think, well the number was normal at 28 when I had bone mets found in 3 different locations.

I have been on Ibrance/Femara for 21 months. Bone mets have shown decreased uptake with each bone scan.

All CT's have indicated I have fatty liver but blood work has never shown elevated liver enzymes until today. I am overweight but actually lost over 100 pounds in the past 15 months . .. isn't weight loss the first step in treating fatty liver? I drink alcohol occasionally, maybe 3 or 4 times a year. In fact the last I had any alcohol was the 4th of July last year!

Has anyone had this issue with tumor marker not working? How has your MO dealt with that? Does your MO still order the test, maybe to monitor changes? Or any other reason?

If you have had a sudden spike in liver enzymes what was the cause? If you have been diagnosed with liver mets how were they found? During routine scan or was your blood work off leading to a scan?

Thanks so much!

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  • HelenFaith
    HelenFaith Member Posts: 53
    edited June 2017

    Hi Livingwithit!

    My experience is new, so I really have nothing to offer. Is CA 27-29 the only one being tested? My doc tests both CA 27-29 and CA 15-3 and both were very evaluated and both have gone down.

    I hope you get answers very soon.

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  • dlb823
    dlb823 Member Posts: 9,430
    edited June 2017

    Living, while your TMs are trending upward, they are still relatively low. My TMs have proven to be very accurate, but still my UCLA onc has always said she isn't concerned about an increase unless they double in one month's time. After I had been on Faslodex + Ibrance for 1.5 years, my TMs did start to rise kind of dramatically (took about 6 mos. to double, but were also 10x higher than yours are now and making 100 pt. jumps), at which point my bone scan was still stable, but chest CT revealed something new possibly going on in my liver-- too small to distinguish or biopsy, but not there previously -- so we did change my regimen to Xeloda. And my liver numbers were also on the rise, but came down very quickly after 1 month on Xeloda, as did my TMs.

    If I was in your situation, I might try to wait until it's been at least 3 mos. to get scanned, just because if something new is brewing, it may be too soon to be picked up. I might also want to speak to your new onc and not rely on the judgment call of a PA. She might be entirely right, but I would still want to know what an onc thinks, and if you can reasonably wait a bit longer to get scanned.

    Other things that can make the CA27-29 go up are inflammation and some meds, so a rise doesn't necessarily mean something is going on. But based on my experience, I think your situation merits watching and scans within a reasonable time -- hopefully just to rule out any progression. Deanna



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  • livingwithit
    livingwithit Member Posts: 39
    edited June 2017

    Helen & Deanna,

    Thanks for your replies. My only monthly blood tests have been CBC and CMP. Both have always been good. Even having been diagnosed 4 years ago originally and going on 2 years for mets I guess I still feel new to this too.

    Because I had no positive lymph nodes at diagnosis and low(er) risk for recurrence according to OncoDx I opted for no chemo so I've never been really, really sick. Idk if that makes sense . . .I mean, I know logically I have a chronic illness. I've spent plenty of time recovering from surgeries and radiation burns, I don't feel good, I have so much pain and fatigue and have already lost 2 cousins in their 40's to breast cancer. I don't look sick. It still feels like such a surprise I think when an appointment does not end with being told "things are looking good, see ya next month!"

    I've been blessed to have had things go as relatively smoothly as they have and when something new turns up it's still a shock.

    Thanks for helping bring me back down to reality! Do either of you participate in a support group outside this site? If so does it help? I'm thinking maybe it's time I look to give and receive more support and perspective.

    xoxo

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  • Lauriesh
    Lauriesh Member Posts: 692
    edited June 2017

    I think you really won't know if your ca 27-29 is an accurate indicator for you unti you have a scan and see if there has been progression or not. When my liver mets were found, my 27-29 had jumped to 50. Not high, but it had hovered at 7-12 for years.

    Because you also have elevated liver enzymes, I would have the scan to rule out liver mets. While my tm jump was small, I had 2 tumors, one that was huge. Yet, after a couple rounds of chemo, my tm dropped back down to around 10 and has stayed there for the last 6 years.

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  • zarovka
    zarovka Member Posts: 3,607
    edited June 2017

    Livingwithit -

    I'll post my CA 27.29 with my CA 15.3 for your amusement as we are very similar ... I had normal TMs when diagnosed. I am wrapping up cycle 18 of Ibrance. My tumor load reduced by 70-80% in the first 6 months, mostly in the first 3.

    I think these tests are supposed to be looking at the same antigen using different techniques ... (I would LOVE to be corrected if wrong) and yet they don't track with each other. One simple explanation is that my TMS are pretty much the same and the variation is simply the variability of the test.

    My gut is that the nurse is over-reacting. I was told that liver mets don't show up in liver blood tests until you have significant impairement, which is unlikely given your recent clear scan. If you don't like scans, get a second opinion, or just cancel the appointment and use that order for a scan at your regular schedule. If you don't mind scans and want to know what is going on, take the order and get it done. Your gut feeling about what to do is what matters here.

    >Z<


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