1. < Breast Cancer

CA 27-29 numbers rising: Does anyone else have an issue like this?

Posted by sandyjr @sandyjr, Jul 1, 2019

My Ca 27.29 seems to be high....in the 40’s....and my oncologist says that that is probably normal for me. He checked the records from my first bc. Does anyone else have an issue like this?

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keepmoving2 | @keepmoving2 | Nov 30, 2021

Hi all - the CA 27-29 question was posted back in 2019 but still always relevant. This reply is lengthy but you will see why. I am MBC patient diagnosed in 2019 - did double mastectomy - knew that it was in my breast lymph nodes but found by my dermatologist in my skin. (Also tested positive for Lyme at same time). So didn't do radiation nor chemo but went straight to Verzenio & Armidex. My team was very clear to me that they were going to use 4 indicators to track my cancer - scans, bloodwork, skin changes & my physical well-being. Re bloodwork - couple of choices - CEA, CA 125 & CA 27.29. We did a baseline of all 3 & quickly determined that the 27.29 was my best indicator. (others were all normal) A little after my surgery but before I started my meds CA 27.29 was 59. That was above the range but some of you know that number can be much higher. A month after I started my meds it started dropping and held steady around between 14 & 28. Yes there was fluctuation but my doc always told me never worry about just one test - inflammation, bad blood draw, test issues, etc can affect a reading. He wanted a trend. Fast forward to April of 2021. My number came in at 58. Damn. Told to sit tight, but was feeling a little off (back, knee, kinda moving around) that was the physical. No skin issues. My May test comes in at a lower 52, then June 31, then a 40. But I developed other physical issues. Ascites mostly. Did scan which showed issues and did CA 125 bloodwork which jumped from 8 to 703. Breast cancer had spread to my Peritoneum & Omentum, (Not Ovarian). So my meds stopped working. Fast. New meds did not work. We pivoted to my 1st chemo infusion treatments of Taxol & Avastin, and Fulvestant butt shots in mid-June. 20 weekly Taxol just finished, maintenance will be the Avastin infusion every 3 weeks and monthly shots. Ca 27.29 has been tracking below 20 and my CA 125 now 8. Scans are clear. So - I share this story for a couple of reasons. 1st - I track my bloodwork. I do it on an Excel spreadsheet but a piece of paper works fine. Every test, every time. Starting it & filling in the old data is time consuming but I see my results and my trends. I am not going to rely on overworked docs and nurses. It lets me control something. I can see for myself what my 'normal' is and peoples numbers can be different. You can ask for other bloodwork to find your baseline. Keep copies of your reports on your scans. 2nd - numbers do fluctuate so don't panic. 3rd - assess everything else - physical and scans. 4th - stay in touch with your medical team. Work the emails and the phones. A nice squeaky wheel - talk to them about the right amount of time between tests, assessments, etc. I have made it very clear to my team that keeping me alive is a "success" or "challenge" - I will do the things I want to do - and I will be totally difficult if they don't take that seriously. Fingers crossed & prayers for all!!

REPLY
2 replies
rraw | @rraw | Nov 30, 2021

My Dr orders CA15-3 tumor marker test for me. Lots of Dr don’t order tumor marker tests for many of the reasons already mentioned. But for me it was a God sent. A fluctuating CA15-3 prompted additional tests which revealed my breast cancer had returned. I had NO other symptoms and otherwise normal blood work numbers. Without the CA15-3 my cancer likely would have gotten out of control before we even knew it was back.

REPLY
2 replies
rraw | @rraw | Nov 30, 2021
In reply to @keepmoving2 "Hi all - the CA 27-29 question was posted back in 2019 but still always relevant...." + (show)
@keepmoving2

Hi all - the CA 27-29 question was posted back in 2019 but still always relevant. This reply is lengthy but you will see why. I am MBC patient diagnosed in 2019 - did double mastectomy - knew that it was in my breast lymph nodes but found by my dermatologist in my skin. (Also tested positive for Lyme at same time). So didn't do radiation nor chemo but went straight to Verzenio & Armidex. My team was very clear to me that they were going to use 4 indicators to track my cancer - scans, bloodwork, skin changes & my physical well-being. Re bloodwork - couple of choices - CEA, CA 125 & CA 27.29. We did a baseline of all 3 & quickly determined that the 27.29 was my best indicator. (others were all normal) A little after my surgery but before I started my meds CA 27.29 was 59. That was above the range but some of you know that number can be much higher. A month after I started my meds it started dropping and held steady around between 14 & 28. Yes there was fluctuation but my doc always told me never worry about just one test - inflammation, bad blood draw, test issues, etc can affect a reading. He wanted a trend. Fast forward to April of 2021. My number came in at 58. Damn. Told to sit tight, but was feeling a little off (back, knee, kinda moving around) that was the physical. No skin issues. My May test comes in at a lower 52, then June 31, then a 40. But I developed other physical issues. Ascites mostly. Did scan which showed issues and did CA 125 bloodwork which jumped from 8 to 703. Breast cancer had spread to my Peritoneum & Omentum, (Not Ovarian). So my meds stopped working. Fast. New meds did not work. We pivoted to my 1st chemo infusion treatments of Taxol & Avastin, and Fulvestant butt shots in mid-June. 20 weekly Taxol just finished, maintenance will be the Avastin infusion every 3 weeks and monthly shots. Ca 27.29 has been tracking below 20 and my CA 125 now 8. Scans are clear. So - I share this story for a couple of reasons. 1st - I track my bloodwork. I do it on an Excel spreadsheet but a piece of paper works fine. Every test, every time. Starting it & filling in the old data is time consuming but I see my results and my trends. I am not going to rely on overworked docs and nurses. It lets me control something. I can see for myself what my 'normal' is and peoples numbers can be different. You can ask for other bloodwork to find your baseline. Keep copies of your reports on your scans. 2nd - numbers do fluctuate so don't panic. 3rd - assess everything else - physical and scans. 4th - stay in touch with your medical team. Work the emails and the phones. A nice squeaky wheel - talk to them about the right amount of time between tests, assessments, etc. I have made it very clear to my team that keeping me alive is a "success" or "challenge" - I will do the things I want to do - and I will be totally difficult if they don't take that seriously. Fingers crossed & prayers for all!!

