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Medical Forum / Diseases and Disorders / Breast Cancer / November 2003

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Cancer Markers

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gabnet' - 21 Nov 2003 19:51 GMT
Hello:

Yesterday I received my cancer markers and the oncologist was happy as
they had gone down.  I have stage IV BC with meds to the liver.  I think
I understand what it means, however I have no clue as to the numbers.
Perhaps one of you might explain.  Also if you might tell me what is
considered normal?? <that I will never be!! <g>>

CEA:   37
27 29  62.4

Laura K.*

gabnet@adelphia.net

Thanks.
Signature

Hugs,

Laura K.*
I'm out of estrogen and I have a gun!

Chris - 22 Nov 2003 02:44 GMT
Your question is best answered by your own oncologist. As I understand
it, tumor markers in breast cancer are much less specific than in other
cancers. There are thresholds for "normal" but I can't remember them (it
has been a couple of years since that was relevant, sigh). You and your
oncologist need to look at your numbers in comparison to how your own
numbers work. If you were at 100 and are now at 62, that is great. If
you were at 32 and are now at 62, that is something to watch. There is
also wiggle room in the numbers themselves, so 62 versus 66 or 58 really
doesnt mean much.

Chris

> Hello:
>
[quoted text clipped - 12 lines]
>
> Thanks.
gabnet' - 22 Nov 2003 15:21 GMT
Hi Chris:

Thanks for answering, but I do discuss this with my oncologist, both she
and I have a very amicable relationship. I know my numbers have
decreased, butI was asking if any one knew exactly what the normal
number is in a person who does not have cancer.

> Your question is best answered by your own oncologist. As I understand
> it, tumor markers in breast cancer are much less specific than in other
[quoted text clipped - 24 lines]
> >
> > Thanks.

Signature

Hugs,

Laura K.*
I'm out of estrogen and I have a gun!

Chris - 23 Nov 2003 15:46 GMT
Your oncologist didnt know this? I am afraid your original post was not
so clear on that point.

> Hi Chris:
>
> Thanks for answering, but I do discuss this with my oncologist, both she
> and I have a very amicable relationship. I know my numbers have
> decreased, butI was asking if any one knew exactly what the normal
> number is in a person who does not have cancer.
Tim Jackson - 22 Nov 2003 16:44 GMT
> Hello:
>
[quoted text clipped - 17 lines]
> Laura K.*
> I'm out of estrogen and I have a gun!

It is best to ask your oncologist what he considers normal.  It depends on
what units it is measured in for a start, and also the baseline levels vary
quite a lot across the population.  It is generally more useful to look at
rates of change than at target levels.  I'm sure someone else can give a
more accurate response, but I think typical healthy levels for "CEA" are
under 3 and for "CA 27-29", in the thirties.  I'm sure I saw someone answer
this recently, but I can't find the post.  If you have recently had
chemotherapy for example, some of your marker levels will probably be
somewhat abnormal anyway, so I don't think doctors are interested in
absolute levels.

Any progressive decrease in levels is good news.

Tim Jackson
Kaye301 - 22 Nov 2003 16:56 GMT
Tim wrote: <<  I'm sure someone else can give a
more accurate response, but I think typical healthy levels for "CEA" are
under 3 and for "CA 27-29", in the thirties.  I'm sure I saw someone answer
this recently, but I can't find the post.  >>

I happen to have a copy of my latest blood levels right next to my computer.
The range for CEA states:  "OR <5."  It used to be <3.  I don't know if our
facility changed the rating or the test manufacturer did.
The range for CA27-29 statwa: "OR < 38.6  (It used to be <37).   Uncer CA 27-29
it states: "Test method: Advia centaur BR chemiluminsecence assay manufactiured
by Bayer corporation
The test is intended for use as an aid in monitoring patients previously
treated for stage II or stage III breast cancer.  Serial testing for CA 17.29
antigen should be used in conjunction with other clinical methods for the early
detection of recurrence.  In--house precision studies indicate  that" (and then
it cuts off--nothing further is indicated).
Tim Jackson - 23 Nov 2003 00:22 GMT
> Tim wrote: <<  I'm sure someone else can give a
> more accurate response, but I think typical healthy levels for "CEA" are
[quoted text clipped - 12 lines]
> detection of recurrence.  In--house precision studies indicate  that" (and then
> it cuts off--nothing further is indicated).

