Can Premarin with Taxoxifen increase the CA125 marker?

[HootyOvO]

Hello I would appreciate your opinion,

Dec 2002 I was diagnosed with stage1-2 ER+, grade 2 breast cancer. Treatment:  partial mastectomy, 24/35 lymph nodes removed and all clear except cancer in entranceway to 1st lymph node I had chemo, radiation, and then Tamoxifen for 5 yrs.

In Dec 2007 diagnosed (totally separate) ovarian cancer; stage 3, aggressive clear celled, totally hysterectomy, fatty curtain removed, specks (1/2 size grain of rice) in right diaphram. In Dec 2007 CA125 count was 874. I had two 2 types/chemo via I.V. plus peritoneal (port) chemo treatments Jan-May 2008 CA125 were averaging 14, 6, 5, 7, 5.

Nov 28/08  CA125 was ‘5’.

Jan 6/09, Due to difficulty with dysfunctional brain (no hormones) oncologist started 0.625 mg Premarin with Tamoxifen. I noticed a steady increase of hard bowel movements and bloating in my abdomen/pelvis.  

Feb 17/09 (43 days later) my CA125 count was 220. I am awaiting results of ultra sound taken on Feb18th and a CT scan on my abdomen next week.

Why would the CA125 count suddenly rise to 220 during the 43 days of taking the Premarin and Tamoxifen?

Thank you for your answer.
HootyOvO

[HootyOvO]

Dear Dr. Goodman,

Thank you so much for your input and suggestions as this is most appreciated!

Feb 18th I had an abdominal ultra sound and that was clear.
My bloating dissipated since halting the estrogen & Tamoxifen Feb 18th

Feb 24th Oncologist performed physical pelvic exam and it was good except for some 'thickening' on my back left wall that was not there in my last pelvic exam on Nov 26th.

Mar 3 CT scan preliminary results showed organs clear but small lesions (cc in size) at the 'north and south' ends of my omentum.

Mar 18 another CA125 and CA15-3 is scheduled.

Mar 25 I will go back to my ovarian oncologist for blood results and detailed results of CT scan.



I would like you opinion on HPA........(Altered functioning of the hypothalamic–pituitary–adrenocortical (HPA) axis.)

Can the deregulation of the HPA response and chronic stress from severe childhood PTSD and repeatedly activating the HPA response but never recovering from the ‘fight or flight’, force an imbalance or impotency of the body’s natural hormone Cortisol?

I also read that although Cortisol is used in ever cell of the body, the majority of the cortisol is stored in the omentum, (where the body draws from fat to create energy in an acute stressed state). Does the majority of cortisol store itself in the omentum and if so, does it also store itself in the fat of our breasts too?

If PTSD and/or smoking, drinking, drugs (over eating?) and (too much or too little?) can deregulate the HPA process (‘top to bottom’) and our immune system shuts down during a ‘fight or flight’ episode, is it possible with a deregulated HPA response our immune system is told by the brain to go on stand by for the duration of the fight or flight episode. But what happens if we are stressed continually? If the HPA process affects our immune system in a fight or flight situation but the HPA becomes deregulated with never ending stressors, can chronic stress cause a deregulation of our immune system too, and therefore limit our body’s ability to fight disease?

Also, can stress and therefore over-eating cause a deregulation of the HPA and impact on the Cortisol just like PTSD, smoking and drugs?

I am most interested in your opinions on this….

Thanks
Hooty

[Annekathryn Goodman, M.D.]

Dear Hooty,
thank you for your complete information. Wow, you have been through so much.
I suspect that the CA 125 and your symptoms are not at all related to taking premarin.

Estrogen may stimulate a breast cancer growth (but this may happen over a long period of time)  but it will not affect the development of ovarian cancer recurrence..Estrogen along with tamoxifen should protect you from stimulating breast cancer growth.   Estrogen does not affect bowel function.

I worry that the elevation of the CA 125 might reflect activity with the ovarian cancer. I would recommend repeating the CA 125 and checking the CT scan.
please let us know how you are doing.
best wishes