CEA levels

[Joannerogers]

Hello all,
I'm not sure if I'm doing this correctly but I'm giving it a try. I'm 53 and was diagnosed 2 months ago with stage IV colon cancer with mets 50% of my liver, in both lobes. I've had 4 folfax treatments and 3 treatments with avastin. My CEA when diagnosed was 1845. It is now down to 1350. I'm thinking the decrease is a good sign but I sure would have liked it if it had decreased a lot more. Is there any correlation with a more dramatic drop and effective treatment?

[trbiggins]

Hi. Welcome to the board. That was a good drop in your CEA. I'm no expert so I won't make assumptions about the actual numbers. A drop in CEA usually means the chemo is doing its job. Hopefully with more treatments it will continue to come down. CEA is not a good indicator for everyone. You will know if it is for you as you progress with your treatments. As you are new to this ordeal, know that there are other treatments for liver mets. Read these boards and you will see many other options that are offered in other parts of the country. I'm assuming you are in the US. Anyway, hate that you had to join this club but I think you will find this board as a great source of information. Ask as many questions as you want to. There are a lot of people here who care and will help you with what they can.

Richard

[Joannerogers]

Thanks for the reply. I am in the U.S. Have you had a liver resection? My onco says if they can shrink the liver tumors enough, surgery can be done. I've just read a lot of bad things about liver resection.

[trbiggins]

I have not had a liver resection, but I hope to one day. That's my only hope for NED as I see it. Sadly, liver mets are hardy; at least mine are. Hopefully I can get them resected if they can be shrank enough.

Richard

[Nik Colon]

I had my surgery April 23 foot of colon and 20% of liver. What were you wondering?

[LeonW]

My onco says if they can shrink the liver tumors enough, surgery can be done. I've just read a lot of bad things about liver resection.

Chemo doesn't work all the time unfortunately, but I my case all went well. My tumors reacted well to chemo (CAPOX) from round2 when Avastin was added. Half a year later they had shrunk enough to warrant the liver resection when more than half was removed. Amazing to see how it regains almost full size in about a month! All scans since then have been clean. Am on half-yearly scans now, next one in October.

Treatments took the entire year 2013, not easy but doable; I used full 2014 for recovery and 2015 is for getting back to normal life. Have been on holidays again and we're planning to move house, etc etc. Future is back

Don't know what you have been reading, but there is also good news around. Don't start your journey in despair . . . .

Best wishes
Leon

[Joannerogers]

I have not had a liver resection, but I hope to one day. That's my only hope for NED as I see it. Sadly, liver mets are hardy; at least mine are. Hopefully I can get them resected if they can be shrank enough.

Richard

As I understand it that is the same for me. I don't know for sure, but I'm thinking they would do the colon and liver surgery at the same time but that seems like a lot do trauma to the body.

[Joannerogers]

Wow that's great! Are you saying you had a year of chemo, then had your liver resection, then a year to fully recover from the resection?, and did you have chemo after the resection also?

[Joannerogers]

I had my surgery April 23 foot of colon and 20% of liver. What were you wondering?

I was wondering about recovery time from surgery and how bad the recovery is. I'm thinking I'm a baby when it comes to pain, and since I'm rarely ill I'm not use to pain and I worry about how bad the pain might be.

Did you have both surgeries at once?

[Nik Colon]

I had my surgery April 23 foot of colon and 20% of liver. What were you wondering?

I was wondering about recovery time from surgery and how bad the recovery is. I'm thinking I'm a baby when it comes to pain, and since I'm rarely ill I'm not use to pain and I worry about how bad the pain might be.

Did you have both surgeries at once?

Yes, both at once. They did a pain block which was great, but where they had to do my liver they couldn't there as they said it was too close to my lung and could shut my breathing. The worst part for me was not being able to take deep breaths because the pain was too intense. They did give me alot of drugs but I believe when they added the torodol that is what helped the most. It's hard to remember as it was so much, but they will give you alot to deal with the pain. I would say by the second day it was doing better and I could yawn but it still hurt just not as bad. I was out in 4 days. The major pain is just in the beginning and I won't say it's easy but after the first day it gets much easier pretty quick. I know they also mentioned an epidural but they said that would be overkill and of course epidurals come with their own risk. The pain blocks I had I believe we're injections they gave me. You can ask your surgeon about what they normally do.

You can click here for a little more detail I wrote right after. It's on page 9 which this link should bring you to if you scroll down to the 2nd post
viewtopic.php?f=1&t=50104&hilit=ongoing&start=120

[JENNJ]

Joannerogers,
I'm so sorry you are in this position. My Dads starting CEA was 930 and dropped down to 56 after 6 treatments. While frantically searching the Internet to see if that was good, I came across an article that stated those with an initial response (drop in CEA and tumor shrinking per CT scan) to FOLFOX and Avastin had better responses to subsequent treatments. So that's a good drop and it's a good thing that you responded. Per the article:
"These findings indicate that the tumor response within initial three months of first-line BEV combination chemotherapy could predict efficacies of subsequent treatments and OS in the BBP strategy for mCRC patients."
Hope this helps!
Katy

[Nik Colon]

I just wanted to add about your CEA level. Although yours was high it has dropped so I would look at that as a good sign. If you look at mine I started out stage4 with mets to liver and mine was only 4.9 to start with so sometimes CEA levels don't always mean a whole lot, it is down and has progressively went down and now is at 1.2. I would say as long as it's dropping that's good. Also I am sure you're aware that they can remove up to 80% of your liver. Best wishes to you and please keep us updated.

[elise]

The liver resection isn't terrible. I won't lie, it's not fun, but really you just do it one day at a time. For me, laprascopic colon resection was easy in terms of the recovery but hard in terms of relearning how my colon worked. Liver resection was harder because of the huge incision crossing my body.

I know I was super happy to be a surgical candidate right away. Otherwise I would have done chemo with the intention of doing surgery ASAP.

Elise

[LeonW]

Wow that's great! Are you saying you had a year of chemo, then had your liver resection, then a year to fully recover from the resection?, and did you have chemo after the resection also?

Not exactly.

• was diagnosed late 2012
• Treatments between Jan and end of Oct 2013: colon resected in Jan; then half a year chemo; a month of rest used for two attempts to embolize liver (which didn't succeed); and finally liver resection in Oct
  NED since Oct 2013
• At home in pretty sad shape Nov and Dec 2013
• Pretty much all of 2014 to recover; no more treatments, only quarterly checks
• Returning to 'normal' life in 2015; future is back since Spring ; next check-up in October

Wish you all the same
Leon