Isn't Google wonderful.  Here is the rest of that text in a lab's spec
sheet,
and also a statement that the "reference interval" (normal range) is 0-40.
http://www.aruplab.com/guides/ug/tests/0080392.jsp
I thought that text block looked unique enough to search for and would
probably be online somewhere. It's not quite the same but obviously derives
from the same source.  I don't know why your report specifies 'normal' to 3
decimal places when it is obviously such a hit-and-miss thing.  I guess
that's a calibration adjustment for the particular machine or reagent batch.

Tim
Kaye301 - 23 Nov 2003 06:01 GMT
Tim wrote: << I don't know why your report specifies 'normal' to 3
decimal places when it is obviously such a hit-and-miss thing.  I guess
that's a calibration adjustment for the particular machine or reagent batch.

Hmm, guess that would explain it.   Thanks!
gabnet' - 23 Nov 2003 05:30 GMT
Kaye301 wrote:  Hello:

Thank you so much for your answer.  I have tried to find the norm but to
no avail.  Your post was truly appreciated.

My husband and I both thank you.

Laura K.*

> Tim wrote: <<  I'm sure someone else can give a
> more accurate response, but I think typical healthy levels for "CEA" are
[quoted text clipped - 12 lines]
> detection of recurrence.  In--house precision studies indicate  that" (and then
> it cuts off--nothing further is indicated).

Signature

Hugs,

Laura K.*
I'm out of estrogen and I have a gun!

Kaye301 - 23 Nov 2003 06:06 GMT
Laura K wrote << .  I have tried to find the norm but to
no avail.  Your post was truly appreciated.

You're welcome, Laura.  I guess the reason that the reference ranges are not
listed is because there is some variance 'allowed' between labs.
Kathleen Langwell - 23 Nov 2003 19:06 GMT
I have only had the CEA marker test, but at my hospital the acceptable
range is from 0.0 to 5.0. I was diagnosed with mets to both lungs in
September and my CEA test came out at 1.8. In July 2001, after initial
treatment, it was 1.1. When I saw the current 1.8 I was hoping that the
x-rays and CT scan might have been wrong about metastatic nodules in
both lungs, but the onc said 'No'. Haven't started treatment for this
yet because I also had a blood disorder which had to be brought under
control first. Have an appt. mid-Dec. to seriously talk about chemo
again. Sigh......

Kathie
Kaye301 - 23 Nov 2003 20:04 GMT
Kathie wrote: <<  I was diagnosed with mets to both lungs in
September and my CEA test came out at 1.8. In July 2001, after initial
treatment, it was 1.1. When I saw the current 1.8 I was hoping that the
x-rays and CT scan might have been wrong about metastatic nodules in
both lungs, but the onc said 'No'. >>

