Hi
I am interested in the experiences of others regarding tumour markers(specifically CA 15/3) in relation to monitoring bone mets. I was diagnosed with bone mets plus a recurrence in my right breast in April 2008, having previously had primary breast cancer in 1994 and 2001. This was treated last year with a mastectomy (interesting thread recently about the pros and cons of mastectomy in the context of secondary disease!) and then Zoladex, Femara and Bondronat. I have kept very well over the period and am currently asymptomatic. I have had bloods taken to look at tumour markers every three months but no scans apart from those on diagnosis. My tumour markers have decreased over that period until the most recent result which has gone up to about the mid point between my highest and lowest reading. The oncologist does not appear to be too concerned but has said he will take another test and will decide if action is needed by way of scanning and/or change of treatment on the basis of that. My questions are:-
Are others with bone only mets monitored by tumour markers but no scans?
How often are your tumour markers monitored?
If you have tumour markers monitored have they ever fluctuated in the absence of disease progression (which my onc appears to be suggesting is possible)
How long do you have to wait for tumour marker results (mine took a lengthy six weeks to report this time!)
Thanks a lot.
ShelleyAnn
I have bone mets which were diagnosed just before Xmas 08. I have bloods taken every three weeks when I have my Pamidronate. My markers have been showing a steady rise since January, despite my being strongly ER+ and on Tamoxifen and I am starting chemo on Monday.
I had MRI and CT scans at first diagnosis but have had none since - only a bone scan which confirmed the CT findings. I am told I will be having another scan at the end of my 18 week chemo treatment.
My markers have risen from 80 to 130 over the last two months - my onc says this isn’t an unduly high figure but because they’re rising rather than falling or staying stable, he doesn’t want to hang about and wants to get on with the chemo asap. I’m hoping that after chemo I can be put on another hormonal drug (as I will hopefully be menopausal by then!)
My blood results are normally available within two or three days - six weeks sounds a VERY long time to wait to me!
Thanks Lesley
I had wondered if they had to do cultures on the bloods which would explain the lengthy wait but it sounds not. Do you mind if I ask which part of the country you are in? I am in Scotland.
ShelleyAnn
X
I was first dx with bc in 1990 with recurrences/new primaries in 1996, 1997, 1999, then in 2002 with extensive bone mets. I am on pamidronate and herceptin 3-weekly. I have tumour markers done every 3 weeks and the results are ready the following day. They fluctuate but only in the range of 16-24. Over the years I have had a lot of bone scans but only when I have a change in the pain level in any area. The last 4 have been 6 months apart.
Hope that is helpful info - if you want to know any more please ask.
Shelley - I think 6 weeks is ridiculous, my tumor markers if taken first thing in AM are available at very end of day - I suspect 6 weeks is the time it takes for results to make their way round the paper trail back to your onc,
I’m on herceptin and pamidronate 3-weekly. Just to offer a different experience, my onc doesn’t set much store by tumour markers, so i’ve no idea what they are/have ever been. instead i seem to be having scans every 3 months.
Im on Herceptin (every 3 weeks) and Zometa(every 6 weeks). My onc doesn’t set much value in measuring tumour markers. I was diagnosed with bone mets in April 08 and I havnt had any scans after treatment(18 weeks tax). I’m seeing my consultant for my 3 month check up on Monday so I might ask him about scans then.
My onc only favours tumor markers in retrospect, i.e. if i have a new pain, he is then likely to order scans and tumor markers. I certainly don’t have to wait that long for either.
I’m now wondering if i should ask them to do my tumor markers every 3 weeks when they do my other bloods.
Tumour markers have not been shown to be a particularly good monitoring tool in most cases of primary breast cancer, but in about half of people with secondaries they can be a reliable way of monitoring and spotting when cancer is on the move.
IN my own case, my tumour markers showed nothing all through my primary treatment, despite numerous recurrences. They showed nothing in the early stages of secondary disease (bone mets), but once there was spread to my lymph system they started to climb out of the normal range (anything up to 30 is viewed as normal).
They climbed steadily from last October to February this year, doubling every three weeks as more lymph nodes became involved and the cancer spread to my liver, despite being on the abiraterone trial. They stabilised a for a couple of weeks after I had been on the abiraterone trial for two months but did not drop enough to give the doctors confidence that abiraterone was successfully holding things back so I switched to xeoloda. When I have my tumour markers taken next week (having been on xeloda for three weeks) I am really hoping they will have dropped back a bit from the 700 plus they were at last month, which will give me some confidence that the xeloda is working (they went down to 9 while on taxotere last year).