Jump to this post

Amen!

REPLY
keepmoving2 | @keepmoving2 | Nov 30, 2021
In reply to @rraw "My Dr orders CA15-3 tumor marker test for me. Lots of Dr don’t order tumor marker..." + (show)
@rraw

My Dr orders CA15-3 tumor marker test for me. Lots of Dr don’t order tumor marker tests for many of the reasons already mentioned. But for me it was a God sent. A fluctuating CA15-3 prompted additional tests which revealed my breast cancer had returned. I had NO other symptoms and otherwise normal blood work numbers. Without the CA15-3 my cancer likely would have gotten out of control before we even knew it was back.

Jump to this post

Thanks for sharing that tumor marker test. Will learn more about it & talk to my team.

REPLY
callalloo | @callalloo | Jul 4, 2022
In reply to @cindylb "This is an interesting discussion. Tumor marker tests are one tool doctors have to monitor but..." + (show)
@cindylb

This is an interesting discussion. Tumor marker tests are one tool doctors have to monitor but they can have great change and variables. It's good to have another option in testing but again, a doctor has to be careful how it is used and interpreted. Case in point.......my husband has CA27-29 tumor marker indicator that has gone from the 40's to 177 in the past year. Granted, he has a cancer of unknown primary which the doctors are now assuming might be lung cancer. We were concerned (as the doctors were) that at 177 it shows a great deal of cancer activity in his body. We know that is happening for him..........BUT..........during our discussion it came out that several factors, in addition to cancer, could be affecting the test including his COPD, his use of inhalers and his vaping of medical marijuana (which is prescribed).
Certainly my husband has cancer and the tumor marker test is showing that but whether it's showing progression in the blood of his cancer, the doctors can't say. Finding the right mix of tests and procedures at the right time for each patient is a real 'art' and one that unfortunately is still a work in progress.
Hugs

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There are several non-cancer-indicating reasons that tumor markers can rise. (Though a non-rise is always welcome to my mind.) I was told that inflammation in the body can be indicated by a higher number.

And my cardiologist once explained that he includes blood work to monitor inflammation buy that a lot of things, including dieting or a radical change in diet can trigger localized or short-term inflammation. So he includes the test along with others as part of an overall 'picture' but, unless other tests indicate a problem, doesn't give it too much weight.

My oncologist has a similar opinion about tumor markers. A rising tumor marker will make him look further in case it's signifying something we need to pay attention to.

I wish there were one simple blood test for breast cancer, similar to the PSA blood test that men can monitor as indicative of prostate health. Unfortunately the science isn't 'there yet' but hopefully is in development.

REPLY
callalloo | @callalloo | Jul 4, 2022
In reply to @keepmoving2 "Hi all - the CA 27-29 question was posted back in 2019 but still always relevant...." + (show)
@keepmoving2

