DEAR DR. ROACH:
Would you please discuss the meaning and significance of blood tests to show the level of cancer markers to identify cancer and track the efficacy of treatments? I am 69 years old and have metastatic breast cancer, diagnosed in July 2022. The primary cancer was treated in 2018-2019 with surgery, chemotherapy and radiation. All during the treatment, my oncologist ordered bloodwork to monitor the level of CA-15-3 and CA 27.29. At the end of treatment, when a PET-CT scan showed no traces of cancer, the levels of the markers were in the low 20s.
During my three years of remission, my oncologist never checked the levels of the markers, stating that they weren’t diagnostic tools, but rather were used only to show trends during treatment. In July 2022, I had a breathing crisis, and CT scans showed a new mass. At that point, the markers were in the 130 range. I started treatment, and regular bloodwork showed those markers decreasing until February 2023. I’m now receiving new treatment to keep the tumor down. The last lab report showed that the cancer markers have decreased somewhat, so it looks like this therapy is working.
Could the markers have been checked regularly during my remission to identify a recurrence prior to the breathing crisis I experienced in July 2022? Are there other cancers that can be detected through labwork to identify potential cancer developing? — A.A.
ANSWER:
I am sorry to hear your cancer came back. There are a host of new treatments for metastatic breast cancer, much better than what we have had in the past.
Tumor markers, like CA-15-3 and CA 27.29, are blood tests that tend to correlate with specific cancer activity. Prostate specific antigen, or PSA, in prostate cancer is one of the most commonly known, and it’s one of the few found useful for screening. A healthy person should have very low amounts of the tumor marker, while a person with extensive cancer should have a very high level. However, no tumor marker is perfect…
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