Xeloda/increase CEA?

[Ashlee H.]

I'm on my second round of maintenance Xeloda. I just got the numbers of my recent cancer markers. My ONC had left me a message my tumor markers were doing fine. However, when I got the actual numbers today I became quite concerned. I do have a call out to my ONC, but you know how that goes - my urgency is not their urgency.
In the last month, my CEA has gone from 2.3 to 2.8. Ok, not a huge jump, but still a 1/2 point.
My CA 19-9, which has always been the first to go up with active cancer went from 19.9 to 23.8. Anything under 33 is considered normal, and in the past I do hang out around 22 - but I was 19 three weeks ago. A four point jump doesn't sound encouraging to me. I'll be retested again in 3 weeks and I know if it is elevated again, I'm back to playing the "Whack a Mole" game.
I dont' know if Xeloda could be responsible for the increases. My last scan showed no active cancer, but I know this just means nothing that can be picked up on the scan. My problem has always been the tiny microscopic stuff.
Has anyone on maintenance Xeloda seen a slight elevation in their CEA at the beginning?
I was just so hoping I'd have 6 months of not having to worry about the beast. I'm all set to get back to work..but if I have to go back on FOLFIRI soon, I just don't know how I'm going to manage it.
-Ashlee

[weisssoccermom]

Ashlee,
I keep a spreadsheet of my blood results so thought I would go back and take a look at my levels during my Xeloda days.
Ok, my CEA went from 1 - 1.4 and moved around in there. Now, long after treatment, my CEA still plays the up and down game. It's been as low as 0.4 then spiked up to 1.5 the next time and continued its upward climb to 1.9 then down again to 1.7 and so on. I've given up trying to figure out the darn number!

Seriously, I wouldn't worry about it. I know, I know.....easier said than done.....and it's a WHOLE lot easier to not worry about it when the next number comes in and shows a decrease!

Jaynee

[RixInPhx]

Xeloda dosing isn't as precise as the 5-FU it is substituting for, and different people 'transform' it into 5-FU at the cells differently.
The onc may have to dial-in the dosage, though usually they start at the highest allowable dosage rate and work downward in response to patient reaction/side-effects.

Today my new onc completely dropped my Xeloda from my Xeliri + Erbitux regimen, while he re-evaluates my complete Dx/treatment history.
We'll dicuss more in 3 weeks.

Hope your onc gets back to you soon.
-Rick

[rp1954]

We track ca19-9 and it has an inflammatory response component, too. So we collect an inflammation marker series, such as crp or esr, all the while trying to reduce inflammation naturally. Further, MCV can be analyzed for its elevation that 5fu or xeloda remains effective chemo. I've seen others on the boards talk about less toxic therapies added with chemo. We've had some correlation of effect that way, including tolerance of increased chemo dosages to hold or drive cea and ca19-9 down.

"a stage IV caregiver"

[michelle c]

Hi Ashlee,

I can't answer your question because I am not currently on chemo. I understand how anxiety provoking a small rise in CEA and CA19-9 is so the purpose of my post is to offer you reassurance. I posted about 3 months ago terrified about my small increase in my tumor markers, although my surgeon was not concerned. I have my tumor markers tested every three months along with other blood tests. My recent one this week showed that the markers had both gone down, what a relief!

My most recent results for CEA and CA 19-9 are:

Sept 0.9; 13
June 1.4; 19
Mar 1.1; 17
Dec 1.1; 13

Looking at my full blood picture from June my white cell count and lymphocytes were down (below normal range). I do remember that I had a trace of the flu and a little unwell at the time at the time my blood was taken (nothing really bad though), could this have something to do with the small rise? - I don't know but I just thought it was interesting enough to mention.

I know it's easier said than done, but try not to worry and to think about "what if". I'm sure that next time your tumor markers will go back down. Hang in there! Sending you positive vibes and big hugs!

[Cj51]

My CEA numbers increased by nearly a whole point and moved around a lot while I was on Xeloda as well. It always made me nervous and my onc always said, "don't worry about it".
Easy for HIM to say.

Best of luck,

Cj

[Mrsrob1000]

Well, am really worried after reading this thread. My DH CEA was 361 on Feb 2 before his surgery. CT Scans from Feb showed a 1" Lesion on his Liver and three Lung Nodules (12, 11 and 7 mm) but nothing else. The surgeons reported suspect areas on his Liver Dome and Diaphragmatic Surface during the surgery in Feb. Unfortunately, the biopsies of these never made it to Pathology nor did they show up in his scans. His CEA was rechecked on March 4 and found to be 256. Unfortunately, it was checked on Monday, May 5 and found to be 551. He is only taking Xeloda. We have an appointment with his Oncologist on Monday and he suggested in the past two other appointments that he would add Advastin into the mix if his numbers were not improving. My DH is 71 years old has other issues with Neuropathy, Psoriasis and Atrial Fib. I am so sad as his Oncologist said if the cancer was aggressive, he could pass in six (6) months. They are not going to rescan him until three months have been completed with Xeloda. In addition, he is not tolerating Xeloda very well. He is on his third round but it had to be broke up due to severe HFS (PAIN, swelling and redness) and the fact that his Psoriasis is flaring with redness, flaking and itching.

Please let me know what if you have any advice for me.

[ASTEPHENS33]

My CEA went up during my Xeloda chemotherapy and stayed up for almost a year after I finished chemo before it went down. Its under 1 now and has been for about seven years now.