CEA Rising but still in normal range UPDATE

[Slug]

My wife saw her onc today for her 6 month visit, and the onc said all blood work was fine, including the CEA which was 2.2
Now that is not a high number, but I have heard that it is the upwards trend that should be concerning
My wife was shocked that it went up again, but the onc gave the usual speech about not being concerned about the rise as its still in the normal range
However, she did say that she will push my wife's yearly scan up to September instead of the usual December date...which makes us even more concerned since the onc said she's not concerned, but then moved the CT scan up by 3 months or so...so why move it up?

Here are the values of the last few cea measurements

June 2012 1.6
Sept 2012 1.4
Dec 2012 1.4
March 2013 1.3
May 2013 0.78
Oct 2013 1.0
March 2014 1.4
July 2014 2.2

Initial cea before surgery was 1.5

over 3 years have passed since surgery and all has gone well, and we are just worried about any new issues arising

Do 3 successive rises of cea be an area of concern?

[justin case]

My wife saw her onc today for her 6 month visit, and the onc said all blood work was fine, including the CEA which was 2.2
Now that is not a high number, but I have heard that it is the upwards trend that should be concerning
My wife was shocked that it went up again, but the onc gave the usual speech about not being concerned about the rise as its still in the normal range
However, she did say that she will push my wife's yearly scan up to September instead of the usual December date...which makes us even more concerned since the onc said she's not concerned, but then moved the CT scan up by 3 months or so...so why move it up?

Here are the values of the last few cea measurements

June 2012 1.6
Sept 2012 1.4
Dec 2012 1.4
March 2013 1.3
May 2013 0.78
Oct 2013 1.0
March 2014 1.4
July 2014 2.2

Initial cea before surgery was 1.5

over 3 years have passed since surgery and all has gone well, and we are just worried about any new issues arising

Do 3 successive rises of cea be an area of concern?

At these CEA measures, perhaps CEA is not a good test to be concerned with. I would consult the oncologist, and see if he/she has any concerns.
Michael

[sjring]

Hi Slug,

I never had particularly high CEA levels. At initial diagnosis I was five just before or just into chemo it maxed at 12 and change. Lately it's been bouncing around between 5 & 6 which my onco says is withing the margin of error of the equipment used to conduct the test.

I tend to use the imaging results as my endpoint to worry or not. Fortunately all of my scans since the staging ones have been positive. I don't necessarily see moving up the scans by 3 months as a cause of concern. It may be more to get you to a peace of mind state sooner..or see if something is up. I wouldn't read too much into it at this point. Have the scan and take it from there.

[Deb m]

Why don't they repeat your cea in about a month and see what it is? My husband was also a stage 2 and his cea's range from 2.4 to 3.2. They go up and down all the time. He has had three in a row that have increased slightly, and then it would come back down. It's nerve racking at first, but then you see the pattern. His ct's are always good. It's so easy to get a cea in a few weeks, and if it stays the same or comes down then that would ease your worries. Just a suggestion. Hope all comes back well and ned.

deb m

[weisssoccermom]

Before you get all worried, make sure that the lab hasn't switched what type of reagent they use.....basically have they switched testing methods. There are now two very different ones that have totally different testing 'norms'. I'm not saying that the lab has....just to verify.

There is the older Bayer/Seimens test (I can't remember which one bought the other out....but same test)
and
the newer Roche test.

Each has their own normal range and you can't compare the two.

Other than that, honestly, the increase isn't that significant and still in the normal range. I know it's hard to wait but in this case, waiting for the next test is probably the best way to go. You could, however, ask your onc to repeat the CEA in a month. That way, if it drops, you can relax. If it continues to rise, then you and the onc can deal with it then instead of waiting another few months for a repeat test.

[michelle c]

I know only too well how anxiety provoking a small rise in CEA can be.

I think that you may be reading a little too much into it here - which is easy to do when you are anxious - I know! I do not think that your wife's CEA has risen three times in succession - she has had a reading of 1.4 a few times previously. This month's one is up marginally. Try not to be concerned - CEA can fluctuate. My onc told me that a CEA test done in the morning could easily be different from one taken in the afternoon on the same day.

I also believe that your onc suggested having your wife's scan brought forward to put your minds at ease rather than her thinking anything is wrong. I think it best to have her CEA retested in a month or so then hopefully it will be down a bit.

Also just check that the lab has not changed their assay system.

All the best and try not to worry. I trust my onc and if he says it's fine then I tend to believe him - it hasn't always been that way at times when it comes to my CEA

I once believed that my onc's previous secretary was being nice to me (usually she was quite dismissive and unfriendly) because she saw my CEA result and it must have been high. I got myself worked up thinking that she must have been feeling sorry for me and hence the reason for her kindness. When I finally got in to see my onc my CEA was fine. I got myself all worried because I let myself - anxiety is an awful thing. Try to relax and just see if the CEA test can be brought forward a bit.

[Slug]

Thanks for the replies and reassurances

So maybe we are a little over cautious, but its so hard to not be with this disease

[Slug]

My wife just came back from her Onc appointment, and she had a clean scan, and her cea dropped and is 1.8 now from the last value of 2.2
we were so worried because of the upwards trend the last 3 values, but this time it has dropped

We are now approaching 3 years since chemo ended and over 3 and a half years since diagnosis

I am more relieved than she is as I am always the one who worrys alot

[GrouseMan]

Congratulations... My wife's bounces around between 1.9 and 2.3 depending how active she is prior to going in and getting her blood drawn. If she has been really active - chasing her dogs at a field trial, running or on a horse for a day or so before the draw its up slightly. Her CEA was initially 110 at dx, she is also on Maintenance chemo of 5-FU/Leucovorin/Avastin once every three weeks right now. So you are doing fine.... Just be aware that other things other than cancer can make it bounce around a little.

Regards,

GrouseMan

[dianetavegia]

CEA can change by .5 if two tests are done from the same vial of blood by the same tech. Sam T who is an old member here is a chemist and tests his own blood and he is the one who told us about that. He doesn't post but is alive and well.

Also, CEA can change if you had one test done in the afternoon and the test 6 months later done in the morning. Such minor changes are probably nothing.

[Maia]

That's great to hear -congrats! Thank you for the update -you may help to so many others on the same situation, in the future!

[Bev G]

Any change to the RIGHT of the decimal place can be ignored (ie 3.2 to 3.9) As others have said there are a bunch of things that can tweak CEA a little. Wouldn't it be fantastic if we could all have all the time we've spent flipping out about our CEAs (me, too) back.

[Lee]

My understanding is upward swing AND numbers doubling.

My numbers move up and down, but stay well below the 5 mark. Your are clearly below the 5 mark also.

Can totally relate to your fears, I too question my Onc on this topic more than a few times.

Lee