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Medical Forum / Diseases and Disorders / Breast Cancer / July 2004Lab Results Question??
My new oncologist, at my first visit, ordered me to go have some bloodwork done. I got a copy of the Lab report today and wondered if any of you can tell me what an Oncologist specifically looks for when he orders blood work. My primary care doctor orders bloodwork but I noticed he checks off different items on the sheet. He is more interested in my cholesterol etc. I think WBC means "white blood count" but other than that, I have no idea what the other stuff means. Is there a website anyone can recommend where I can educate myself about this stuff? I won't be seeing my new Onc until August and I would like to have some idea of what the results mean. His office is very busy and I don't expect them to call me about the results. (Maybe that is a good sign.<g) Thanks for any info you can provide. Bea -- http://www.labtestsonline.org/ Is the best site I've found for lab information > My new oncologist, at my first visit, ordered me to go have some > bloodwork done. I got a copy of the Lab report today and wondered if [quoted text clipped - 13 lines] > > Bea > My new oncologist, at my first visit, ordered me to go have some > bloodwork done. I got a copy of the Lab report today and wondered if > any of you can tell me what an Oncologist specifically looks for when he > orders blood work. The oncologist is primarily interested in white cell count, as you say. This is because depression of the white cell population is the most dangerous side effect of chemotherapy, they watch it constantly during treatment and often (if not usually) have to restrict treatment to allow the count to recover. He is also interested in the other counts that might be indicative of impending problems with the cancer, eg bone marrow invasion, and he may also be testing for 'tumour marker' compounds as a rough measure of the state and size of any cancer present. Tumour marker tests are really only recommended for use in treatment of stage IV cancers, but some doctors like to give them in primary treatment, either as one more piece of evidence to the jigsaw puzzle of detecting possible metastases, or as a way of enhancing the patient's confidence in their care (or some would say, to boost their charges). Some centres routinely give white-cell-boosting drugs during chemo to counter this problem. While it certainly allows chemo to be more effective, there are concerns that it may also boost the cancer or have other harmful side effects which cancel out the benefit. I believe there are studies ongoing on this. Tim Jackson Tim wrote: << Tumour marker tests are really only recommended for use in treatment of stage IV cancers, but some doctors like to give them in primary treatment, either as one more piece of evidence to the jigsaw puzzle of detecting possible metastases, or as a way of enhancing the patient's confidence in their care (or some would say, to boost their charges).>> Not necessarily, on my chart it states that the CA 27.29 test is recommended for monitoring stage II and III breast cancer. The statement is made by the company that manufactures it. As far as paying for it, it doesn't cost me anything extra since I receive my care through a non-profit HMO, and all those expenses are covered. > Tim wrote: << Tumour marker tests are really only recommended for use in > treatment of [quoted text clipped - 6 lines] > for monitoring stage II and III breast cancer. The statement is made by the > company that manufactures it. Well, they would, wouldn't they? I meant "recommended" by independent organisations such as ASCO in the US or NICE in the UK. Tim Tim wrote: << Well, they would, wouldn't they? I meant "recommended" by independent organisations such as ASCO in the US or NICE in the UK. >><BR><BR> I hear 'ya.. oops other sent too soon...Tim wrote: << I meant "recommended" by independent organisations such as ASCO in the US or NICE in the UK. >> I think you are right--still not recommended by ASCO but am beginning to think that it couldn't hurt. However, I feel that our HMO is using them to delay diagnosing recurrence until tumor markers reach measurable level which means cancer is quite advanced. Many report that their physicians diagnose on basis of scans and symptoms. I think our HMO coordinates that together. I have had scans that could be suggestive of such but more importantly symptoms--yet my one onc tells me (based on tumor marker), I "have no cancer." I sure wish I could believe him and when I have a bit more time will summarize the latest saga. I am kind of concerned that something is going on in my spine along with liver. Liver function tests are starting to rise and scan reports are quite confusing--almost like they are creatively manipulating what is stated to be vague. The problem is that the 2nd lesion found in the liver -- the one that I was told was nothing and probably just a 'fold in the gall bladder' seems to be the one that is growing... Thanks to everyone for helping me understand my report. However, Kaye, you and Tim quirked my curiosity about the CA 27.29 test. On my report it states: "Because the concentration of CA27:29 in any given specimen can vary due to differences in assay methods and reagent specificity, values from different assay methods cannot be used interchangeably." Also: " CA27.29 levels regardless of values, should not be interpreted as absolute evidence of the presence or absence of disease. CA27.29 is not intended for use as a cancer screening test." So