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Cea Level Is Up What Does It Mean?

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Cea Level Is Up What Does It Mean?

Postby cinnamongirl56 » Mon Dec 12, 2011 2:07 pm

Ok got a call from my Onc about the blood work done on Friday and normally during my treatments my CEA levels have been running from .9 to 1.2 and he tells me that my last blood work it is 10.6........ Which he says he feels there is active cancer and I need to be treated with a new chemo but I don't need to ruin my holidays and can wait until January. So now I am worried about this. Is that what it means when your CEA level goes up or could it mean anything else because unless we do a biopsy there is no way to say for sure it is cancer so I am confused at what I should be doing or if there is something else to look for or what. I will be going on 5fu and Irinotecan..........thanks
RC. 4/10 .. 54 yrs old
9/10 surgery
11/10 liver met
12/10 4 tx Avastan/5Fu scan
2/1/11 CT Scan liver met shrunk
3/4/11 Liver resect-lung spot
7/11 finished chemo scan 8/25
8/11 NED
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Re: Cea Level Is Up What Does It Mean?

Postby Ashlee H. » Mon Dec 12, 2011 2:16 pm

I'm assuming CEA has been a good marker for you? Of course you can always hope for a lab error, and you should have another test just to confirm it has jumped. For me, after the CEA jumps, we do a PETscan...which usually confirms the beast is back. I'll be joining the January FOLFIRI gang since I am glowing and my numbers are up.
-Ashlee
Stage IV w/liver met dx 7-1-09
KRAS Mutant
Member of the HIPECKERS (2011) and OLYMPHIANS (2012)
2/14 - standard chemo has stopped working
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Re: Cea Level Is Up What Does It Mean?

Postby RixInPhx » Mon Dec 12, 2011 2:25 pm

An increase of that much generally does mean that a known cancer has become more active.
An increase in CEA can also be caused by some other physical conditions, especially an intestinal ailment.

Do you have a suspected tumor, showing on a scan or such?
That's the only way there would be something to perform a biopsy on.

Folfiri is one of the first-line defenses against CRC (Folfox is the other), so it seems like a good approach.
A few weeks won't make a difference, since most CRC is very slow-growing.

HTH, Rick
M 61, Dx 6/10 CRC st 4, unknown primary CEA 843
2 kg peritoneal mass, met to skull; no surgery
Various regimens of all CRC chemo drugs
Mets to lung 8/11 CEA 135
Folfiri/Erb/Ava 12/11 CEA 320
No progression 5/12 CEA 192
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Re: Cea Level Is Up What Does It Mean?

Postby cinnamongirl56 » Mon Dec 12, 2011 2:28 pm

I don't know if it's been a good marker because until I went to the Onc for my second opinion my local Onc never mentioned it but I looked back at my labs and saw that when I had blood drawn that sometimes the CEA was .9 and other times it was 1.2 so I didn't even know about them.........
Rick.......yes when I had the CT scan last Thursday there was a dark spot on the scan that they couldn't identify but thought it might be cancer as when my liver was resected in March they couldn't get a clear margin on one side and so I had 7 more treatments of 5fu,oxy,avastan & lucovorin?sp.......
RC. 4/10 .. 54 yrs old
9/10 surgery
11/10 liver met
12/10 4 tx Avastan/5Fu scan
2/1/11 CT Scan liver met shrunk
3/4/11 Liver resect-lung spot
7/11 finished chemo scan 8/25
8/11 NED
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Re: Cea Level Is Up What Does It Mean?

Postby SkiFletch » Mon Dec 12, 2011 3:16 pm

Since you're going to be waiting through the new year (and I agree with that sentiment), perhaps the best way to proceed would be another CEA reading just before you plan on going back on treatment to confirm an anomoly/illness/inflamation/lab error. If that CEA is elevated further, it's more than likely cancer; if it's stable, there are more questions to answer (maybe another CT and/or biopsy); if it's decreased, anomoly/illness/etc might be the cause.
11/13/09 5cm Stage IV 9/25 lymph nodes w/2cm peritoneal met at 29 YoA
12/15/09 LA right hemi-colectomy
6/16/10 Folfox FINISHED
8/10/10 Prophylactic HIPEC
10/9/10 got Married :D

"Can any one of you by worrying add a single hour to your life."
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Re: Cea Level Is Up What Does It Mean?

