Expert: Claes-Gustaf Nordquist, M.D. - 10/24/2008

Question
QUESTION: My wife has metastatic breast cancer.  (brain, liver, lung, bone) - none in her breast interestingly enough.  It was diagnosed due to a large cyst/tumor in her brain causing symptoms.  Brain tumors have been Gamma knifed and one surgically removed.  Other tumors are being treated with Herceptin, Taxol and Arimidex.  Her CA 27.79 has gone from 230 to 30, however her CEA started at 3,300 and is still around 1,500.  I can't find anything mentioning numbers this high -- any ideas or comments?
Thanks



ANSWER: She obviously has a big burden of tumor. Her numbers indicate that that burden has decreased due to the given therapy but not as much as we would wish. She is a stage 4 case and that situation is at present unfortunately incurable. It is often controllable though at least for some time. Here that is unfortunately much more doubtful. I'm sorry to have to tell you that I expect her survival time to be measured in months at most. I'm sorry I have nothing better to tell you!


---------- FOLLOW-UP ----------

QUESTION: Perhaps I painted too grim a picture...  All brain tumors appear dead and shrinking.  There are 5-6 small tumors identified elsewhere - 2 in liver small, 2 in bone, small and one in the lung.  A CT scan yesterday showed all are 50% decreased in size.  Her health is excellent and she is only 50 yrs old.  additionally we are only 2 full months into treatment.  That's why the puzzlement over this large CEA number?

Answer
My assessment was actually unfortunately based on those tumor marker numbers and experience of previous cases where the cancer has spread to the brain. So unfortunately the picture is grim. The decrease seen is completely in line with what I wrote in my previous answer.
I do hope I will turn out to be wrong but I fear I will not.