CEA after CRS with HIPEC

Posted by elizabethbv @elizabethbv, Sep 26, 2022

Hi everyone,
My dad was diagnosed with Stage 4 CRC 2 years ago. He responded very well to initial treatment and had no evidence of disease for several months.

More recently, we discovered it had spread to his peritoneum. Thankfully, it had not spread much, and he was able to undergo a successful CRS/HIPEC procedure in which all visible cancer was removed.

He is about 6 weeks out of HIPEC, and his most recent blood work showed that his CEA levels have almost doubled since right before the surgery. His treatment team expected there to be some elevation because this was his 6th surgery and most intense by far, so there is a lot of scar tissue and inflammation.

He has scans scheduled for next month, but those have always come back clear since his initial surgery to remove the primary tumor.

Has anyone experienced a sharp elevation in CEA with themselves or a family member after a successful HIPEC procedure? Any insight would be really appreciated. Thank you!

Interested in more discussions like this? Go to the Colorectal Cancer Support Group.

Teresa, Volunteer Mentor | @hopeful33250 | Sep 26, 2022

Hello @elizabethbv and welcome to Mayo Connect. It is wonderful that your dad has an advocate who is looking out for him and gathering information. After having had six surgeries, I'm sure you and he are looking for a smooth recovery without a lot of stress.

On Connect, we do have a discussion group on this type of cancer treatment. Here is the link.
--HIPEC
https://connect.mayoclinic.org/discussion/hipec/
You might also want to check out a discussion group on Colorectal Cancer.

--Living with Colorectal Cancer - Meet others, Come Say Hi
https://connect.mayoclinic.org/discussion/living-with-colorectal-cancer-meet-others-come-say-hi/
I would encourage you to read the posts and learn more about experiences of others who are dealing with this disorder. I would also like to invite @virgo1952 to this discussion as she mentioned a relative who had HIPEC surgery.

I know that your dad's CEA numbers are high, but I'm wondering how he is feeling. Is he having many digestive problems? Is he having good pain control?

elizabethbv | @elizabethbv | Sep 27, 2022

In reply to @hopeful33250 "Hello @elizabethbv and welcome to Mayo Connect. It is wonderful that your dad has an advocate..." + (show)

Teresa,

Thanks so much for the reply. He’s always been very active and is only in his 50’s, and I’m thankful that his recovery has been quick and smooth. He is still having some soreness, but otherwise has been able to return to work and his regular routine.

All of this is why I was pretty caught off guard by the most recent spike in his CEA. We’ve been told the increased inflammation and scar tissue may be the cause of this. But, the uncertainty is hard to deal with.

I will look into the other resources you mentioned! Thank you!

Teresa, Volunteer Mentor | @hopeful33250 | Sep 28, 2022

In reply to @elizabethbv "Teresa, Thanks so much for the reply. He’s always been very active and is only in..." + (show)

Hi @elizabethbv

That's great that your dad feels well enough to be back to work. That must be encouraging to all of you!

Often, lab numbers can increase for reasons other than cancer. I have a rather rare form of cancer, neuroendocrine tumors, and there is a blood test that can be used (CgA) that is often elevated, but when follow up tests are done, it does not reflect any new cancer. Lab tests should not be taken as a sole indicator of cancer activity. It's important that it be combined with other tests, symptoms, etc.

Yes, uncertainty is hard to deal with, however, I'd encourage you to do your best to relax (I know it's not easy) and to enjoy the fact that your dad is getting back to his regular routine.

When is your dad's next follow up? Will his doctor be repeating the blood work and doing other tests?