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Tumor marker ca15-3

kglee
kglee Member Posts: 29

I have have been cancer free for seven years. My doctor perform

tumor ca 15-3 at my follow up visits. It has been in the 20' s until this week and it was 112. My doctor wants to do a pet scan. I've read that sometimes the tumor marker test aren't always reliable or indicate cancer. I have a high deductible on my insurance so this will be out pocket. Not sure if I want to spend $4,000 on a test that is 50/50. Does anyone have experience with the ca15-3 test and know the reliability? Is 112 enough to be alarmed I don't even know the number when I was actually first diagnosed. I had a different doctor and he never went over my blood with me.

Comments

  • sandibeach57
    sandibeach57 Member Posts: 1,387

    Hello Kareng1227.

    Ca 15.3 is a breast tumor marker that is used to monitor the trend of cancer behavior, for example, a continued monthly increase over 6 months could indicate cancer growth. Cancer cells shed this protein, but other conditions can cause elevations, like inflammation.

    For some, this is not a reliable monitor. In my case, it is.

    I have never had a PET scan. if your medical oncologist is concerned enough to want to order scans, would your insurance cover CT with contrast and bone scans?

    My MO uses the following to evaulate my cancer:

    1. how I feel

    2. Labs to include chemistry and hematology tests,

    3. Tumor marker, Ca 15.3

    4. Scans, CT/Bone, alternating with abdominal MRI every three months.

    Hope this helps and maybe others will advise, too.

    P.S. Please insist your MO go over your lab results. Also ask for a copy of your labs and the previous clinic note before you leave your medical appointment. In most cases, labs are drawn prior to your appointment and should be available when you meet with your MO.

  • april1964
    april1964 Member Posts: 153

    kareng1227, my med onc and surgeon both told me that testing tumor markers is for stage 3 and up... they said it isn’t standard practice for stage 1



  • sandibeach57
    sandibeach57 Member Posts: 1,387

    April, that makes me sad to hear that the tumor marker is not ordered with routine labs during oncology follow up visits.

    I was dx with DCIS (bilateral mastectomy) in 2006 and again, 2007 (chest wall radiation, 5 years Tamoxifen).

    At my annual followup prior to the 2016 Stage IV dx, my MO always ordered the Ca 15.3 to monitor any trends. I did this for 10 years and so thankful.

  • KBeee
    KBeee Member Posts: 695

    You caould ask for a repeat in a few weeks to make sure it was not a fluke reading. If still elevated, you also could ask for the cost of a CT and bone scan instead and see if it is cheaper. Sorry you're dealing with this.

  • mtks
    mtks Member Posts: 51

    Hi, i am 9 years out from ILC/stage1 (left breast) /no node involvement/ Dale mastectomy w/ reconstruction . I recently (March) found a lump in the shower on my rt breast area , right above and towards the outside of my silicone implant.. Dr and CT show it muscle even though now you can see it where before it was palatable.. Now i have inguinal lymph nodes.. was just left side but now on both sides, down my left leg back of knees with pressure and ache. Headaches that come on all of a sudden followed by left side throat and neck pain that last 20-40 minutes. Weird, i know. My oncologist keeps using the CEA tumor marker on my follow up ck ups??. Does anyone have ANY info they want to give me. Not getting anywhere and symptoms are worsening! I did have a ANA , dsDNA blood work done that came back positive.. Rheumatologist ruled out autoimmune disease. No further testing on it has been done. Its the only thing thats been positive besides my CT Spenoid & ethmoid sinus debris with rt maxillary sinus cyst, which i have had for years that wont clear up with RX nasal irrigation’s and antibiotics, help please

  • KBeee
    KBeee Member Posts: 695

    I had a CT (for GI issues) a month before my recurrence, and it did not show the lump. My doctors were "sure" it was scar tissue. I thankfully, insisted on a biopsy. Have you had any imaging on the lump? If your doctors are not lisstening, get another opinion.

  • kglee
    kglee Member Posts: 29

    Thank you for all the replies. Long story short, after pet scans and biopsy, it has been confirmed that breast cancer has spread to my liver. Doctors working on a treatment plan, of course pending insurance approval. Put it appears it's the same breast cancer. Meaning estrogen/progesterone positive and HER2 negative. Dr. seems this is a best case scenario. No chemo, a combinations of drugs. If I google breast cancer spread to the liver, results are scary of survival rate. My doctor seems to think I will have good results. Still can't help but be nervous. Thanks again.