my question is: Do any of you know what a good or even bad number is when given for this test? There is a number on the page for my test result but no reference for me to understand if it is in the good or bad range. It says reference range is: <38unit so is any number less than 38 good?? Thanks! Bea >Thanks to everyone for helping me understand my report. However, Kaye, >you and Tim quirked my curiosity about the CA 27.29 test. [quoted text clipped - 16 lines] > > My first Onc. stated that 35 was a usual number if there was no cancer, However mine were at 40 for the first 2 years or so elevating to 120 by the start of the fourth year. Trying to get my second Onc to give the test was like pulling teeth. I had to beg. I went for 2- 4 month checkups with no test. When I insisted on one 4 months ago the level had gone from 120 to 1300. He then told me that something was going on. After a bone scan anad 2 ct's it was found that I had bone mets to the head and 3 ribs. Last week he told me the second ct had a questionable area in the pelvic area and after taking Arimidex for 2 months , my marker had risen to 1800...He never said that the markers tests were of any use to my diagnosis. Since any treatment I had would be pallative, in nature. I have now changed to another Ins carrier (Kaiser) and am starting all over with a new Dr. Hopefully my new Dr. will want to fight with me, on this..( last Onc. didn't even mention the ct results as being ,"Not good" until the my very last appointment, when it was too late to order a new ct) I'm sure 1800 is extremely high..I, so far, have no complaints with the exception of a really bad backache that started the day after my first ct and bonescan..Possibly the problem is that questionable area in the pelvic area. No bone mets were found in that area..Pat from Apple Valley, CA Pat, my best thoughts are with you. Which Kaiser will you be going to? Once you are in the system you can go to any of them for 2nd opinions. They have some of the top specialists. We were at a barbeque on the 4th with 2 friends/friends who are Kaiser administrators. They said they get about 12 physician applicants for every opening. Take care and wishing you the best! >Pat, my best thoughts are with you. Which Kaiser will you be going to? Once >you are in the system you can go to any of them for 2nd opinions. They have [quoted text clipped - 3 lines] >Take care and wishing you the best! > I will be going to the Fontana facility..I haven't gotten much done yet, only with them 9 day so far...The Dr.(very young) I saw, I liked very much..HE will not be my PCP. There is an office for PCP's here in Victorville, so at least everything won't be down the hill. My first interaction with Kaiser, so far, back exrays and full blood test WITH the CA test included without begging. I am impressed!!...Pat Bea wrote: << It says reference range is: <38unit so is any number less than 38 good?? >> Yes. My initial reading was 58.6 or 59. > So my question is: Do any of you know what a good or even bad number is > when given for this test? There is a number on the page for my test > result but no reference for me to understand if it is in the good or bad > range. It says reference range is: <38unit so is any number less than > 38 good?? Thanks! Yes. In fact any number not massively higher is pretty good too. A real positive result is many times higher, the trouble is that cancer does not always give a high result, at least in the early stages. Tim Jackson > My new oncologist, at my first visit, ordered me to go have some > bloodwork done. I got a copy of the Lab report today and wondered if > any of you can tell me what an Oncologist specifically looks for when he > orders blood work. In addition to what others have mentioned, my oncologist also orders a liver panel or basic metabolic panel. Did so initially, and does annually now that I'm in post-treatment follow-up. As I understand it, this is primarily to look for degradation of liver function that might indicate liver metastases. Some abbreviations/terms in test results that would be liver-related are AST, Alk Phos (or ALP), ALT, bilirubin, albumin, or total protein. The web site "Guess Who" posted will explain what these mean. Most lab test results will have a column flagging any items that are outside the normal range, and/or a column that indicates what the normal range is. If something is marked as abnormal, don't panic -- many of us have some value on some test that strays a little outside the normal range, as these are just averages. The doctor will evaluate the total picture of related tests, and may order scans if ncessary, to follow up. Alarmingly, after a while you get pretty good at reading these test results, after going through a period of looking up items individually to figure out what they are. Ah, the hobbies that circumstance drives us to . . . ! Best wishes to you, Bea! Ann T. Bea wrote: << I got a copy of the Lab report today and wondered if any of you can tell me what an Oncologist specifically looks for when he orders blood work. >> As others wrote, they look at complete blood count, liver function tests, sometimes tumor markes, sometimes calcium levels, sometimes specific hormone tests. One of the liver function tests--alkaline phosphatase may be elevated for liver mets or bone mets. Sometimes it can be elevated for other reasons--something genetic? going on. Tumor markers may show rise of cancer cells in different areas. Blood level differences may also be a sign of oncological activity. |
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