Detecting Recurrence in Blood Work
Dear OncoLink "Ask The Experts,"
I was diagnosed with breast cancer in October 2005 at the age of 43. It was Stage I breast cancer, had 4 rounds of chemotherapy, radiation therapy, and am now on tamoxifen. I recently went in to have routine blood work done. What kind of questions and what information from that blood work should I be looking at? Are there markers that can indicate problems with a recurrence?
Carolyn Vachani RN, MSN, AOCN, OncoLink's Nurse Educator, responds:
There are a few things that your healthcare team can look for in blood work that may indicate recurrence. Calcium levels can be elevated if the cancer has spread to the bone. This tends to happen with more extensive involvement of the bone with disease. Liver function tests may be checked. Elevation in these tests can signal liver involvement with cancer, but keep in mind that many things that are not cancer can cause elevation in liver function tests. Abnormalities in a complete blood count, which evaluates white and red blood cell counts and platelets, may signify the presence of disease in the bone marrow. Again, low blood counts can also be caused by things that are not cancer. While all of these tests can be helpful, they are best used in conjunction with a history and physical exam.
Some physicians periodically check tumor markers, although it is not known how this will affect a patient's course of disease. In other words, determining that a tumor marker is elevated, and thus often treating that patient before symptoms develop, does not necessarily result in the patient living longer. While it seems obvious, studies have shown that screening cancer survivors with regular radiology tests (such as bone scans) to detect metastases, and treating the patient when cancer is detected on the scan, does not result in the patient living longer. Patients who were treated when they developed symptoms, such as pain, lived just as long as those followed with scans. You can read more about tumor markers.