Worried about rising CEA levels

There is no need for concern at those levels... Too much has been made of this test, eg Mayo is not concerned at all until you hit 20. 5 is considered normal and you are only seeing variability of the assay itself

@jthompson4, how did your appointment go with the new oncologist? What did they say about your CEA levels?

Thanks Colleen,
They said that they will test cea in 1 month but that from the cat scans and mri it looks good and the cancer was caught early. She said that cea is slightly elevated but she is not very concerned. She said cea is looked more at on the west coast than the east but I’m not entirely clear why west coast docs put more weight on it. Thanks

Hi. About 3 years ago My husband had CRC 3b. Had surgery and chemo. At first cea was 84 and after chemo it was about 1. After 1 and half year it started to rise. This rising process took 15 month till now. From 1 to 1.1, 2,2.2, 2.5,2.9 and one month ago was 4. We did CT and colonscopy,endoscopy. There was nothing just two polyps removed and some hemangium on liver and two stable small lesions in lung. We are going to do PET in one week. But i very nervous about him just 40 years old.do you think his cancer is coming back???

hi @sallyg
How did the diagnosis go with you with regards to the investigation.
hi all
My mother has always been a healthy women who had been taking care of all the house work and been a pretty active lady. She also had a strict regime when it came to food like she has only home cooked food, stick to a fish based diet, no smoking, no alcohol. Recently my mother was diagnosed with colonorectal cancer. Dr was able to operate the same out. Her CEA before the operation was 17. After removal it was coming down and it went down to 6. Her chemo started with CEA of 6 but after 1 Chemo it went to 11. After another Chemo it was 19. We go curious and did a re-test after two days and then CEA showed 21. This has got everyone panicking. PET scan and contrast scans where all showing negative and she does not seem to show any health issues other than side effects from chemo which seems to be impacting her appetite. We just wanted to figure out what other tests we might need to do to confirm is there is really an issue or not. Will colonoscopy and endoscopy help? Or should we wait and do another PET scan. The fact that the chemo seems to be killing her appetite and in turn causing headaches/mouth sores seems concerning due to which we don't want to keep continuing with her chemo if the CEA is a false positive and she has no real issues. Having said that, please can someone guide us on what might be the best next steps to diagnose. As of now she has done 4 chemos, the Dr suggested 8 cycle regime to being with so we are planning to check the CEA and PET once again after 8 cycles and might even go for a colonoscopy post that if CEA is still elevated and PET is negative. But any other suggestions will really help. Sorry if anything I have mentioned is confusing as I am tensed about all this and still trying to wrap my head on the situation as well as trying to chain the flow of thoughts.
We just need some guidance what might be the best next steps if CEA is high and PET scan is negative. Can we stop chemo and wait and watch? Or is there something we can test to confirm.

An initial rise in CEA level during effective chemotherapy in colorectal cancer patients may not always indicate progression of disease but may be a transient CEA surge in patients responding to chemotherapy. Please see previous threads on this topic. With the advances being made in other tests the utilization of CEA, for surveillance during and after chemo is no longer preferred. A much better test is circulating tumor DNA, please ask your oncologist about CTDNA testing. For a specific cancers and stages eg colon cancer stage two or three, a more refined CTDNA test called Signatera, made from genes from your tumor, has shown excellent predictive results. I would suggest you shouldn't be so worried about CEA.

Thanks a lot for sharing the details @roywalton. Much appreciated. I will check more details on CTDNA and Signatera tests. Also will go through all the previous threads in detail.

I finished my chemotherapy course seven months ago (breast cancer with involvement of 3 lymph nodes) and I finished radiotherapy five months ago. Now mammography and all tests are good. But now the c.e.a was 9.20. After two weeks, the repetition of this item was 9.17 and again after three days it was 10.48. Colonoscopy, endoscopy and pap smear were good. Except for stomach polyps and inflammation in response to pap smear.
Do you think it is possible for me to have a recurrence of cancer in this short period of time after the treatment?

I had a low Cea after surgery for cancer of the sigmoid colon. After 3 years of test ing every 3 months it started to rise slowlly. I was sent for cat scan that didn’t pick up the mets to my liver. Only when I had a pet scan were they spotted. By this time my Cea was87. Because they were spotted so early I’m having surgery in September to remove them. So my advice is please try to get a pet scan to check it out. Im very fortunate that Im in Uk and my treatment is free. Im not sure how much a pet scan costs but it could well be very important. Good luck and God bless.

Hi All, wanted to share that my mothers CEA started dropping from 5th chemo onwards. Which is a positive indicator.
Making sure I share this, so that it might help reduce anxiety since I was super anxious initially,
My mother had a tumour in her colon with CEA 17. After operation, the CEA came to 6.
However, after her first chemo, the CEA level came to 11.
Then on second chemo, the CEA level became 19. We thought this was an issue in test and re-did in two days. But now the CEA was 21.
We got so worried, we decided to not do CEA till the end of her 8 chemo cycle.
However, the Dr asked her to test the Chemo after the 5th cycle and it came to 4.5. Last week her 7th cycle was done, and this week on test the CEA is once again at 4.5
I have read different researches in the interim and according to these researches, the recurrence of cancer increases with CEA being at different level with higher probability from > 15, there are definitely exceptions to this. We are just hoping things stay the way it is and she fully recovers. We are planning to a round of CEA, PET scan and contrast CT one month after he r eight cycle to hopefully confirm things are all good.
I really want to thank all the people in this forum from the bottom of my heart for providing guidance, support and blessings during this time. Thank you so much.