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Tumor Markers UP During Chemo??

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mysishastnbc View Drop Down
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    Posted: Nov 09 2010 at 4:17pm

My 38yr old sister is having treatment 5 of 6 today of Cytoxin/Taxotere. Her blood test result for the CA27.29 today she discovered in 2 wks went from 33 to 57, and of course we are worried sick. (normal range 0-38 she said.)

For a brief summary- She had a left side mastectomy end of July, with removal of a 2.7cm tumor and of the entire axillary nodes (16), with 1 positive node, TNBC with very high markers in all areas, i.e. Ki67-90%. The plan is to start end of Nov Carboplatin/Epirubicin, but she is still researching for the best option.

Is there anyone else who had a rise in the tumor markers during chemo? We are desperate today, for any support, thoughts, or similar situations out there?? but she will try to meet with the doctor, which may take time. 
Dx 7/2010 age-38
IDC TNBC, St-IIb, Gr-3, 2.5cm, BRCA-
8/10 MAST left side, and Axillary Dissection 1 of 16 Node+, DD Taxotere,Cytoxin x6 every 2wks - epirubicin x4 + gemzar x8.complete 2/8, rads.
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Post Options Post Options   Thanks (0) Thanks(0)   Quote mainsailset Quote  Post ReplyReply Direct Link To This Post Posted: Nov 09 2010 at 5:01pm
My onc told me that he wouldn't do tumor markers during chemo because they often came back just plain whacky. Instead he did a baseline before treatment started and then 6 weeks after and every 3 months afterwards. My current onc has agreed with that premise.
At this point in her treatment, if her doctor concurs that the tumor markers concern him/her, would he consider offering her a CT or MRI to see if she has something else going on?
dx 7/08 TN 14x6.5x5.5 cm tumor

3 Lymph nodes involved, Taxol/Sunitab+AC, 5/09 dbl masectomy, path 2mm tumor removed, lymphs all clear, RAD 32 finished 9/11/09. 9/28 CT clear 10/18/10 CT clear
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Post Options Post Options   Thanks (0) Thanks(0)   Quote TNBC_in_NS Quote  Post ReplyReply Direct Link To This Post Posted: Nov 09 2010 at 5:19pm
Hi there mysishastnbc:
 
I am so sorry your sister is going through this horrible disease! But, I am glad that you found us here on this site! We do have a wonderful bunch of people here that I am sure will be right here to answer your questions. 
 
Personally, my onc did not do tumor markers at all.  After my treatment was over, it was over. 
 
I did find a lump in the same breast and had mammo and u/s which then warranted a biopsy under u/s.  I had that on the 21st of Oct and at that time, the rad could not see the lump??? Told me to come back in six months....I am still waiting on BRCA test results after six and one half months.  I see your sister is negative (that is a good thing.)  I am not sure if these tests are fool proof or not.  Every study has a different theme and one says it is good the other says there are too many false positives, so who really knows.  I would say, if your sister is having symptoms, then get it checked out, but other than that, we just leave well enough alone...
 
If you are really concerned, then your sister should as for an MRI or CT scan to rule out any new recurrences.  I had a bone scan last week to rule out mets in the ribs, (they have been sore for over three months now.)  If your sister is still concerned, then maybe a second opinion may help. 
 
If I am + for BRCA then I will go to Toronto to see Dr. Dent who is the guru for TNBC.  Other than that, I am at the mercy of the environment, like the rest of us.
 
Thank you for caring and sharing about your sister, she is very lucky to have you by her side. 
Bless you both,
Helen in NS
Diag@57TNBC04/092.5cm Lquad 05/09 TCx4Radsx30CT03/01/10 FU03/31/10ClearBRCA- 01/2011 RTNBC BMX 06/14/2011~2013 clear
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Post Options Post Options   Thanks (0) Thanks(0)   Quote mysishastnbc Quote  Post ReplyReply Direct Link To This Post Posted: Nov 09 2010 at 5:54pm
I can't tell you how much I appreciate your support and comments! Thank you to Mainsailset and Helen- I just read them to my sis while she's getting chemo. I am hoping and praying for the best for her, and all of you; she has 2 little girls 2 and 5 yrs old. 
Dx 7/2010 age-38
IDC TNBC, St-IIb, Gr-3, 2.5cm, BRCA-
8/10 MAST left side, and Axillary Dissection 1 of 16 Node+, DD Taxotere,Cytoxin x6 every 2wks - epirubicin x4 + gemzar x8.complete 2/8, rads.
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Post Options Post Options   Thanks (0) Thanks(0)   Quote dmwolf Quote  Post ReplyReply Direct Link To This Post Posted: Nov 09 2010 at 6:51pm
Tumor markers reflect liver unhappiness and gut infections/turn-over.   Since chemo taxes and inflames the liver and attacks the GI tract, I would think all those epithelial cells floating around could easily elevate a tumor marker.  I'm really surprised they even took one during treatment.   Try not to worry (easier said than done!).

