My Dad had blood test in July and August for some of the biomarkers. The numbers are shown below, where the number in the bracket is the normal range.
CEA 11.29 (5) CA125 89.70 (30.2) CA199 18.08 (30.9) CA153 >200 (32.4) CA724 4.58 (6.9) CyFRA211 7.3 (3.3) NSE 10.51 (17)
CEA 11.67(5) CA125 107.17 (30.2) CA199 36.16 (30.9) CA153 >200 (32.4) CA724 4.55 (6.9) CyFRA211 10.23 (3.3) NSE 11.16 (17)
I am concerned about these results, since some of them are above the normal range, and some also increased in the last month. Recent chest CT does not find any recurrence except a little chest fluid (46*11mm).
My questions are: Do these biomarker results indicate a possible recurrence? My Dad is off treatment right now, shall we consider some new treatment?
Wed, 08/20/2014 - 19:50
This is the background info about my father's Dx and treatment so far:
My father, age 69, non-smoker, diagnosed with stage IIIA lung adenocarcinoma (PT1bN2M0) in Dec 2013. EGFR 20 positive.
Dec 2013--May 2014, surgery followed by four rounds of cisplatin and Gemcitabine.
June 2014, radiation therapy, but was not able to finish due to severe fatigue.
June 2014 to now, no treatment, still suffers from severe fatigue.
Some of the biomarker values are high. All CT/PET examination show no sign of recurrence.
Wed, 08/20/2014 - 19:57
In the absence of other evidence, rising tumor markers are not a reliable indication of progressing cancer. As Dr. West wrote about CEA:
"...this is just a number and not something that we would be inclined to over-interpret. If someone is feeling well and has stable scans, we're happy, even if a tumor marker is creeping up. Nobody has every died from an elevated CEA. If it's concerning, it's because of it potentially reflecting worsening disease, but the more reliable measures are whether scans show enlarging cancer lesions and whether the patient is doing well or poorly clinically." - http://cancergrace.org/forums/index.php?topic=10686.msg86353#msg86353
You can read more of his comments on tumor markers here: http://cancergrace.org/lung/2007/06/16/tumor-markers-in-lung-cancer/
Wed, 08/20/2014 - 22:19
I hate seeing clinical decisions made in lung cancer based on serum tumor markers, as this is completely without any evidence to support it. I do not ever make decisions about starting treatment in lung cancer based only on a serum tumor marker result. I understand the temptation, but this is why most experts in lung cancer don't ever check these tumor markers -- with no evidence that they have ever helped a patient live a day longer for checking them, I think they are more likely to lead to bad clinical decisions.