Cancer marker fluctuations: Does your oncologist test for C27-29?

None of my oncologists do this test. Maybe because the results fluctuate? Curious how many have docs who do blood testing like this.

I have heard that many doctors don’t. I wish I could hear from others if they get this test and if their scores fluctuate.
Thanks 🙂

Hi Lisa. I've found the 27-29 not to be very reliable as mine, having started at 88 back in 2019, blipped down and up over the course of the last 3 years,never going above the original number but never below 43. I'm tested monthly. It's only recently one of my meds was changed due to a slight bit of progression and my markers are up to 92 which can be sign of cancer "die off". I've been reminded that sometimes tumor markers "can be" somewhat telling but scans are what truly tell the story. You can have markers rise but no progression. I also know a lady whose numbers are in the teens but has mets all over her body and is stable. I always go by how I feel. Do I hurt anywhere? If I do, my Onc may scan to see if something new is going on. Even then I've had scans show no progression.
My feelings are that I could do without this particular marker test but my Onc insists in case the numbers ever take a huge jump, like into the hundreds.
Peggie

My first oncologist always did this test, I always thought it was odd since mine fluctuated a lot. If I asked he would say it is not a big deal, “it does that”. The doctor I have now uses scans.
Reading the post from @mom23boys I can see how my previous doctor may have viewed this test.

I can add that my oncologist at Cleveland Clinic monitors the tumor markers. My impression is that an increase in one isn't definitive since there are many things that can trigger that other than an increase in cancer cell growth. But a no-increase result is good news. I'm thinking the test can be a canary in the coal mine, a data point.

My Doc uses the CA15-3 tumor marker test. I believe it saved my life. I wasn’t having any pain, my other bloodwork was stable but the tumor marker was rising, this rising triggered a scan which showed serious progression. Had we waited until I started to experience pain or other abnormal bloodwork who knows how much progression would have occurred! Yes mine to do go up and down sometimes…. A big rise triggers a scan.

Interesting and thank you for sharing. What is “cancer die off?”

In the first few months on a new treatment (usually 60-90 days) you can see your tumor markers rise due to the meds killing off cancer. Those dead cells are released into the blood stream and can make it look like your markers are rising but it's for a good reason. Once die-off slows down you see your markers drop down. This is why they tell you not to worry too much at first if your markers rise. It is not always due to progression. I hope that explains it.
Peggie

I'm going to ask my doctor to get tumor markers checked every 3-4 months. We were doing it every 6 months but it's a simple test I can get done at Quest and is reassuring to see no change.

As a caveat, the test results can increase with some other cause like inflammation, allergic responses, etc., somewhere in the body. My cardiologist once pointed out that, for example, dieting can trigger an increase in inflammation markers which is why he doesn't pay too much attention to tests for inflammation as part of a coronary-health work-up. But does them anyway because they can be reason for looking further.

Without markers of any kind, I am still puzzled as to how we would know we have metastasis. I mean, with osteoporosis, osteoarthritis and lupus, I am not going to notice unusual pain for a good long time. So wonder if spread to bones would be evident, in reasonable time. I don't really know.

I had a CT of my lungs for another reason and there is a nodule. Apparently 50% of scans will show at least one nodule. But I will push to have a repeat in a year.

I had a brain MRI and CT, again for another reason, but without contrast so that doesn't tell me much.