love,
d
DX 2/08@43 stg II IDC; gr2,0 nodes. Neoadj chemo, first ACx2 (fail) then CarboTaxotereX6(better). Lump, Rads done 11/08; Clodronate. False alarm queen: PetCT lung & TM marker. NED. PBM w/recon 9/10.
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Post Options Post Options   Thanks (0) Thanks(0)   Quote 123Donna Quote  Post ReplyReply Direct Link To This Post Posted: Nov 09 2010 at 6:57pm
Hello!  I echo the comments of the previous posts.  My onc waited until I was done with chemo before doing the CA 27.29 tumor markers.   Like Denise said, it could be problems with the liver.  Mine elevated at one time, but it was due to surgery and a trial drug I was taking.  The next time I was tested, the tumor markers were back in the normal range.

Donna
DX IDC TNBC 6/09 age 49, Stage 1,Grade 3, 1.5cm,0/5Nodes,KI-67 48%,BRCA-,6/09bi-mx, recon, T/C X4(9/09)
11/10 Recur IM node, Gem,Carb,Iniparib 12/10,MRI NED 2/11,IMRT Radsx40,CT NED11/13,MRI NED3/15

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Post Options Post Options   Thanks (0) Thanks(0)   Quote mysishastnbc Quote  Post ReplyReply Direct Link To This Post Posted: Nov 09 2010 at 7:26pm
Incidentally, she saw her doctor last Thursday, and he did not mention it, the tests being from 2wks ago and 4wks ago. Today while getting chemo, she asked for her blood results, being in the medical field she wanted to see, and saw the CA27.29 herself. She will call him tonight! One day to the next, or even getting by an hour at a time is difficult. I have found great comfort reading this forum. I think I was able to offer her some comfort today from your posts showing elavated but not to worry. She has had bone pain in the left femur, but most likely attributing to the Neulasta shot, and bone marrow overworking around 4-5 days after chemo especially. She got an order to do an MRI for that, but when the pain came in the other side, too, she is leaning towards the shot as the root cause for now, since she's hitting the taxotere/cytoxin every 2 wks and just finished the 6th today-yeah! No doubt very hard on the liver and kidneys, though.
Dx 7/2010 age-38
IDC TNBC, St-IIb, Gr-3, 2.5cm, BRCA-
8/10 MAST left side, and Axillary Dissection 1 of 16 Node+, DD Taxotere,Cytoxin x6 every 2wks - epirubicin x4 + gemzar x8.complete 2/8, rads.
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Post Options Post Options   Thanks (0) Thanks(0)   Quote LRM216 Quote  Post ReplyReply Direct Link To This Post Posted: Nov 09 2010 at 7:35pm
Normal.  In fact, oncologists that use tumor markers won't even take them for a few months after chemo has ended.  Best of luck to your sister (and to you too!).
Linda - diagnosed at age 62
Diag 2/23/09 IDC 1.2 cent. IDC right breast,Stage 1, Grade 3,0/1 nodes - Triple Neg
4 DD AC every two weeks, 1 Dd Taxol, then 3 Taxotere every three weeks - rads x 33
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Post Options Post Options   Thanks (0) Thanks(0)   Quote 123Donna Quote  Post ReplyReply Direct Link To This Post Posted: Nov 09 2010 at 7:38pm
I'm sure the bone pain is from the Neulasta shot.  I'd get terrible bone pain about 2 - 3 days after the shot.  You could almost feel the the throbbing in the bones, mostly back and legs.  Many on this site have said to take Claritin (not D) to help with the pain.  I tried it my last treatment and it helped.  So does a heating pad and warm bath. 

