Had colon cancer and now CEA is rising: Scared

Thank you so much🙏🙏🙏🙏

Hello, i wanted to update that we went to oncologist today. She said we
have to do petscan or ctscan and one colonoscopy after two months.
I said that i have read cea up to 20 is not important.
She said no just for smokers.
In your case up to 5 and now its 4.6
I am soooooo worried. My husband is sooo worried. He lost his confidence.
Do you think his cancer 3b is returning?????

Can you please provide more history? When was your surgery what did they find? How many lymph nodes were sample and how many were positive? What has been the follow up since surgery? When was the last colonoscopy? What is your age? Any other symptoms? This information would be helpful.

Thank you.

Sure. He is now 42 years old. His cancer was stage 3b. 8 lymph nodes
removed and 3 was positive.
He did surgery 4 years and 9 months ago exactly.
One month after surgery started chemoterapy for about 8 or 9 months.
After that we follow up every 3 months with colonoscopy and ct scan and
this cea
There is two small noduls in lung which told us it is nothing and every
time they were unchangable
We did last petscan and last colonoscopy 10 months ago. Pet was clear and
in colonoscopy there were 3 polyps which removed and were ok.

His cea before surgery at the time of surgey was about 89 or 92 . After
surgery came to 12 and then below 1. After one year after it is about two
years that this cea is increasing from 1 or 0.65 and reached to 4.6 now.
I hope this can be enough information.
Thank you so much for this kind reply.
Also i have to apologize for my english if there are mistakes.
3 months ago gastro Doc told us his calprotectin is 210 and high and he has
inflammationin colon and gave him mezalazin tablet.
Next week we are going to gastro Doc.

Sorry i forgot to mention that his calprotectin now came to 67. It means he
doesnt have too much inflammation. Although the good range in laboratory is
under 50.
I mean that 3 months ago we thought ok this upward cea is for inflammation.
But now what????
What should i do?

Hi - thank you for all the information. It appears the treatment and follow up is as expected, however I suggest it would have been much better if the surgeon would have taken more than 20 lymph nodes to get a broader assessment of The degree of metastasis. That being said it appears that a tumor sample was not taken at time of surgery and that prevents you from being able to assess with a circulating tumor DNA test. However I would ask your doctor if he could check on that and there's a potential you could continue your screening with either the Signatera test, or a new and possibly better test being offered by the company Exact Sciences, Madison Wisconsin. The most interesting thing however is the last point you made related to calprotectin, because as you know this essay looks for inflammation in the gut due to either a bacterial infection or other inflammatory bowel syndrome.... And it just so happens that any inflammation can cause an increase in CEA. Ask your doctor about this as well. So given the relatively low CEA level and the potential for inflammatory bowel disease I will be less concerned about cancer. I hope that's the case for you!

Less than 50 μg/g: Considered normal
50-100 μg/g: May indicate mild inflammation
101-250 μg/g: Suggestive of moderate inflammation
Greater than 250 μg/g: Highly suggestive of significant inflammation

Those are the laboratory ranges and mild inflammation could result In elevated CEA. The bowel issues should be assessed as part of the colonoscopy

Good luck

One additional comment on CEA. I had stage 3B as well My CEA before surgery was 1.8, And I had a 3 cm tumor in my sigmoid colon. So I believe most institutions are not placing a great deal of reliance on CEA and I don't think you should either

Thank you so much. I hope he gets well soon and there no sign of cancer on
him.
Also Best wishes for you.
God bless you and your family