CEA levels: I need some reassurance

Posted by natakadrit @natakadrit, Aug 19 4:23pm

My mother was diagnosed with triple-negative breast cancer on January 20 of this year. Her CEA level was normal (2.6; her hospital has a normal range between 0.0 and 3.8). She had a complete mastectomy on March 3 and started 4 rounds of TC chemo on March 30. She was T1CN0 with no lymph node involvement. On March 16, her CEA went to 3.9.
Each round of chemo was followed by an administration of Neulasta and her last chemo was on June 1. She was completely fine during chemo and has regained a healthy appetite and better sleeping patterns after all of this. However, I am concerned that after six weeks out of chemo, her CEA was retested and was 4.2. I wasn't terribly worried because I thought that it was a transient thing due to chemo and the Neulasta. However, this week she was retested and now the CEA is 5.6! Her other tumor marker, CA 27-29 have been in the normal range. Her CBC are looking great but her LDH has gone slightly over the normal threshold (262). I need some comfort or something that tells me this rise in CEA isn't due to Mets or a secondary cancer elsewhere. Her doctor doesn't want to see us until November but that just seems too far off. She wants her to have a colonoscopy. Forgive me for my ramblings but I think I shall go mad if I don't get some sort of guidance. I've scoured the internet but there really isn't anything that points to rises in CEA nearly three months of chemo cessation that doesn't have to deal with cancer. Please help!

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Hi @natakadrit, I can imagine that any change in tumor markers is worrisome. CEA or carcinoembryonic antigen (as well as other markers like CA27-29) plays a role in diagnosis, monitoring response to therapy, early detection of metastasis and determination of recurrence in patients with breast cancer. But CEA alone doesn't tell the full story. As @cindylb aptly said in another discussion "Tumor marker tests are one tool doctors have to monitor but they can have great change and variables." And @mom23boys said "people's numbers bounce around and no two people seem to have the same starting point or "normal".

Further monitoring will tell if this reading is an anomoly or needs further testing. I know that November seems like a long way off. Might you be able to ask for an earlier appointment or additional blood tests to monitor between now and November? Your mom's doctor should at least be able to explain why that isn't necessary if it isn't or order new tests.

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@colleenyoung

Hi @natakadrit, I can imagine that any change in tumor markers is worrisome. CEA or carcinoembryonic antigen (as well as other markers like CA27-29) plays a role in diagnosis, monitoring response to therapy, early detection of metastasis and determination of recurrence in patients with breast cancer. But CEA alone doesn't tell the full story. As @cindylb aptly said in another discussion "Tumor marker tests are one tool doctors have to monitor but they can have great change and variables." And @mom23boys said "people's numbers bounce around and no two people seem to have the same starting point or "normal".

Further monitoring will tell if this reading is an anomoly or needs further testing. I know that November seems like a long way off. Might you be able to ask for an earlier appointment or additional blood tests to monitor between now and November? Your mom's doctor should at least be able to explain why that isn't necessary if it isn't or order new tests.

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Hi Colleen! How have you been? I saw you mentioned me so had to stop in and say hello. I've had some minor progression, a few new lung mets and a diagnosed blockage in my superficial femoral artery which is actually working it's way out thru statins and daily aspirin and trying to walk as much as I can, which isn't much due to pain but that's what is helping. Switched to Faslodex from Letrozole due to the lung mets but I can't complain. I got a good 3 years out of my first line.
Take it easy!
Peggie

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Hi natakadrit. I don't know much about CEA tests as my Oncologist doesn't do that one. They often will go off how the patient feels, whether the patient is experiencing any pain that may indicate progression, and hence do a CT or other scan to check if they are concerned. Many of us get scanned every 3 months except when we speak up and have a concern, then maybe we'll have ours moved up. You may talk with her doctor about your concerns and see if that is something they'd consider for both you and your mom's peace of mind. I wish you the very best.

Peggie

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My oncologist doesn’t order a CEA test but she has ordered the Ca27-29 test.

I’m over three years out from my treatment and my numbers seem to go up and down for no apparent reason.

I talked to my oncologist at my last appointment and she indicated that many things can influence the numbers, especially our diet and that she realizes how much stress is brought upon us with these numbers.

Therefore, she’s going to stop testing and we’ll rely on my yearly mammogram, bloodwork and clinical exams.

Hope this helps. ♥️

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@mom23boys

Hi Colleen! How have you been? I saw you mentioned me so had to stop in and say hello. I've had some minor progression, a few new lung mets and a diagnosed blockage in my superficial femoral artery which is actually working it's way out thru statins and daily aspirin and trying to walk as much as I can, which isn't much due to pain but that's what is helping. Switched to Faslodex from Letrozole due to the lung mets but I can't complain. I got a good 3 years out of my first line.
Take it easy!
Peggie

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So good to hear from you, Peggie. I appreciate that you come to help other members when I tag you. Thank you.

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