When my CT scan last year stated that the single node in the hilar region was
"stable" I freaked because none of the previous scans ever mentioned it.  My
tumor markers were okay at the time.  The node was 1.0 cm.  I have had
difficulties upon exhalation which developed after my last taxotere.  It didn't
happen after the radiation.  
It (the fluid like feeling) went away about 2 mos. after I stopped the
Herceptin and about one month after I started Celebrex, although a slight
wheeze-like feeling was still there, but that went away the next month after I
doubled the Celebrex.  That was when I had that CT scan that reported that node
to be
stable--so my questions were did I have the beginnings of congestive heart
failure or was there a malignant node there that was helped by the Celelbrex.
Then last June, the wheeze-like feeling (although definately not an asthmatic
'wheeze'--more like an added vibration upon exhalation) returned.  It remained
until after I again doubled the Celebrex--to the maximum safe dosage which has
optimal anti-tumor effect.  (Half that dosage has more stabilizing effect on
tumors--at least the ones studied in colon cancer).
So, when others talk about cancer returning, there is no consistent standard
being used to determine.  From what I gather what one cancer center or
radiologist and oncologist may report and treat as 'recurrence' or metastases
may be ignored by another cancer center because of its relatively small size.
So, how can one say that early treatment is not beneficial if  there are no
consistent or standardized ways being used to determine---or rather if the
standardized ways in place are not the most effective for determining earliest
of recurrence,
In regard to use of tumor markers, I had wondered why they were not in use in
helping diagnose breast cancer.  Both my CEA and CA 27-29 were elevated at time
of dx.  My CEA was around 13 and my CA 27-29 was 58.  I then, recently learned,
that tumor markers are NOT generally elevated in early stage breast cancer.
So, in my case, with all that I had going on 9 positive nodes, 3 types of
aggressive breast cancer, and extensive lympho-vascular invasion, my thoughts
are that I was closer to stage IV than stage IIb (which was the initial
pathological stage reported).
At least my oncologist had the sense to recognize that and am guessing that was
why I was allowed Herceptin out-of-protocol after being rejected for a trial
for it.  I am glad that I had a positive response.  My tumor markers didn't
return until normal until after I had been on the Herceptin and completed 4
taxanes.  I first had 4 AC, then 5 weeks of rads wihtout boost (which I am not
sure was enough--rads was only based on main tumor that had clear margins but
they didn't consider location (upper inner quadrant) or fact that I had high
grade dcis and separate tumor in nipple within dermal lymphatics) .  Then I had
the taxanes---2 Taxol and 2 Taxotere with Herceptin for a year, along with
Arimidex (which I only got because I rejected Tamoxifen), then the Celebrex,
then Doxycycline, the Zometa (had 3 doses for osteoporosis preventin, although
am concerned about possibility of bone and spinal mets), then synthoid (when
thyroid stopped working), and then statin drug (with  sudden high
cholesterol--from Arimidex?).
I still wonder if the supposed hemangioma on my liver, which was never
confirmed, was a liver metastases, especially since I lost 17.5 lbs in about 3
weeks between my diagnosis and initial surgery.  I also wonder if the enlarged
retroperitoneal nodes which were reported not likely to be associated with
breast cancer (they aren't for the most common type--ductal--which 85% have but
are 3rd most common site for lobular which I had--and the rectal bleeding which
began the day before first surgery--out-of-the-blue with no pain or other
symptoms (although I had reported weird change in shape of b.m. 3  mos before
my dx which nobody every addressed) and that bleeding continued until after
first chemo treatments (AC) was completed.  I did have supposed normal
colonoscopy AFTER completion of AC.   However, bleeding again recently
began...w/no discomfort...
gabnet' - 23 Nov 2003 22:59 GMT
Hello Kathie:

I have stage 4 bc with med to the liver.  The reason I am so darn
confused is that both my oncologist in NYC where I was undergoing
treatment and now here in Florida I had two different numbers.  They
said that the reason they were both so different (but had come down from
its original numbers)  is that they utilize two different testings.  I
have to say that I feel great, actually better then I have in years??  I
know this sounds amazing, but it iss totally true!!! <g>  Gosh, I think
I was better off when I was stupid!

Thank you Kathie, your post was very appreciated.

> I have only had the CEA marker test, but at my hospital the acceptable
> range is from 0.0 to 5.0. I was diagnosed with mets to both lungs in
[quoted text clipped - 7 lines]
>
> Kathie

Signature

Hugs,

Laura K.*
I'm out of estrogen and I have a gun!

Pat rom Apple Valley, CA - 22 Nov 2003 17:06 GMT
My First Onc. Said 35 was the number to have for the 27.29, tho mine
were at 40 for the 2 years that I went to him after my treatments..(So I
guess that was normal for me) When they went up to 80 then to 120. My
new Onc,( moved away from the first one)  won't even order the tests as
he says they are not an indicator or not much of one. But ask Linda
Bliss, as soon as hers went up her Onc checked and indeed found a
problem.. If your are going down, Thank God!!!..Pat From Apple Valley,CA

>Hello:
>
[quoted text clipped - 13 lines]
>Thanks.
>  
 
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