  • KBeee
    KBeee Member Posts: 695

    I am so sorry to hear this. I hope you have a treatment plan soon. A week after I was diagnosed with a recurrence, a local gal I met in chemo the first time was diagnosed with liver metastases. That was Feb 2015. She's had to change her meds twice now, but she's been stable since her last med change.

  • sandibeach57
    sandibeach57 Member Posts: 1,387

    Kareng1227. I am sad to hear about your liver mets.

    Please don't read those old stats in Dr. Google. I am 3 years out from my liver mets dx and doing fine.

    Come join us over in the liver mets topic. I am suspecting you will be put on Ibrance and letrozole (or faslodex). There are threads for that, too.

    I will try to post the links..give me a few minutes so I can add them here with an edit!

    We will help you through these rough first few months of the shock. Lots of virtual hugs to you.

    https://community.breastcancer.org/forum/8/topics/...

    https://community.breastcancer.org/forum/8/topics/...

    https://community.breastcancer.org/forum/8/topics/...

    S

  • marianelizabeth
    marianelizabeth Member Posts: 1,156

    Karen, glad you did have those tests despite the results. As Sandi suggests, there are good threads and lots of support.

    I only had CA15-3 tumour markers done after my BC metastasized but it is doubtful they would have shown anything. Over the past several months mine have gone from just above normal to 52 but two weeks ago they went back to normal. Weird as my neuropathic pain went crazy about 3 months ago when it was 52 but CT and MRI showed no progression. I have just had a fairly invasive surgery for the pain and start chemo again tomorrow. My MO has asked for a PET scan as it seems something is happening.

    Marian

  • kglee
    kglee Member Posts: 29

    Thank you for the information and support.

  • Anewbreath
    Anewbreath Member Posts: 122

    SandiBeach5- thank you for your explanation of TM! That is what my MO is saying we are looking for trends and that is what we are seeing now and if they change he will order scan. So, really TM are individual and whatever is normal for each patient. So,it sounds like you get regular scans also? Your TM don’t correspond with your scan results?

    Our BC history is quite similar when I look at your history. Did you take tamoxifen for 10 years? I did. Not sure that was the best decision now? I was also diagnosis in feb 2007 with stage 2b and reoccured in Dec. 2017. I’m so happy you have gotten 3 years out of ibrance and praying for many more!

  • sandibeach57
    sandibeach57 Member Posts: 1,387

    Hi Anewbreath. I get scanned every 3 months. My TM varies slightly, but nothing to alert my MO. I am not in the normal range. You are right, you establish your own baseline at the metastatic dx. Mine fluctuate between 36-55. At this time, my scans do not show new disease and my labs are normal.

  • Anewbreath
    Anewbreath Member Posts: 122

    Sandibeach57-I promise i’ll get it correct some day. Thank you for further explanation. In my opinion your TM seem to correlate with your scans. >55 is very low. And you are NEAD. You have had 3 years of sold clinical evaluation. My concern is what I don’t see. That’s where my faith has to take over. The possibility of my cancer being highly active even though I feel fine, my CBC is normal and my TM are in normal range and my small townMO feels I’m doing good.

  • sandibeach57
    sandibeach57 Member Posts: 1,387

    Yes, Anewbreath, that is the down side of metastatic or Stage IV breast cancer..micromets are hiding (and maybe active) and just waiting for the opportunity to grow. Can big a big unknown and that sucks. No scans or blood work can see them, but they are there..ugh.

    So my MO said I was in clinical remission (for now) with no evidence of ACTIVE disease. She goes by:

    1. how I feel

    2. scans

    3. labs

    4. CA 15:3 (remember not everyone has reliable tumor marker that correlates with disease progression/stability)

    CA 15:3 normal reference range is less than 30 for the laboratory I use. My new normal median is around 50 and it fluctuates some.

  • Anewbreath
    Anewbreath Member Posts: 122

    You are so kind to explain your TM, SandiBeach5! Makes complete sense. Thank you, friend! I hate the reality of how unpredictable MBC is! Desperately unfair to all of use just trying to do our best in life with what we have been given😞. Those sneaky cells that hide.....need to be DESTROYED🙏🙏

  • ZZZAAAZZZAAA
    ZZZAAAZZZAAA Member Posts: 23

    Hello there .........my mother have breath cancer with mestas in liver one spot 1.5 cm ..and she take only hormone armidex and now armossen 25 mg ...and she can t take chimotherappy because she have 71 years .....

    here ca 15 is 778 ....any experience here ..i m scarry the doctor say we will continue hormone armossen 25 mg

    any experience here ??