Postby Seriously, WTF? » Mon Dec 12, 2011 4:52 pm

I'm with Fletch on this one.
ALWAYS IN MY HEART!
5/7/2013
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Re: Cea Level Is Up What Does It Mean?

Postby Ivona » Tue Dec 13, 2011 4:25 pm

Are you on treatment right now? Normally CEA tests aren't done when you are on tx.
dx'd Oct '08 (age 48)
T3bN2Mx
9/23 LN's
resection Nov '08
Folfox Jan '09 - March '09
Xeloda March 24/09 - July 6/09

"Yesterday is history, tomorrow is a mystery, but today is a gift. That is why it's called 'the present'. "
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Re: Cea Level Is Up What Does It Mean?

Postby Ashlee H. » Tue Dec 13, 2011 4:27 pm

Ivona - would "treatment" include chemo? I've always had my CEA/CA 19-9 tested every 2-3 weeks while on chemo.
Stage IV w/liver met dx 7-1-09
KRAS Mutant
Member of the HIPECKERS (2011) and OLYMPHIANS (2012)
2/14 - standard chemo has stopped working
3/14 - Stivarga
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Re: Cea Level Is Up What Does It Mean?

Postby CRguy » Tue Dec 13, 2011 4:57 pm

Just to add in here from the Canadian perspective (BC anyway), no, they won't always do CEA under active treatment BUT, it and other markers can be used to monitor treatment trends if they are valid for that patient. They never were for me, but we did them anyway and they stayed low even during treatment (however they were also low with a bleeding rectal primary tumour hanging out in my back door ! ).

Secondly, also a yes to Fletch...the first thing they do here with any increase is repeat a CEA in 3-4 weeks. If still up, proceed to other diagnostics.

Third, and we haven't had this much lately, but have had lots of discussion about the changeover in CEA testing and reporting techniques a while ago. So if your prior CEA was done under the old system the values will be lower than the values tested under the new system. Added to that, the Canadian guidelines were altered to bring values in line with the WHO values...so there are other issues affecting exact valuations.

Fourth (sorry didn't mean to get this longwinded :shock: ) docs will generally monitor trends not just one value and MUST always take that info back to the individual patient situation, one size does NOT fit all, and they should be treating the patient...not the lab result.

Finally...lab error. It does happen. It needs to be ruled out.
Hope that helped a bit cinnamongirl56 ??
I think we can add a new term here CEAnxiety to scanxiety :shock: but it is better IMO that they are looking seriously at anything which could give them a heads up on needing more info or treatments. Remember there are still a number of other things which cause CEA increases, so "false positives" in the CRC monitoring sense are common.

One breathe at a time, sometimes what we have to do best !

Cheers
CRguy
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Stage IV A rectal cancer/lung met
7 Year survivor
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Re: Cea Level Is Up What Does It Mean?

Postby cinnamongirl56 » Tue Dec 13, 2011 7:56 pm

I am not in active treatment right now the plan is to start treatment again in January but since I have had more time to think about this I am going to ask my Onc at JH about waiting 4-6 weeks and redo CT and Labs before going on the new treatment. The reason for this is because when we discussed options before we had my results I asked what the plan would be if CEA is NOT elevated and he said we would wait about 6 wks scan and do labs again and if it stayed that way we would wait and scan again. So if the plan is for me to start treatment about the second week in January then I will have waited 4-5 weeks anyway so why not check the CEA again to see if it was a fluke or lab error...........By the way I go next Tuesday to my local Oncologist for a port flush and labs so I am going to be very interested in seeing what my CEA will be then. Thanks for the info..........

CRguy, I guess I missed the discussion about the changeover in CEA testing and reporting techniques can you tell me where I can find the discussion I would be very interested in reading about that. I didn't realize there were old and new systems..........

CRguy wrote:Secondly, also a yes to Fletch...the first thing they do here with any increase is repeat a CEA in 3-4 weeks. If still up, proceed to other diagnostics.