Donna
DX IDC TNBC 6/09 age 49, Stage 1,Grade 3, 1.5cm,0/5Nodes,KI-67 48%,BRCA-,6/09bi-mx, recon, T/C X4(9/09)
11/10 Recur IM node, Gem,Carb,Iniparib 12/10,MRI NED 2/11,IMRT Radsx40,CT NED11/13,MRI NED3/15

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Post Options Post Options   Thanks (0) Thanks(0)   Quote mysishastnbc Quote  Post ReplyReply Direct Link To This Post Posted: Nov 11 2010 at 6:20pm
My sis has the PET body scan scheduled for tomorrow morning, partially due to the femur pain, also. I've tried to reassure her, I feel you are all correct, that the liver could be overreacting, not giving correct readings at this time, or even microscopic cancer cells being destroyed can cause the rise in cancer antigen 27.29. Hopefully, this will give her some peace of mind with positive results!
Helen in NS- did you get your results from the bone scan last week? Thanks again for taking time for all your comments! I need this site! Love and Concern to All, Janet
Dx 7/2010 age-38
IDC TNBC, St-IIb, Gr-3, 2.5cm, BRCA-
8/10 MAST left side, and Axillary Dissection 1 of 16 Node+, DD Taxotere,Cytoxin x6 every 2wks - epirubicin x4 + gemzar x8.complete 2/8, rads.
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Post Options Post Options   Thanks (0) Thanks(0)   Quote hhhh Quote  Post ReplyReply Direct Link To This Post Posted: Nov 11 2010 at 6:44pm
mysishastnbc, my mom had a terrible and i mean TERRIBLE backache after her first cycle of chemo...turned out it was the neulasta shot and a couple of extra strength tylenol took care of it. thankfully it hasn't happened since. keep us posted on your sister's scan/mri results.
Daughter of one of the most amazing women in the world...

she was diagnosed 8/2010, had lumpectomy, TAC X 6, rads.

52 yrs, stage 2A (3cm, no nodes), triple neg, grade 3
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Post Options Post Options   Thanks (0) Thanks(0)   Quote LRM216 Quote  Post ReplyReply Direct Link To This Post Posted: Nov 11 2010 at 9:57pm

Add me to the list of neulasta sufferers.  I was soooooo bad each of my 8 rounds of chemo, that I had to end up taking narcotics around the clock (1/2 dose every 6 hours) just to be able to cope with the pain.  Mine was truly severe.  God forbid this crap ever comes back, I don't fear the chemo half as much as I do the neulasta shots.  They just about did me in, but my blood counts tanked after each round of chemo, so I had to have them.  Ugh, nasty, nasty side effects from that.  I wish your sister all the best and that nothing at all shows up on the PET.

Linda

Linda - diagnosed at age 62
Diag 2/23/09 IDC 1.2 cent. IDC right breast,Stage 1, Grade 3,0/1 nodes - Triple Neg
4 DD AC every two weeks, 1 Dd Taxol, then 3 Taxotere every three weeks - rads x 33
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Post Options Post Options   Thanks (0) Thanks(0)   Quote zoomommy2 Quote  Post ReplyReply Direct Link To This Post Posted: Nov 11 2010 at 11:04pm
I had Neupogen shots instead of Neulasta.  I had them 10 days out of every 14 day cycle and had the bone pain.  Sure wish I'd known about using Claritin.  Not sure if it would have helped the pain, but I sure would have tried it.  The Neupogen worked, however, and I never had to miss a round of the DD A/C.
Lee in Denver
dx6/09,stageII,gr3,(L)mastectomy 7/09,ACx4,Taxolx7,Avastin study,gall bladder surgery 1/10,4/11 Stage 4, mets to lung, 4/11 Started Taxotere and Xeloda, 5/11 Taxotere stopped, off Xeloda
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Post Options Post Options   Thanks (0) Thanks(0)   Quote snugltz Quote  Post ReplyReply Direct Link To This Post Posted: Nov 11 2010 at 11:20pm
I am with you LMR216,  The Neulasta was awful.  I am five weeks out of my last chemo treatment and I still have pains.  Not sure how much is chemo and how must is Neulasta but at least some is.  My oncologist said people come in crawling they are in so much pain from the Neulasta.  Now that was a bit of an exageration, but still says how much it bothers some.
1 cm, 0/2 neg nodes, lumpectomy 6/16/10, cytoxin/taxotere 4x every three weeks, rad start 11/8 33X
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Post Options Post Options   Thanks (0) Thanks(0)   Quote LRM216 Quote  Post ReplyReply Direct Link To This Post Posted: Nov 12 2010 at 10:01am
Snugltz -  I literally felt like I WAS crawling into work some days. 
Zoomommy - I did the Claritin thingy - oh well, so much for that - didn't do squat for me.  I envied all the gals that said it worked for them.  With the amount of pain I would have swallowed lye if someone said that worked! 
Linda - diagnosed at age 62
Diag 2/23/09 IDC 1.2 cent. IDC right breast,Stage 1, Grade 3,0/1 nodes - Triple Neg
4 DD AC every two weeks, 1 Dd Taxol, then 3 Taxotere every three weeks - rads x 33
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Post Options Post Options   Thanks (0) Thanks(0)   Quote mainsailset Quote  Post ReplyReply Direct Link To This Post Posted: Nov 12 2010 at 10:24am
I had the Neulasta shots but they overworked for me. I was giving the shots to myself at home and so I cut back the number of shots until I could even out the results. In the end I was giving myself 2-3 shots a week instead of the 5 that were prescribed. I never had any bone pain...
dx 7/08 TN 14x6.5x5.5 cm tumor

