Lung Cancer: The Meaningless Decrease and Increase of Tumour Markers After Chemotherapy

HK (S97) is a 57-year-old man from Indonesia. Blood test showed that his CA 19.9 was elevated. A CT scan on 15 March 2011 in Singapore revealed a small right pleural effusion and small nodules in his right lung.

A PET scan done on 17 March 2011 indicated:

Hypermetabolic primary tumour at the right lung apex.
Smaller subcentimeter nodules (below the resolution of PET) in the right lung, suspicious for intrapulmonary metastases.
Right pleural effusion with multiple FDG-avid pleural nodules.
FDG-avid left supraclavicular, subcarinal and right paratracheal nodes, suspicious for nodal involvement.

HK underwent chemotherapy as below:

Date	Procedure	CEA	CA 19.9
19 March 2011	Biopsy at a hospital in Kuala Lumpur.
22 March 2011	Lung cancer confirmed.
24 March 2011	Chemo – first cycle, day 1 – Gemcitabine + Cisplatin
30 March 2011	Chemo – first cycle, second injection	12Apr 11 = 85.5	12Apr 11 = 435.9
20 April 2011	Chemo – second cycle, day 1 – Gemcitabine + Cisplatin
26 April 2011	Chemo – second cycle, second injection
28 April to 1 May 2011	Fevers < 38 C, admitted to hospital
11 May 2011	Chemo – third cycle, day 1 – Gemcitabine + Cisplatin	11May11 = 123.5	11May11 = 291.6
18 May 2011	Chemo – third cycle, second injection
31 May 2011	PET scan – results showed improvement	30May11 = 90.5	30May11= 220.3
1 June 2011	Chemo – fourth cycle, day 1 – Gemcitabine + Cisplatin
8 June 2011	Chemo – fourth cycle, second injection
22 June 2011	Chemo – fifth cycle, day 1 – Gemcitabine + Cisplatin
29 June 2011	Chemo – fifth cycle, second injection
13 July 2011	Chemo delayed due to lack of blood
20 July 2011	Chemo – sixth cycle, day 1 – Gemcitabine + Cisplatin
27 July 2011	Chemo – sixth cycle, second injection
11 August 2011	PET scan – results showed no changes or further improvements	10Aug11 = 64.2	10Aug11 = 164.8
13 August to 17 Nov. 2011	Three months on Tarceva – Rashes in the face and legs.	14 Sep11 = 130.3 12 Oct 11 = 217.7	14 Sep11 = 85.7 12 Oct 11= 114.1
17 November 2011	PET scan – results showed cancer was more aggressive	16Nov 11 = 523.0	16Nov11 = 438.2
26 November 2011	Chemo – first cycle of Alimta
16 December 2011	Chemo – second cycle of Alimta	4 Jan 12 = 666.5	4 Jan 12 = 4,422.0
5 Jan12 to 1 Feb.12	Chinese herbs
3 February 2012	Started on CA Care herbs – Caspsule A + B, Lung 1 and Lung 2, Pain, Liver Tea	1 Feb. 2012 =737.5	1 Feb. 2012 = 3,917.0
	While on CA Care’s herbs	10 Mar 2012 = 629.8	10 Mar 2012 = 3,609.0

Comments

Study carefully the rise and fall of his CEA. From 85.5 it increased to 123.5 and then decreased to 64.2 after which it started to climb to 130.3 to 737.5. After CA Care’s herbs it went down to 629.8.

Study carefully the rise and fall of his 19.9. It started with 435.9. With chemotherapy it decreased to 291.6, 164.8 and eventually 85.7. However with more treatment the CA 19.9 started to increase to 114.1, 438.2 and eventually 4,422.0. After CA Care’s herbs it went down to 3,609.0.

When the CEA or CA 19.9 went down after chemotherapy, patient and his family were happy and the doctor surely is similarly happy and “believes” that the treatment has done the trick. But there is no cause for celebration because the decrease of CEA and CA 19.9 are just meaningless. It happens often – only that those concerned never want to see reality. They want to believe that chemotherapy is going to cure their cancer!

In the case of HK above, again I say, the increase and decrease of his tumour markers is meaningless. At the end of the day, this is what his lung looked like. No use and no cure.