Q: Could you kindly specify what blood tests should be done and frequency of testing once the treatment has begun. I have been doing the CEA every 3 months, which is on a continual rise. My Dr knows nothing about DCA, but is willing to work with me if she is aware of what should be checked regularly. Keith

A: Dear Keith,
thank you for your question. In short, you should monitor your complete blood count, your liver enzyme levels (AST, ALT, GGT), bilirubin, CRP (C reactive protein), creatinine, urea, electrolyte levels and CEA.

•Liver enzymes are important to monitor your liver function. Rarely, but they can get elevated from the DCA and the other natural treatments that you‘re getting. They can also rise if you take too much paracetamol/acetaminophen (Tylenol), antibiotics or other drugs that can cause a liver reaction. Cytotoxic chemotherapy can as well cause liver injury and the elevation of liver enzymes as well as bilirubin.

Stop taking DCA if you experience abnormal liver enzyme (AST, ALT, GGT) elevation 2.5 times from the upper limit of normal levels. Take 1) silymarin or milk thistle, 2) essential phospholipids. Take a break till the liver enzymes return to normal levels. Then you can resume DCA.

•CEA is a tumor marker that is most useful for tracking the dynamics of cancer. The increase of CEA might indicate that the tumor is growing while the decrease of CEA might indicate that the tumor is decreasing in size. Have a regular check every 3 months to see whether the cancer is responding to therapy, also check if stabilisation is achieved.
This is how your papers should look like.

• Full blood exam / Complete blood count. It is a basic blood test that should be done in every hospital or clinic setting. 1) Reduced HGB (hemoglobin) could mean that you have iron deficiency anemia, other types of anemia or chronic bleeding. 2) Reduced WBC (white blood cells) and neutrophils are often encountered 1-3 weeks after cytotoxic chemotherapy and could indicate suppressed bone marrow function. This could lead to increased susceptibility to infections as well as fever. 3) Low platelet count (below <30) could indicate that you‘re more prone to bleeding after medical procedures or when you hurt yourself. An example of a complete blood test would be: • Basic metabolic panel. It shows the blood biochemical properties which are important to monitor the function of the kidneys, liver and other organs. 1) Glucose shows whether you have diabetes, chronic catabolism, 2) Creatinine tells a lot about your kidney function. Usually elevation above the normal level indicates decreased kidney function, dehydratation, 3) Urea also indicates your kidney function as well as catabolism intensity in the body as it‘s a byproduct of protein breakdown, 4) Calcium levels can be elevated if there are endocrine disorders present, it‘s also frequently elevated when one has cancer (especially lung cancer), 5) Albumin and protein levels are important to monitor if you‘re suffering from cachexia, in case they‘re down please consider adding more protein to your diet or additional protein supplements, 6) Sodium, potassium and chloride are important because they maintain your blood-pressure, they participate in the generation of nerve impulses. Levels below or above the norm can be dangerous in some cases. Potassium significant drops or elevation can cause heart rhythm problems. 7) Alkaline phosphatase can get elevated in case of obstruction in the bile or if metastasis are causing bone breakdown. 8) LDH is most often elevated in cases of leukemia, it signalizes that there is blood cell breakdown going on. 9) AST, ALT and GGT enzymes are important to monitor your liver enzymes. An example of a comprehensive metabolic panel would be:
• Tumor markers. These biomarkers are helpful in following the effectiveness of the therapy. Their elevated or reduced levels can help you follow the changes of your cancer. The most accurate tumor markers that correlate with the size of the tumor are – 1) CA-125 (for ovarian cancer), 2) PSA (for prostate cancer) and 3) CEA (for colon cancer). You can repeat them every 3 months to see how well is the cancer responding to treatment.

If possible, perform these blood tests at least every 1 or 2 months or before any major procedures to track your situation and discuss further steps with your oncologist.

Also, when you‘re following an anticancer regimen, it is helpful to have a Computed tomography (CT scan) or a Magnetic resonance imaging scan (MRI scan) at least once in 3 months. Ultrasonography (ultrasound) diagnostics can also provide information. CT scans are most valuable for tracking the majority of the cancers such as lung cancer, liver cancer, colon cancer, cancer which as spread and others. MRI scan is valuable for tracking

These imaging tests should provide information whether the tumor is growing or shrinking.
These tests are really helpful to build a complete image about your health as well as the changes in the tumor. Your doctor should be completely aware of these tests and explain you the importance of them in greater detail.

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