3 Lymph nodes involved, Taxol/Sunitab+AC, 5/09 dbl masectomy, path 2mm tumor removed, lymphs all clear, RAD 32 finished 9/11/09. 9/28 CT clear 10/18/10 CT clear
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Post Options Post Options   Thanks (0) Thanks(0)   Quote LRM216 Quote  Post ReplyReply Direct Link To This Post Posted: Nov 12 2010 at 10:46am
Mainy - are you sure that wasn't neupogen?  I never heard of Neulasta being given in more than 1 shot 24 hrs. after chemo?  I heard they hurt though, too.  Guess anything regenerating the bone marrow will hurt.  I swore I could feel the marrow churning in my bones and it wasn't a pleasant feeling either!
Linda - diagnosed at age 62
Diag 2/23/09 IDC 1.2 cent. IDC right breast,Stage 1, Grade 3,0/1 nodes - Triple Neg
4 DD AC every two weeks, 1 Dd Taxol, then 3 Taxotere every three weeks - rads x 33
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Post Options Post Options   Thanks (0) Thanks(0)   Quote mainsailset Quote  Post ReplyReply Direct Link To This Post Posted: Nov 12 2010 at 3:32pm
Sorry, brain dead, yes you are right it was the neupogen. I gave myself the shots and never had any bone pain, just the over generation of the White count.
dx 7/08 TN 14x6.5x5.5 cm tumor

3 Lymph nodes involved, Taxol/Sunitab+AC, 5/09 dbl masectomy, path 2mm tumor removed, lymphs all clear, RAD 32 finished 9/11/09. 9/28 CT clear 10/18/10 CT clear
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Post Options Post Options   Thanks (0) Thanks(0)   Quote zoomommy2 Quote  Post ReplyReply Direct Link To This Post Posted: Nov 12 2010 at 6:28pm
I felt "some" relief when it was explained to me that the pain was the bone marrow regenerating.  At least there was a reason for the pain.
Linda, sorry the Claritin didn't work for you.  I agree, lye would have been tasty if it had actually worked!
Lee in Denver
dx6/09,stageII,gr3,(L)mastectomy 7/09,ACx4,Taxolx7,Avastin study,gall bladder surgery 1/10,4/11 Stage 4, mets to lung, 4/11 Started Taxotere and Xeloda, 5/11 Taxotere stopped, off Xeloda
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Post Options Post Options   Thanks (0) Thanks(0)   Quote LRM216 Quote  Post ReplyReply Direct Link To This Post Posted: Nov 12 2010 at 6:33pm
Zoomommy - Lol!
 
Mainy - you? brain dead?  Never, sweet sister, never.
 
Hugs,
Linda
Linda - diagnosed at age 62
Diag 2/23/09 IDC 1.2 cent. IDC right breast,Stage 1, Grade 3,0/1 nodes - Triple Neg
4 DD AC every two weeks, 1 Dd Taxol, then 3 Taxotere every three weeks - rads x 33
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