Hi all - the CA 27-29 question was posted back in 2019 but still always relevant. This reply is lengthy but you will see why. I am MBC patient diagnosed in 2019 - did double mastectomy - knew that it was in my breast lymph nodes but found by my dermatologist in my skin. (Also tested positive for Lyme at same time). So didn't do radiation nor chemo but went straight to Verzenio & Armidex. My team was very clear to me that they were going to use 4 indicators to track my cancer - scans, bloodwork, skin changes & my physical well-being. Re bloodwork - couple of choices - CEA, CA 125 & CA 27.29. We did a baseline of all 3 & quickly determined that the 27.29 was my best indicator. (others were all normal) A little after my surgery but before I started my meds CA 27.29 was 59. That was above the range but some of you know that number can be much higher. A month after I started my meds it started dropping and held steady around between 14 & 28. Yes there was fluctuation but my doc always told me never worry about just one test - inflammation, bad blood draw, test issues, etc can affect a reading. He wanted a trend. Fast forward to April of 2021. My number came in at 58. Damn. Told to sit tight, but was feeling a little off (back, knee, kinda moving around) that was the physical. No skin issues. My May test comes in at a lower 52, then June 31, then a 40. But I developed other physical issues. Ascites mostly. Did scan which showed issues and did CA 125 bloodwork which jumped from 8 to 703. Breast cancer had spread to my Peritoneum & Omentum, (Not Ovarian). So my meds stopped working. Fast. New meds did not work. We pivoted to my 1st chemo infusion treatments of Taxol & Avastin, and Fulvestant butt shots in mid-June. 20 weekly Taxol just finished, maintenance will be the Avastin infusion every 3 weeks and monthly shots. Ca 27.29 has been tracking below 20 and my CA 125 now 8. Scans are clear. So - I share this story for a couple of reasons. 1st - I track my bloodwork. I do it on an Excel spreadsheet but a piece of paper works fine. Every test, every time. Starting it & filling in the old data is time consuming but I see my results and my trends. I am not going to rely on overworked docs and nurses. It lets me control something. I can see for myself what my 'normal' is and peoples numbers can be different. You can ask for other bloodwork to find your baseline. Keep copies of your reports on your scans. 2nd - numbers do fluctuate so don't panic. 3rd - assess everything else - physical and scans. 4th - stay in touch with your medical team. Work the emails and the phones. A nice squeaky wheel - talk to them about the right amount of time between tests, assessments, etc. I have made it very clear to my team that keeping me alive is a "success" or "challenge" - I will do the things I want to do - and I will be totally difficult if they don't take that seriously. Fingers crossed & prayers for all!!

Jump to this post

I'm glad to read that monitoring tumor markers caught a problem early! My oncologist includes them too. And it reassures me because there are so few very-early indicators of breast cancer developing. Even if insurance considered covering monthly mammograms or CT scans, it would be bad medicine as excessive radiation. And a lot of breast cancers, mine included, gave no symptoms at all and were only caught by mammo and ultrasound followed by vacuum-assisted, wide-needle biopsy. The good thing about the simple blood test for tumor markers is that, if a result looks 'interesting', it's easy and inexpensive to repeat quickly. I don't really understand why all oncologists don't automatically include these tests. Data is data and every data point contributes to the big picture. A data point that seems to contradict all the others can be re-verified and, if just an anomaly, discounted.) I had the OncotypeDX test done for the same reason and am glad that it was available.

I support keeping copies of, and tracking, all of one's medical tests and results. By having a hard copy of my own medical file, I can make an appointment with a new doctor without waiting for someone else to forward a file. This helped me get a second opinion, on the same day I called for one, with an oncologist who was otherwise booked six weeks in advance but had a cancelation that very day, as I could take a copy of the medical record with me. (The doctor thought it great that I kept a current copy of all tests.) It also made a big difference during lockdown when medical facilities were radically understaffed so getting a file forwarded by my PCP was impossible for over a month.

REPLY
mamabea | @mamabea | Jul 17, 2022
In reply to @rraw "My Dr orders CA15-3 tumor marker test for me. Lots of Dr don’t order tumor marker..." + (show)
@rraw

My Dr orders CA15-3 tumor marker test for me. Lots of Dr don’t order tumor marker tests for many of the reasons already mentioned. But for me it was a God sent. A fluctuating CA15-3 prompted additional tests which revealed my breast cancer had returned. I had NO other symptoms and otherwise normal blood work numbers. Without the CA15-3 my cancer likely would have gotten out of control before we even knew it was back.

Jump to this post

What are they doing for you?

REPLY
mamabea | @mamabea | Jul 17, 2022

I had a normal mammogram, normal blood work and 48.5 CA 27.29. What can medicine do if it's cancer?

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6 replies
dianemh | @dianemh | Jul 18, 2022
In reply to @mamabea "I had a normal mammogram, normal blood work and 48.5 CA 27.29. What can medicine do..." + (show)
@mamabea

I had a normal mammogram, normal blood work and 48.5 CA 27.29. What can medicine do if it's cancer?

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My last CA 27-29 was 625 and they still can’t find any new cancer so not sure how great a test this is

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1 reply
callalloo | @callalloo | Jul 18, 2022
In reply to @mamabea "I had a normal mammogram, normal blood work and 48.5 CA 27.29. What can medicine do..." + (show)
@mamabea

I had a normal mammogram, normal blood work and 48.5 CA 27.29. What can medicine do if it's cancer?

Jump to this post

The tumor markers can respond to all kinds of things in the body, especially inflammation. A rise in the test result does not necessarily mean that there is cancer activity. My oncologist includes the blood test along with others because a rise in the number, especially a continuing upward rise, might reflect cancer so can be an early warning signal. And a decrease or no-change is good. But, for example, my cardiologist discounts the CRP test can indicate inflammation in the body because there myriad possible reasons for non-significant inflammation. He told me dieting or any significant change in eating patterns can trigger temporary inflammation of no importance.

Having noted that, there are people who've posted on Mayo Connect that their lives were saved because elevated tumor markers were the only sign that a cancer might have recurred. So I'm glad that my oncologist tracks the results because more data is better than less I think.

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