Elevated CA 27 - 29 levels

[Lorraine512]

In November, 2006, I had a lumpectomy for Stage 0 breast cancer, the 7 weeks of radiation.  I've had follow-up mammograms and blood tests every 6 months since the end of radiation February of 2007.  My last mammo, which was done in March of this year was clear.  I saw the medical oncologist in November of 2007 and the CA 27-29 levels were within the normal range.  I had another blood test done 4 months later {early March of this year} and the levels went from 28 to 39.  My medical oncologist had another blood level drawn and within 1 week, it had elevated to 40.  She scheduled a bi-lateral mammogram for next week.  She assures me because I had Stage 0 breast cancer, the chances of it recurring are small, but they can't explain the elevated CA 27-29 levels.  If the mammogram does not show any signs of recurrance, what would be the next step in finding out why the CA 27-29 levels have increased?  Would a full body scan show if a stray cell they missed in radiation possibly have attached itself to an organ?

[BhumikaMD]

Hi,

Do not panic and try to relax.

Your specialist is doing the right thing and you should trust her .

Keep us posted and let us know if you have any doubts.

Regards.

[Lorraine512]

Hi.....

The bi-lateral mammo was clear....no sign of recurrance.  My oncologist wants to wait a month for another blood test and see where the numbers are then.  She again reassured me "not to worry......the numbers sometimes elevate for no apparant reason.  Stage 0 breast cancer is non-invasive and the possibility of metastasizing is minimal".  Even though she assured me of this, my mind is racing with all the "what if's".

[BhumikaMD]

Hi,

It is very important that you are convinced with the treatment plan and have a good rapport with your specialist. If you want, i think you should go ahead and get your records transferred.

You can ask your specialist for a bone scan / full body scan if you have any doubts.

There is no specific upper limit of normal in case of tumour marker levels.

Your oncologist will be able to help you best with your doubts and whether these rising trends are of significance.

Let us know what your doctor advises.

Keep us posted about any doubts that you are having.

Hope this helps.

Good luck.
  

[bloatedmom]

There shouldn't be a delay if you want to transfer your records.  You can also fill out the forms and then pick up the records and take them yourself.  That should be doable in 24-48 hours.  Don't let the concern of getting records moved dictate where you get your care.  Go where you're comfortable!

[Lorraine512]

Thank you for your speedy reply.  You confirmed my thoughts on the "string of events" to take place.  One of my concerns is how long they will wait before they decide what course of action to take.  Will they do an MRI or full body scan if nothing suspicious shows up on the bi-lateral mammogram?  Or will they just "wait and see" where the numbers go?  How high do they have to go before they take futher action? Can I insist on having an MRI or full body scan done?  I work at a major hospital in Boston, MA, where the top cancer treatment centers and physicians are.  My original diagnosis and treatment was done elsewhere and I'm really not very comfortable with how they're handling my case.  I'm seriously considering having my medical records transferred to where I work, but I'm afraid the delay in transferring my records will cause further damage.  

[BhumikaMD]

Hi,

The  tumor markers are considered of significance on the basis of serial values or trends. An increasing tend in consecutive reports indicates recurrence or spread, etc.

If the tumor marker is being used to determine whether a treatment is working or if there is recurrence, the tumor marker levels are often measured over a period of time to see if the levels are increasing or decreasing. Usually these "serial measurements" are more meaningful than a single measurement.

CA 27–29 levels can also be elevated by pregnancy, endometriosis, ovarian cysts, benign breast disease, kidney disease, liver disease and cancers of the colon, stomach, kidney, lung, ovary, pancreas, uterus, and liver.

In most cases, a CA27.29 would not be sufficient information on which to base treatment decisions.

You could also talk to your oncologist about this .

Let us know if you have any other doubts and post us about what your doctor advises.

Regards.