What is measured with tumour marker is a certain protein that is shed when there is uncontrolled cell growth. So small rises in tumour markers could indicate a cyst, an ulcer or some other relatively harmless growth going on. Big jumps, or steady rises over a period of time, are obviously taken more seriously and would suggest the need for a bone, ct or mri scan.
I think it is worth having tumour markers done because, unlike ct scans, they are relatively easy to do and could pick something up that has not caused any symptoms. Certainly, with my liver spread, I had no symptoms at all and had it not been for the fact I was on a trial and therefor having regular CT scans as well as tumour markers we would not have known about it until I became symptomatic (and perhaps the disease would be even more advanced).
i was treated (bilateral mastectomy and chemo) for breast cancer in '97. 3 years ago, i was diagnosed with mets on my spine, sternum and 6th right rib. hormone treatment just didn’t suit, so i had ovaries removed last year. now i’m on painkillers only and have my spine ‘fused’ for stability. it’s just been discovered that i now have mets on my left thigh bone. my question is - why are my doctor’s not seeing this as an increase or spread of the cancer? they are saying that it isn’t a spread because it’s still in the same organ and although i understand what they mean, because it’s in a new site altogether, i just cannot accept their decision not to treat. Also, because i kept asking them more questions, they eventually decided that it may be a good idea to check my Ca 15-3 levels (i’ve just been having scans as and when really), is this a good indicator for a spread? and at what level is it deemed necessary to treat (even if nothing may be showing on the scans)?
Perhaps this is a question for you to put to your oncologist. Most people with bone mets are treated with some form of bisphosphonates such as intravenous - zometa (zoledronic acid), or pamidronate, and in tablet form - ibandronate. The iv form is given every 3 or 4 weeks. If your med team have found another area that the bone mets has spread to then it is active and I would have thought called for treatment. I think the tumour markers are a good indication of changes, if done regularly. Under 30 is considered normal, but any move up into the hundreds would indicate a problem. But if you are in a hospital where they don’t think much of tumour markers they are unlikely to do them.
I am bone only. My ca15-3 was 27 at diagnosis. It has moved downward to 21, 20, 16,then up to 19 and tidy was 22. I get checked once a month and get the results within 30 min.Every 3 months, I go to MD Anderson for scans. So far all sclerotic activity. Healing. Prayers.
Hiya .
I’m assuming you are not in the UK ? I saw my oncologist today and asked about tumour markers and he said he didn’t use them for bone Mets. He said regular scans and blood tests were more accurate.
Welcome to the site.
Xx
Hi, i also asked for CA153 as a way of monitoring my skin mets (which has now spread to bones and pleura).I started at around 45 and apart from a few little ips have increased to 125 at last reading…this relly knocked me for 6 as i was exp[ecting them to have dopped following new treatment. Although the onc registrar said not to worry too much i cant help it. Sometimes i wish i’d never asked for them.
I was a bit surprised when I realised my last post to this thread (just 3 down) was in 2009!! At least it shows we can still resurrect threads from a few years back and they are still relevant. My tumour markers still continue to be done regularly each time I go for treatment for extensive bone mets, although that treatment has changed since that last post to the thread. After 10 years on herceptin and pamidronate/zometa I am now on kadcyla plus zometa. I get the results of those CA15-3 tms along with the other blood tests on the same day. As for the tms they haven’t really changed that much but my onc seemed to think there was some significance in the fact that prior to changing chemo in 2014 the markers were around 22-27 but after the change went down to between 16-20! I found that interesting as all my blood tests for this tm are in the range of normal but for me that slight shift did indicate changes. They can be a useful tool but can’t be relied on alone.
Hi I am in UK also. I had to ask for my tumour markers which now get done every 3 weeks. My tumour markers have gone from 48.9 to 34 in 6 months of herceptin treatment x
I would like to ask the same about tumor marker. I am worried sick now as I had just received my tumor marker test result this morning. As far as I know, i did not have any history of cancer or tumor ever. I went for the test due to curiosity to know the status of my body condition since there are a lot of increasing cancer cases nowadays. However, upon receiving my test result this morning, i discovered the CA 125 and CA 15.3 are high beyond normal range. My test result for CA 125 is at 52 (reference range is between 0 - 35) and test result for CA 15.3 is at 33.8 (reference range is between 0 - 31.3). The results freak me out and i am not sure what it means. Is this alarming? Does it means that i am getting cancer or its an early stage of cancer?