Also it sounds like that some of your Onc do other things when your CEA are up and I like that idea because if I don't need the chemo yet I would prefer to wait.
What other diagnostics do they try?
Again thank you all.
RC. 4/10 .. 54 yrs old
9/10 surgery
11/10 liver met
12/10 4 tx Avastan/5Fu scan
2/1/11 CT Scan liver met shrunk
3/4/11 Liver resect-lung spot
7/11 finished chemo scan 8/25
8/11 NED
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Re: Cea Level Is Up What Does It Mean?

Postby Livelife » Tue Dec 13, 2011 8:09 pm

Ashlee H. wrote:Ivona - would "treatment" include chemo? I've always had my CEA/CA 19-9 tested every 2-3 weeks while on chemo.


Same in Australia - I have always monitored CEA and CA19.9 (every 2 weeks) whilst on treatment/chemo. Mainly because both markers have proved very sensitive to my dis-ease activity.

In approximately 20 CEA & CA19.9 tests done, I have had one lab error where the number had blipped up. However the next test showed the trend continuing down.

cheers
Murray
Riding Americas http://www.steelhorsetour.com
Mar11 DX St4 liver&lungs,37yo
CEA3213, CA19.9 13000
Apr11 XELOX+AV
June11 Got married:)
Aug11 No Ox,cont.Xel+Av
Jan12 CEA17, CA19.9 76
Primary GONE!
Xel+Av
Nov12 Markers skyhigh
FOLFIRI+Erbitux
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Re: Cea Level Is Up What Does It Mean?

Postby CRguy » Tue Dec 13, 2011 8:20 pm

cinnamongirl56 wrote:CRguy, I guess I missed the discussion about the changeover
What other diagnostics do they try?
Again thank you all.

Jaynee's post gives the summary here

here, after a retest, they would go to CT, PET, MRI...etc. whatever imaging is most appropriate (even ultrasound maybe ??) for your own situation.

Cheers
CRguy
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7 Year survivor
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Re: Cea Level Is Up What Does It Mean?

Postby cinnamongirl56 » Tue Dec 13, 2011 9:02 pm

Livelife what is CA 19.9 ?? I don't think I have seen this before.
RC. 4/10 .. 54 yrs old
9/10 surgery
11/10 liver met
12/10 4 tx Avastan/5Fu scan
2/1/11 CT Scan liver met shrunk
3/4/11 Liver resect-lung spot
7/11 finished chemo scan 8/25
8/11 NED
User avatar
cinnamongirl56
 
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Joined: Sun Aug 29, 2010 2:37 pm

Re: Cea Level Is Up What Does It Mean?

Postby cinnamongirl56 » Tue Dec 13, 2011 9:08 pm

thanks CRguy...... you have given me plenty to think about before my port flush next Tuesday......
RC. 4/10 .. 54 yrs old
9/10 surgery
11/10 liver met
12/10 4 tx Avastan/5Fu scan
2/1/11 CT Scan liver met shrunk
3/4/11 Liver resect-lung spot
7/11 finished chemo scan 8/25
8/11 NED
User avatar
cinnamongirl56
 
Posts: 156
Joined: Sun Aug 29, 2010 2:37 pm

Re: Cea Level Is Up What Does It Mean?

Postby Livelife » Tue Dec 13, 2011 9:15 pm

cinnamongirl56 wrote:Livelife what is CA 19.9 ?? I don't think I have seen this before.


CA19.9 is a carbohydrate antigen that can be expressed by carcinomas of the gastro tract. It is probably most commonly found in pancreatic cancers but can be used to monitor cancer activity for CRC. Normal levels are below 37U/ml

It is used commonly in Australia to monitor treatment progress if your cancer is sensitive to it. In my case, the trend is almost identical to CEA so it is good to have 2 tumour markers to watch as well as LDH for general inflammation.

cheers
Murray
Riding Americas http://www.steelhorsetour.com
Mar11 DX St4 liver&lungs,37yo
CEA3213, CA19.9 13000
Apr11 XELOX+AV
June11 Got married:)
Aug11 No Ox,cont.Xel+Av
Jan12 CEA17, CA19.9 76
Primary GONE!
Xel+Av
Nov12 Markers skyhigh
FOLFIRI+Erbitux
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