  • sandibeach57
    sandibeach57 Member Posts: 1,387

    Hello. I am trying to understand your question.

    So far, it seems your mom is hormonal positive (ER+) and HER2 negative and has one metastatic 1.5 cm lesion in her liver with no bone or brain mets.

    She was on Arimidex , now on 25 mg Aromasin. Her most recent Ca15.3 is 778.

    Are you concerned that she might not be responding to her treatments because her Ca 15.3 is high? When I was first diagnosed, my Ca 15.3 was in the 800's. With treatment, it gradually decreased.

    I do not know when she was diagnosed, or if this is her first bout with breast cancer, or when she started her antihormonal treatment and how long her Ca 15.3 has been monitored. If recently, her tumor marker could be high because the dying cancer cells are shedding protein, therefore increasing the Ca 15.3.

    The tumor marker is really just a guideline for her medical oncologist to monitor the trend of how she is responding. In saying that, for some patients, the tumor marker is not a reliable source of information and not helpful.

    What is important is her monthly labs (CBC, blood chemistries to monitor her liver function) and her bone and CT scans and how she generally feels.

    If she is de nova (first time diagnosed), she might be considered oligometastatic (one treatable lesion). Her medical oncologist would be more aggressive with her treatment and treat for curative intent. I will try to add a link that discusses ablation and other treatments for liver mets.

    Also, has targeted therapy been discussed to add to her antihormonal meds, like CK4/6? Was her liver biopsied and tissue sent for Foundation 1 or similar to look for tumor genetics or mutations?

    Is there a way for you to complete the treatment data so others can see your mom's breast cancer history and treatment?

    If your mom is tolerating treatment and her scans are stable (no regression) and there is no progression or no new lesions, she will be with you a long time! It is a scarey time. Please don't believe the statistics on the internet..the data is old.

    Read, read, read all you can about her disease. Write down your questions and go with your mom to her oncologist and get answers.

    Be strong. We live with our disease and have good lives.

    https://community.breastcancer.org/forum/8/topics/...

    https://community.breastcancer.org/forum/8/topics/...

    https://community.breastcancer.org/forum/8/topics/...

    https://community.breastcancer.org/forum/8/topics/...

    Bestbird's guide is very informative. You can order online from Amazon or if you follow instructions in the topic, she will send a pdf free of charge. This will help you understand your mom's Stage IV breast cancer and current treatment options.

  • sandibeach57
    sandibeach57 Member Posts: 1,387

    ZZZAAA...

    One last thought. If your mom's CA 15.3 is trending upward, then her MO will probably order scans to get a better understanding of her cancer, like a bone and CT scan with contrast. Abdominal MRIs with contrast are really useful for liver evaluation. I have never had a PET scan.

    If the liver lesion is growing or there are multiple lesions, her MO will probably change her treatment..either Faslodex plus a targeted therapy or start Xeloda, which is an oral chemotherapy.

    If she is in an emergency situation (for instance, if her liver is greatly enlarged, or there is large amount of abdominal ascites or her liver enzymes and total bilirubin are extremely high), then her MO might have to start a palliative but effective form of IV chemo. I had to do that. I am an older woman, like your mom, so I am surprised she was told she was too old for chemotherapy.

    I realize English is not your primary language. Do you have someone to translate or have a translation application to help you?

    Keep us posted. You are a good son.

  • ZZZAAAZZZAAA
    ZZZAAAZZZAAA Member Posts: 23

    the doctor say she can t take a chemo is very very dangerous for her health that s all and he keep in hormone armosin 25 mg only i m scarry about the ca 15.3 is 778

  • sandibeach57
    sandibeach57 Member Posts: 1,387

    ZZZAAA..

    Your mom's medical oncologist will probably order scans if the TREND of her ca15.3 continues to increase.

    I am not familiar with her history, but I am guessing if there is proven progression from her scans, she will be put on Faslodex (a SERD) plus a targeted therapy, like Ibrance. Xeloda might be another option her MO might order. It is an oral chemotherapy and is tolerated well among our Stage IV folks.