Scared- CEA elevated slightly..

[Mhp8982]

This all started with an annual trip to my gynecologist. I had pains in my lower right side that I suspected were ovarian cysts. They did an ultrasound and did indeed find 2 moderate to large cysts. So they decided to do blood work.. Everything came back normal, even the ca-125. But my CEA came back slightly elevated at 3.3. I am not a joker nor have I ever been. I called and spoke with my OB office.. And asked them about this and they just told me I needed to get in with my family dr and get a colonoscopy. So this completely threw me for a loop. So I did this and I have it scheduled for Friday December 5th.

Okay.. So I am,pretty scared now.im 32 with no family history of any types of cancer. My dad does have a lot of intestinal issues... Diverticulitis, IBS, a bowl blockage at one time and he and both my brothers have had benign polyps removed. But never anything cancerous. I will do the colonoscopy.. That's fine. I have had issues off and on with constipation and Hemmorhoids.

It's just that me and several others, including my sister in law who is an ER doctor and my mother in law who is a nurse.. Don't know why they even tested for those things.. Saying they are not good at diagnosing, but more for following people who have already been diagnosed.. And many things can cause them to be elevated other than cancer.. Plus mine are minimally elevated. They said my cysts wouldn't cause that to be elevated.. But is it possible still? I've also wondered about having thyroid issues.. And then it also says "infections" well does that mean any infection? I just don't knowmwhat to think.. Is it common for CEA levels to be slightly elevated for other reasons?

I'm scared.. I have a two year old. I'm trying not to worry. My doctor sister in law thinks it's a cover their butt kind of thing..don't worry I am still going to have it done. I just want to be here for my son. I keep thinking we are getting somewhere.. Finding the solutions, then more keeps getting dumped on me and more tests.

Thanks for reading!!

[GrouseMan]

That's not really an elevated CEA. Normal range depending in the lab and method used can be between 5 and 1. Additionally several things can cause CEA to be a little high. Exercise, any inflammation etc. There are a lot of forum threads concerning evaluation of CEA levels on this site. For some its a good biochemical marker to monitor their treatment. Some cancer patients CEA levels could show in the thousands. For most its rarely that high, and usually for folks its a good marker for gets well above 10. Generally oncologists look at the trend up and down over time. Single measurements before a diagnosis found in the normal range are not very meaningful. Presently my wife's (having stable tumors - she is on chemo for life) is at 2.3 or so. It was as high as 110 at the beginning of her treatment over a year ago.

Personally - I don't think you have anything to worry about, but the colonoscopy is good to do and will result in a base line to watch given your dad and brothers issues. My wife didn't have risk factors either, and was always fit and athletic. At the time of diagnosis she was training for a marathon. So - better safe than sorry. Two years earlier at 50 had her GP insisted she have the scope when usually recommended for the first time she might not be in the boat she is now. But seeing as she was so fit and healthy her GP didn't push - You are doing the right thing. But no reason to worry so much. It is what it is, and hopefully if there is any issue, you have caught it as early as you possibly can!

Searching CEA on these forums gets 11124 hits on this site alone (742 pages). See: search.php?keywords=CEA&fid%5B0%5D=1

Its discussed quite a bit here.

GrouseMan

[Mhp8982]

Thank you. That made me feel so much better. I did search it on the forums.. But it's overwhelming and I wanted to share my specific situating. I see that other things can cause a slightly elevated CEA level.. I just can't find out how common it really is. Im meeting with the dr doing my colonoscopy today.. Hoping maybe he can offer some peace and reassurance.

[Mhp8982]

Also my OB office nurse had me so freaked out.. Telling me.. Get in asap.. Like I was dying. But I come to find out they barely know anything about CEA.. It's been a rough couple,of weeks. One thing after another.

[nkoske]

Carcinoembryonic Antigen

CEA is an oncofetal antigen that is elevated in ~75% of patients with a colorectal cancer recurrence. The sensitivity and specificity of CEA for detecting a postoperative recurrence depends on the threshold level considered abnormal. Using a CEA cutoff of 10 IU/L, the sensitivity and specificity for detecting any recurrence were 44% and 90%, respectively, as compared with 80% and 42%, respectively, when a cutoff of 6 IU/L was used. CEA is most sensitive for hepatic and retroperitoneal metastases and least sensitive for local recurrences and peritoneal or pulmonary disease. The levels of serum CEA may rise with a median lead-time of 4.5 to 8 months prior to the development of cancer-related symptoms. The lead-time, combined with the sensitivity for hepatic metastases offers the main justification for following patients with serial CEA monitoring. Two of the published meta-analyses concluded that only trials using CEA testing in the intensive arm demonstrated a significant improvement in survival with follow-up. These studies also included hepatic imaging, thus confounding the results and creating ambiguity as to the benefit of CEA testing alone. An elevated serum CEA triggers a complete evaluation for recurrent disease, including chest, abdominal, and pelvic imaging and colonoscopy. In cases where no site of disease can be found, an FDG-PET scan or even a second-look laparotomy may be employed to detect the site of disease recurrence. It is important to note, however, that the false-positive rate for CEA elevation during follow-up may be as high as 16%, resulting in an extensive work-up to find the suspected recurrence and unnecessary anxiety for the patient. The controversy surrounding CEA testing is not centered on the ability of serial CEA to detect a resectable hepatic metastasis, resulting in an earlier hepatic resection with curative intent, but whether earlier surgery translates into a survival benefit at the population level.

