Extreme tumor markers (CEA, CA 15-3)
Hi Everone,
I'm Peter; this is my first post in this forum. However, I used to read it a lot. I'm here to understand my wife's situation; maybe some of you have experienced similar things to what we did a couple of days ago.
Long story short, my wife was diagnosed with hormone-positive breast cancer in October 2020; she had chemo, surgery, and hormonal therapy; everything went fine until August 2022, when it turned out that she developed liver metastasis. They started with chemo again until August 2023. The liver function normalized quickly. CT showed no progress. They changed her treatment to kisqali (ribociclib) in August 2023. Liver enzymes went down even more. Last week, she had a CT, which showed no progress on the liver and did not find progression to other organs. The blood tests were super great. All liver enzymes were in the lower part of the normal range, the LDH was in the normal range too. But we had the tumor marker results, and both the CEA and the CA 15-3 were super high.
CEA: 49 (<3.4)
CA 15-3: 1400 (<30)
And I'm in panic mode right now. The oncologist only saw the CEA; she was not concerned; she said that the disease was stable based on the CT and the blood tests, and this fluctuation was normal. But we got the CA 15-3 later on. These tumor markers are super high. My wife is doing great, swimming, trekking, cooking, and working. She lives a very active life and does not have any symptoms, but these tumor markers concern me a lot.
Has anyone experienced super high tumor markers during treatment while the disease was stable? Thank you for sharing your experiences.
Comments
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Hi Peter! We're sorry to hear about your wife's situation, and we appreciate your reaching out to our community for support. There's no doubt that elevated tumor markers are worrying, but we know there are many factors that can affect them. Hope you get responses here from other community members who may have had similar experiences, and their insights may be helpful.
Also, we encourage you to start the conversation in The husband's and partner's corner thread, a discussion created specifically for husbands and partners of breast cancer patients. We know it can be incredibly valuable to share your story, thoughts, and feelings with others navigating similar roles. 😊
Hope this helps! Feel free to reach out to us if you have any questions. Wishing you and your wife the best.
The Mods
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Dear Moderators,
Thank you. :-)
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Hello,
Generally a single or two data points for tumor markers should not be a big concern. Instead look for a rising trend from multiple values.
Regardless, tumor markers (Ca27.29, Ca15.3, CEA, etc) do not 100% correlate with disease status for all patients at all stages. Although it seems they do for a large number of patients, particularly in metastatic setting. Below is a list of non-cancerous reasons that could cause tumor marker to rise. Cancer can also progresses without a rise in marker. To add to the confusion, sometime when a regimen is working a phenomenon named "tumor flare" can occur, causing a temporary rise in tumor marker.
It seems CEA is a bit more relevant for bone met. Bone is a common site for ER+ cancer to spread to. If there is a rising trend for either marker, ask for a full body bone scan and PET scan or whole body MRI.
- Chronic hepatitis, Liver cirrhosis, Tuberculosis, Sarcoidosis, Benign breast disease, Pelvic inflammatory disease, Endometriosis, Systemic lupus erythematosus, Lactation and pregnancy
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Hi Peter,
I agree with nnguyen and would ask for a chin down or full body petscan. Is your wife's cancer Ductal or Lobular? Sometimes Lobular is hard to pick up in scans. It is wonderful that she feels well and can be so active.
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Dear nnguyen and aprilgirl1,
Thank you for the responses. We talked to an oncologist yesterday, and he pretty much reinforced what you wrote, it can be nothing or there is some activity. He suspects that the bone might be impacted because the scans always see something on the spine, but it could not determine if it is a metastasis or a non-cancerous lesion. However, the alkaline phosphatase value was always in range, it never grew, and did not cause symptoms. He recommended a PET scan as well, so that will be the next step.
aprilgirl1: She has ductal, ER+, Ki67 is 60%. Fast growing, but responded very well to treatment so far.
Thank you,
Peter
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Hi I will definitely ask for a full PET scan.
When I had a lot of bone metastasis my markers fly high, but my alkaline phosphatase was high as well...very high. So may be something else, but is always better to check, as early detection is better.
I wish you good luck, hopefully is everything ok. Also performance status is a good sign too, and very important for the overall situation, my oncologist always told me.
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Thank you amel_83. Hopefully, everything is ok, because every other test was negative and brought good results, including liver enzymes, LDH, which accurately indicated tissue damage in the past, alkaline phosphatase, and CT scan too. Overall condition is also good. Who knows what is going on here…
I also wish you all the best, and a long disease-free period. Stay strong!
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We're thinking of you, @peter77! Please keep us updated with how your wife is doing.
—The Mods
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Dear Moderators,
My wife is still doing well; she talked to the oncologist. There will be another tumor marker test in early January, and they repeat the CT and a bone test in late January. They identified something on her spine 1,5 years ago, but they could not figure out what it was. There have been many imaging tests, including MRI, CT, and bone scan, but contradictory results. Sometimes, these results described it as a benign lesion, other times as a suspected metastasis, and other times as treated metastasis. The bottom line is that she has never received any bone-specific treatment. Now, they recheck it, and if it is a metastasis, they will extend the current therapy with a bone-specific treatment. The oncologist suspects it may be the root cause of the elevated markers.
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