Tumor Markers

[Marilli]

Hi - How many of you get tumor markers and how reliable are they?  My husband has bone metastasis and are stable at the moment, however, his lung has a new spot, but his tumor markers are on the rise, his last CA27-29 was 735 and they keep going up.  Even after radiation they went up.  What else could cause tumor markers to rise? Could an inflammation cause this?  Thank you.

[Marilli]

Hello again - Thank you for all your information.  I know this is not a breast cancer forum but since his cancer has metastasized to his lung I thought I would post here. As I mentioned before my husband had a liver transplant and has a suppressed immune system, therefore, chemo has not been an option for him.  He has had all the hormonal treatments, plus drugs that don't even pertain to breast cancer.  Since his radiation and drug called Targretin he has felt poorly, out of breath, lightheaded, chills, overall feeling unwell.  I was wondering if you think that someone in his situation could tolerate Herceptin or Tykerb.  He doesn't have the best heart function, but his ejection fraction is 60.  We are seeing a heart specialist this morning.  He does not want to die from treatment this is why we have avoided Herceptin since it does affect the heart.  Any information you could provide would be so appreciated.  Thank you.  Idi (P.S. I wrote earlier but it did not show up on the board) so if it shows up twice just ignore.  Thank you.

[DrBhumikaMD]

Hi,
The tumour marker CA27.29 is most commonly used for breast cancer. It can also be seen to rise in colon, gastric, hepatic, lung, pancreatic, ovarian, and prostate cancers. There are certain benign conditions also which lead to a rise in CA27.29 values but a rise of >100 is not seen in benign conditions.
The false positive rates for many tumor marker tests are usually around 5%. Also, there have been cases reported in the literature where necrotic tumor is believed to have degraded, releasing entrapped tumor markers, yielding a false positive result. Therefore, high values in a single test is not taken into account, but instead persistent high elevation or progression in a series of tests over weeks or months is considered significant.
Tumor marker levels may rise after effective treatment including radiation therapy due to cell lysis, but this increase does not indicate treatment failure. However, a consistent increase in tumor marker levels, coupled with lack of clinical improvement, may indicate treatment failure oe development of metastsis or progression of the cancerous lesion.
If the CA27.29 values of your husband are progressively increasing, are >100 and he also has a new lung lesion then it is a cause of concern. You need to discuss this in detail with your oncologist. He also needs to be assessed clinically before anything can be said for sure. Goodluck.