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From Canyon To Cove: Some answers just lead to more questions

August 18, 2011|By Cindy Frazier

I'm cancer-free. At least that's what my last "tumor marker" test showed after a few weeks of intensive treatment with radiation and chemotherapy.

The test result caused my oncologist to smile — a rare sight.

Call me a skeptic, but I wanted to know more about the test and its veracity. The radiation doctors (three or four of whom I saw during my 5.5 weeks of daily treatments) had told me several times that this test, called CA 19-9, is considered accurate only if a prior test has shown an elevated level.

Some people are just not sensitive to the test. Furthermore, I had read that it is only accurate in a diagnosed case of pancreatic cancer, which in my case, it had been explained to me, was in question.

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"It might be or it might not be [pancreatic cancer]," the radiation doc said to me one day, out of the blue. "We'll never know for sure, but I think it is."

This statement had been nagging at me for weeks when I finally saw for myself the results of the post-surgery biopsy. Puzzling through the medical jargon, one thing was clear: The tumor wasn't in the expected location. It was next to the pancreas, not in it.

But could it have sprung from it? A special test was ordered to determine this, and it indicated a tumor of pancreatic origin. So that tipped the scales back to the middle.

So this explained the doubt in the doctors' minds. At this point my question was: Did the tumor marker test mean anything?

So I hunted down a prior test — taken before any chemo or radiation treatments — and it showed the same number. Exactly.

The "normal" result for this test is 0 to 37. My number in both was 17. Did this mean I'm not sensitive to the test? Is it worthless? Apparently not, or my oncologist wouldn't have been smiling when she gave me the results, right?

But why wasn't it zero? I asked her. If I'm getting all these treatments, it should wipe out the cancer cells completely, no?

"Everybody has cancer cells," she reassured me. "Your number is normal. I could have that number. That's good."

So was I cancer-free before the exhausting and debilitating treatments? Did I really need to subject my body — after a difficult surgery — to the further assault of radiation and a 24-hour infusion of chemotherapy?

Should I have gotten the proverbial second opinion before embarking on this treatment? Maybe. But in dealing with a serious illness, you have to listen to what is not said, as well as what is.

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