‘So Much for my Big Plan’ to Bid Farewell to Cancer: A Reflection on Tumor Markers During Survivorship

While not all oncologists test for cancer antigens or “tumor markers” after there is no evidence of disease, I am glad mine does. This test, useful during treatment, also offers a marker to monitor after we are better in case it rises dramatically. A complicated number, one that may even be relatively low in some patients with active disease, it is considered in the context of other information from bloodwork and/or scans. Taken in perspective, a cancer antigen test adds to the ongoing process of due diligence when a person is at increased risk for future cancer or metastatic disease.

Those first years after being treated for invasive cancer, it was normal for me to be nervous, to worry about recurrence or metastatic disease. Because there was a time my tumor marker number was off the charts, seeing it drop year by year gave me hope and allayed my fears. When the number finally settled down, it was a smaller number, so stable I breathed a sigh of relief. After 10 years, this year, I was ready to be worry-free, at least about cancer. I had decided that this would be the year I would bid farewell to my cancer journey. So much for my big plan.

After receiving the most recent antigen report, I was surprised to see that the marker had risen enough to alarm me but not my oncologist, thank goodness. Because my oncologist has said everything is fine, I think everything is fine. I assume that the hiccup is related to another health issue I am tending to. Sometimes other things going on will affect tumor markers, which is why they need to be assessed by an oncologist. Even so, despite my understanding of the use of tumor markers, the surprising number was a wake-up call not to take survival for granted.

While logically I know I am fine, the week after I read the report, I found myself feeling fragile, even mortal. Now and then, I would shed an unsolicited tear without even thinking about the test. One day, to perk myself up, I played old-time Gospel music for hours, listening to all the different interpretations of a sweet afterlife. The music was soothing. I also shared my surprise with a few friends, explaining that while the increase did not mean anything significant for me, it nonetheless rattled me. It is always good to talk things out with others who will offer compassion and understanding, even about a result that is not a true cause for alarm. Emotions are emotions.

Sometimes after an experience with cancer begins to feel resolved, you begin to see it through your rear view mirror. I truly believed that would happen this year. Even the screening mammogram for my remaining breast was the most stress-free mammogram ever, despite my risk for additional breast cancer and my knowledge that my mother’s second diagnosis came about 15 years after the first. Live and learn. This year’s number taught me that there is no rest for the cancer weary. But a tumor marker is just one number, not a prophecy, and I will keep on doing the best I can (a) to savor survival and (b) to hope.

While a medical team is the ideal resource to help us navigate medical information as we work hard to be proactive survivors, no matter what stage we are in during the cancer journey, the following resources can supplement our understanding of tumor markers:

• CA 27-29, Univ. of Rochester Medical Center Health Encyclopedia
• Blood Marker Tests, Breastcancer.org
• Tumor Marker Tests, The U.S. National Library of Medicine

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