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Worried about rising CEA levels
I was diagnosed with colon cancer in 2009. At that time they removed 1/3 of my colon. We did blood screening through the Mayo clinic and they came back that I had a predisposition for polyposis. The cancer had not gotten out of the colon area. Over the next 7 years I was having regular colonoscopies and the doctor removed polyps every time. He recommended that I have the reminder of my colon removed and attache the small intestine to the rectum. That surgery was done January 2016. Up until this surgery was done my CEA levels were in the 3-4 range. This past April I was in to my oncologist for my check-up and my level has increased to 6.1. We redid the test again in 6 weeks which was yesterday and they have increased by 0.3 to 6.4. I was wondering if anyone else has had this problem? I have had my mammogram done and it is clear, I don't have any more colon so it can't be colon cancer, I had a hysterectomy when I was in my 20's so that rules out ovarian cancer. Any help with this would be greatly appreciated. Thanks in advance.
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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
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5 Reactions@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
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2 ReactionsHi. 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???
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1 Reactionhi @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.
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3 ReactionsThanks 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.