Excerpt from this paper: Surveillance after Curative Resection of Colorectal Cancer http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2796101/

As you can see probably not worth getting excited until it gets higher. From my research threshold levels can be anywhere from 5 to 15. So, 3.3 would not trigger a work-up.

[dianetavegia]

High normal for Labcorp for a female non smoker is 3.9.

If you take Biotin for your hair and nails, it can cause an elevated CEA. Any obstruction, (studies are looking at constipation) can cause an elevated CEA. Thin people have higher CEA's than obese people. IBS, IBD, Colitis, polyps can cause elevated CEA's. Being over 70 causes much higher CEA readings in healthy people.

The adjunctive use of CEA and CA125 is recommended for the classification of ovarian cysts.
http://www.ncbi.nlm.nih.gov/pubmed/10462954

http://onlinelibrary.wiley.com/doi/10.1002/dc.2840060304/abstract

Cancers associated with elevated CEA results:
Colorectal cancers ** Breast, lung, gastric, pancreatic, bladder, kidney, thyroid, head & neck, cervical, ovarian, liver, lymphoma, melanoma.

http://www.oncolink.org/treatment/article.cfm?id=296

[orcasres]

My CEA, when I was diagnosed with cancer, was only 0.5. Since then it has bounced up as high as 4.5 while I remained NED and my oncologist says it is just not a good indicator for me, which is true for some folks. Getting the colonoscopy is a great idea; we do see a greater number of younger folks showing up with cancer these days so it is good to have it checked out. Even if there is an issue they can get you early treatment. Also issues like diverticulitis can be diagnosed and treated. So try and relax; you are doing the right thing for yourself and your young family.

I will give you my standard advice about prepping for the scope. Follow the instructions carefully so that your prep is complete and the GI doc can see everything. The prep is the worst part, but it is very important to be well prepared.

Lois

[Mhp8982]

Well I went to see my dr today who is doing the colomoscopy. He had me do a ct scan because one of the cysts has a solid part to it but they couldn't really see what was going on with it. So I just did that. He wasn't really on earned with the CEA levels. Although we are still don't the colonoscopy. So scared!

[wwroam]

I have a theory that elevated bg levels can raise CEA levels as well. From january 2011 my CEA rose about 40% until I was diagnosed Type 2 diabetic in June 11. I quickly got my bg levels down to roughly non-diabetic range and my CEA dropped to the previous long term levels. No evidence other than my own experience. I'm sure that other conditions may have similar effects.

[Mhp8982]

My doctor said CEA can go up sometimes for no apparent reason at all. He has seen it many of times.

[Mhp8982]

We discovered through ct that the cyst is a dermoid cyst... 98% of the time are not cancerous. My dr thinks it is why my CEA levels are slightly elevated. But we are still doing the colonoscopy to be safe. The ct also showed that everything else inside looks good.

[Mhp8982]

High normal for Labcorp for a female non smoker is 3.9.

If you take Biotin for your hair and nails, it can cause an elevated CEA. Any obstruction, (studies are looking at constipation) can cause an elevated CEA. Thin people have higher CEA's than obese people. IBS, IBD, Colitis, polyps can cause elevated CEA's. Being over 70 causes much higher CEA readings in healthy people.

The adjunctive use of CEA and CA125 is recommended for the classification of ovarian cysts.
http://www.ncbi.nlm.nih.gov/pubmed/10462954

http://onlinelibrary.wiley.com/doi/10.1002/dc.2840060304/abstract

Cancers associated with elevated CEA results:
Colorectal cancers ** Breast, lung, gastric, pancreatic, bladder, kidney, thyroid, head & neck, cervical, ovarian, liver, lymphoma, melanoma.

http://www.oncolink.org/treatment/article.cfm?id=296

Biotin is in my multi vitamin and my b complex vitamin.

[Mhp8982]

I can't find any information that supports how biotin increases CEA levels though.

[dianetavegia]

From LabCorp's page:
In patients receiving therapy with high biotin doses (ie, >5 mg/day), no sample should be taken until at least eight hours after the last biotin administration.
Biotin is found in Brewer's Yeast!
https://www.labcorp.com/wps/portal/!ut/p/c1/04_SB8K8xLLM9MSSzPy8xBz9CP0os_hACzO_QCM_IwMLXyM3AyNjMycDU2dXQwN3M6B8JG55AwMCuv088nNT9SP1o8zjQ11Ngg09LY0N_N2DjQw8g439TfyM_MzMLAz0Q_QjnYGKIvEqKsiNKDfUDVQEAARgwHA!/dl2/d1/L0lJWmltbUEhL3dQRUJGUUFoTlFBaERhQUVBWEtHL1lJNXlsdyEhLzdfVUU0UzFJOTMwT0dTMjBJUzNPNE4yTjY2ODAvdmlld1Rlc3Q!/?testId=408053

[Mhp8982]

That link doesn't take me to anything.. Just a main page. But that means the biotin in my women's multi could make it elevated?

We did a ct scan and they found that it looks like,a dermoid cyst on my ovary.. And he thinks that is what is causing the elevated levels. Still doing colonoscopy on Friday.. Then probably surgery to remove the cyst. Still feeling anxious.