Cause for Concern?

[JudyC]

My sister's resection surgery was March 30. There was no CEA recorded prior to surgery.
They started recording her CEA on April 17th. It has been recorded roughly every two weeks or so and it's as follows.
3.4 (first record)
2.6
3.0
3.3 (most recent)
Is there cause for concern with this trend?

Also... is there a scale called Abbott's? If so, this is the scale they are basing it off of.
Would this be deemed normal on that scale? High? Low?
Thanks for any help.

[SkiFletch]

Eh, not really. The only thing it MIGHT be cause for is a short-interval follow-up CEA. ie if CEAs are happening every 3 months, maybe do a 1 month just to make sure. Those kinds of values are still well within the "noise" of day to day life though wouldn't worry a bit about it at all. Those values are "normal" for either scale, although I've never heard of "Abbott's" scale...?

[CRguy]

... is there a scale called Abbott's?

I suspect your reference is to Abbott Laboratories, the supplier of the test kit methodology. Generally the "normal" non-smoker values are either < 4.0 units or < 5.0 units depending upon which test methodology is used (here in Canada anyway.)
There are older topics on the forum which deal with the transition from one system to another... but as Fletch says, those values should just be within the expected value range... if not -> retest in 4 weeks, reassess, rescan... etc. BTDT

[JudyC]

Thanks Fletch and CRguy...
These are being taken during her chemo approximately every two weeks or so. The last two increases were within a little over a month time period. That's why we were concerned. I guess we'll see if it goes up again next time. (One of the docs said it could mean that cancer cells are being killed off but seemed that he was grabbing at any explanation).
I think you are right about Abbott CRguy. We asked the nurse what scale they were using and she didn't know about that. She gave us the laboratory instead.

Thanks again.

[EdFromCT]

It's primarily the trend that's significant with CEA, not so much the average value. And in this case there's no obvious trend. For what it's worth, I had CEA values in exactly the same range during 2009 and 2010. It averaged about 3.2 both during and after chemotherapy, even though my scans and colonoscopy have always been clear after surgery.

In early 2011 my oncologist switched to the Roche assay, which often gives higher values than the Abbott test (the new reference range is up to 5.0 for my lab, for nonsmokers). Again my CEA levels have always been above normal, at 5.6, 6.3, 6, 5.7, and 5.8. But again there's no trend. Although most CC survivors who have been NED would be somewhat concerned by a value of 5.8, for my oncologist and me it has pretty much become an indication that everything is normal. Hopefully your situation is similar.

-Ed

[Gaelen]

Isn't your twin JBinNJ? And didn't she post somewhere early on that she was a smoker? CEA elevates during chemo,even in non-smokers. And you can also google "abbott" to confirm CRguy's reply that abbot isn't a scale, it's a lab.
So, as Fletch points out, not so much a concern.

[dianetavegia]

JudyC, my CEA was 3.4 after my colon resection and for 2 1/2 years. Never changed even during chemo. Went to 4 and then six months later 6.4. My CT scan showed a dot they'd noted on my very first, pre surgery, CT scan had grown to almost 1.5cm (dime size). I had a liver resection and my first CEA after that surgery was 2.1.

Are you sure there was no pre surgery CEA? The gastro I saw prior to my colonoscopy drew blood that included a CEA. We had to ask for it. Also, the hospital drew blood prior to admittance and that included a CEA. There was one drawn after surgery, in the hospital. Again, we had to ask for those to be sent to the oncologist. Might investigate!

[Ashlee H.]

Lots of excellent responses to a similar question last month -

viewtopic.php?f=1&t=34179

[weisssoccermom]

Your paperwork should say what the 'normal' ranges are. There is, to the best of my knowledge, no such thing as an "Abbott's scale". The only two assay methods that I know of are the Roche (newer test with the higher 'normal' values) and the Bayer/Seimens (I can never remember which company bought out the other) which tends to have the lower 'normal' values. Every report that I've ever seen for any type of blood test ranging from the average CBC (and all it's components) to more specific tests such as Vitamin D, CEA, thyroid, endocrine panels, etc. all show the 'normal' values on the paperwork. Doesn't the paperwork with the values on it show this information?? If so, where do the values fall in relation to what is given as 'normal'?

[EdFromCT]

Actually, there really does seem to be a CEA test kit from Abbott Laboratories. A Google search for "abbott cea" will yield numerous hits, ranging from a 1984 comparison against the Roche assay to a set of regulatory documents filed in 2012. I have no idea how many labs use which assay method, and upon checking my records I'm actually not sure whether my own pre-2011 tests were done using kits from Abbott, Bayer, or someone else. For the tests done since the start of 2011, I have a clear indication that the Roche assay was used.

Anyhow, the bottom line is still to use the reference range indicated by your own oncologist's test lab, for whatever version of the test is used. This may even vary slightly from one test lab to another when the same assay kit is used, although not by much. And even more important, don't panic based on small fluctuations that may seem to show a three-point "trend". Wait for confirmation from further tests, or better yet, from more reliable methods such as scans.

-Ed

[JudyC]

Diane- I asked and they said there wasn't one taken. Maybe it's not standard at this hospital?
Soccer- No and my concern is of a couple of increases in a row.
Ed- thank you very much for the information!

[jens22]

Those numbers are all within normal limits. Especially since she's in the middle of chemo. 2 years ago to the date I started my chemo from your sisters date. Please tell her to enjoy the summer on her non chemo times. You have to dig deep but she'll be amazed how she'll get through it.

[JudyC]

Thank you very much Jens22

[Icesk8tr]

Judy,
As others have said, those numbers are within normal limits.

I hope your sister is feeling well. We have missed seeing her on the forum.

Christine

[JudyC]

thank you Christine.... Very much appreciated.