CEA levels?

[tahiti]

I'm sorry if this topic has been beaten to death but I just got some results (not bad) that has me scratching my head.

Prior to my resection, I had my CEA checked by my surgeon. It came back as 2.8 with a high end of normal being 2.4.
1 month after surgery it came back at 1.4.
During chemo, I had it checked twice, 2.6 and 2.7. The reference range for this test (different lab) was a high end of normal being 5, so it's normal (but not normal if you use the range of the first test). My onc said all was ok.
Tuesday it was checked again and is 2.1 (so normal regardless of reference range is used).

I'm going to ask my onc on Monday about these different ref ranges (I read smoker's range is up to 5, non smokers are 2.5, I don't smoke) but while my concern is not necessarily a recurrence right now, it's that this is not a reliable test for me. My surgeon said it IS since it was elevated prior to surgery. But my levels were just as high during chemo and I was told it was ok.

I hope this makes sense and does anyone have any insight? Are there different "types" of CEA testing, perhaps one more sensitive than the other?

TIA!

[some]

Ah! This drives me crazy too!

We've been told not to worry too, but it is difficult and hard to reconcile that it is a good indicator when justifying treatment, but not a good one to tell us what is really going on for sure.

I don't get the number you listed below with a high end of normal being 2.4. I thought that the two companies (Roche & Seimans I believe) had different scales for normal, but didn't realize one was that low for normal.

My recent freak out over CEA was last week when they tested my husband before Folfiri/Erbitux chemo round 6. It came back as 2.1. They say that normal is below 5, but don't mention that the higher end is really for smokers. The onc even told me he had one patient that was accidentally tested for CEA and it was 25. They monitored and scanned him up and down for YEARS! It was always 25 and there was never any evidence of cancer. How can that be? Is there variation in the population?

The strange thing about my husband's CEA is it was .9 before he had surgery and they found the cancer had broken through the colon and seeded to the peritoneum. Then, it was .9 after he had HIPEC and was fully resected. They didn't/don't think it was an indicator though I understand that can change sometimes. Does anyone have stats on CEA becoming an indicator at a later time? Since we don't know what the CEA was during the Folfox treatment last year (they didn't test because it wasn't an indicator), we don't know if it was elevated then too due to the chemo itself. Chemo is known to cause CEA to elevate slightly (though I don't know how many points that allows for before concern), or so I've been told. The onc at UCSF said she doesn't like to test CEA during chemo because it freaks patients out and she is correct! We don't know why it was added to his last bloodwork since the onc said he didn't order it. I think maybe the chemo nurse who cares for my husband and is awesome may have added it.

Tia - What was your stage? Were you on adjuvant chemo?

Serena

[so-scared]

My Dh's CEA became an indicator over time. When he was diagnosed it was 4.6 with normal being under 5. He had multiple liver mets at the time he was diagnosed. For the first 17 months it was normal. Then last Oct. it was 20 ... in Dec it was 125.8. So it did become an indicator for him when initially it wasn't at all. It went down to 11 in Feb and then started creeping back up. Voila .... progression. I think it is good when it is an indicator. It gives you another way to monitor what is going on.

[janklo]

It also can be an indicator at first and then not. My daughters was off the charts, like 1100 when diagnosed and returned to normal after surgery and chemo. Then during her recurrence with peritoneal mets, it remained normal. So you never know what your body is going to do next.

[dianetavegia]

Lab Corp has a normal of 3.9 for non-smokers. It would ease your mind a lot if they'd always use the same lab with the same test methods and values.

Really good news for you is that studies have shown low CEA results at dx seem to have higher survival rates than those with highly elevated CEA's at dx. I believe it was a study from China.

[faith1]

cea markers pick up other proteins in the body.i have psoriasis and that can make my reading higher.
best

[weisssoccermom]

The first and most important thing to do is find out which test was used at each time you've had your levels tested. A few years back, the main test used was the Bayer/Seimens testing method (can't remember which company bought the other out....the two names are used interchangably). Then around September of 2009 (I believe), I was talking with my surgeon who brought it up that some labs had begun to change to the Roche assay method which does have totally different normal values. One of her patients had an issue because her levels had spiked from something less than 1 to 2+ and understandably this patient was totally freaked. My surgeon called the lab and it was only then that she learned that a new methodology was being utilized. I remember passing this information onto the board back then. So, check that out. The two levels are not the same and you just can't compare the two. So yes, there are different tests that use different reagents....and they register different normal levels. You are also quite right that the levels for smokers/non smokers are different...but keep in mind that you need to keep comparing apples to apples.....the same test to the same test. Neither test is more sensitive than another....just different. Either one is perfectly fine. The confusion comes in when you look at the different 'normal' levels and they're not at all close to each other.

Levels during chemo oftentimes come back as high.....it truly is nothing to be concerned about, particularly since yours came down after chemo was done. I know it can be disturbing but truthfully, it is nothing you need to be concerned about. You'll find that many on the board saw a spike in their CEA levels during the first part of their chemo cycles and then the numbers dropped again.

Yes, your doc is quite correct that, based on the first draw having a high normal of 2.4 (that would be the Bayer/Seimens method), you did register above normal. While it wasn't 'off the charts' high, it was, nevertheless above normal so it 'appears' that the CEA level might be a good indicator for you. Again, you have to remember that you just can't look at the numbers (from different testing methods) and compare them to one another. It's important that you find out which methodology is being used and keep getting your levels tested at the same lab in the future.

Hope this helps.
Jaynee

[dianetavegia]

Do a member search for Sam T or SamT. He's a PHD in Chemistry and does his own tests. He posted that he takes one vial of blood and does two tests each time. EVERY test is different by around .4 and if I remember correctly, he said margin of error is 10%.