NED but rising CEA

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Shân
Posts: 14
Joined: Wed Sep 30, 2015 6:50 pm
Location: Old Greenwich CT

NED but rising CEA

Postby Shân » Wed Mar 30, 2016 4:27 pm

I just got NED results on Pet and CT scans this week but CEA rose from 4.3 to 6.1 in 2 weeks. I've had severe chest pains caused by neulasta so am hoping my increased CEA is a result of inflammation not something more sinister, but difficult not to worry about it!

Anyone else had a similar experience?

Thanks

Shân
Dx 3/14. Stage 111b. Aged 51 Mother of 4
3/14 Sigmoidectomy (6 positve lymph nodes out of 15)
12 rounds of oxaliplaton, 5 F-U and leucovorin
9/14 PEP scan tumor in superaclavicular lymph node
Stage IV
10/14 Radiation,
1/15 PEP activity in the lymph nodes in abdomen.
12 rounds irinotecan and avastin
4/15 NED
9/15 PEP activity in the lymph nodes in sternum
10/15 Radiation SBRT
1/16 PEP activity in another 2 superaclavicular lymph nodes
2/16 irinotecan and avastin
3/16 NED but CEA 6.1

midlifemom
Posts: 1358
Joined: Wed Jan 15, 2014 10:58 am
Location: NJ

Re: NED but rising CEA

Postby midlifemom » Wed Mar 30, 2016 7:14 pm

Shan,
I have had rising CEA with stable CT scans for a few months now. It is frightening.
Butt, the docs seem to rely more on the CT than the CEA exactly for the reason you state - other things can impact cea, like inflammation.
You may want to have the CEA retested in a few weeks to see if it's a trend or just an anomaly.
Good luck.
Stage 3 cc - dx Jan '14 age 53, cea 2.9
t2n2m0, KRAS mutant, MSS
Folfox Feb - Aug '14
Nov '14 cea 27.7 -2 liver masses
Dec '14 left lobectomy and HAI
Jan '15 FUDR and FOLFIRI
Aug '15 fudr done, liver clear, add avastin for lungs. Cea 4.3
Feb '16 CEA rising
May '16 2 wk break then drop Iri for 6 weeks.
Jul '16 cancer grew, constricted main bile duct. Stent inserted. On break till jaundice clears. CEA climbing. Doing reduced Folfox. Allergic to Oxali.
Sep'16 chemo failed. Trial or hospice?

bluebird
Posts: 7
Joined: Sat Feb 20, 2016 4:23 pm

Re: NED but rising CEA

Postby bluebird » Thu Mar 31, 2016 2:58 am

Dear Shän,

I am a caregiver, my wife is in stage 4. She is doing chemotherapy and it is working well. from your signature,
------
Stage IV
10/14 Radiation,
1/15 PEP activity in the lymph nodes in abdomen.
12 rounds irinotecan and avastin
4/15 NED[/i]
-----
If convenient, can you share more info what you have done during this period? how the cancer cells from lymph nodes are removed? by chemo or others?

many thanks!

User avatar
Shân
Posts: 14
Joined: Wed Sep 30, 2015 6:50 pm
Location: Old Greenwich CT

Re: NED but rising CEA

Postby Shân » Thu Mar 31, 2016 5:24 am

Thanks midlifemom, feel better already with your advice :)
Dx 3/14. Stage 111b. Aged 51 Mother of 4
3/14 Sigmoidectomy (6 positve lymph nodes out of 15)
12 rounds of oxaliplaton, 5 F-U and leucovorin
9/14 PEP scan tumor in superaclavicular lymph node
Stage IV
10/14 Radiation,
1/15 PEP activity in the lymph nodes in abdomen.
12 rounds irinotecan and avastin
4/15 NED
9/15 PEP activity in the lymph nodes in sternum
10/15 Radiation SBRT
1/16 PEP activity in another 2 superaclavicular lymph nodes
2/16 irinotecan and avastin
3/16 NED but CEA 6.1

jhocno197
Posts: 817
Joined: Mon May 11, 2015 9:33 pm

Re: NED but rising CEA

Postby jhocno197 » Thu Mar 31, 2016 8:27 am

A one-time rise is not always something to worry about, particularly since it was not a huge one.
If it continues to rise over the next few times it's checked, or has a huge jump, then it might mean something concerning :).
DH - dx Dec 2014, stage IV with bladder & peritoneal involvement - non-resectable
Colostomy
FOLFOX failed
FOLFIRI failed
Tumor actually distending pelvic skin
Not a candidate for last-ditch pelvic exenteration
Stivarga finally begun 2/19/16
Tumor growing/fungating
Lonsurf started 11/18/16
Died 3/10/17

lpas
Posts: 1010
Joined: Wed Nov 19, 2014 11:11 pm

Re: NED but rising CEA

Postby lpas » Thu Mar 31, 2016 10:22 pm

I see in your signature that you just had Iri and Avastin in February. FYI, my CEA shot up from 1 to 3 during FOLFOX and I8 months later I'm still not back to my level at diagnosis. I'm betting this is inflammation from the chemo. Good luck!
11/14 Dx sigmoid CC @ 45yo
12/14 Colectomy + hysterectomy
Stage IIIB, T3N1bM0, 2/20 nodes, MSS, G2, KRAS(A146T), TP53, SMAD4, ERBB2, CEA 1.0
2/15-7/15 XELOX & celecoxib
2/19 clean scope
11/19 clean CT
Ongoing cimetidine & other targeted supplements
Mom to a 6 & 8yo

User avatar
Shân
Posts: 14
Joined: Wed Sep 30, 2015 6:50 pm
Location: Old Greenwich CT

Re: NED but rising CEA

Postby Shân » Fri Apr 01, 2016 8:05 am

Thank you all for your replies.

Bluebird in answer to your question " if convenient, can you share more info what you have done during this period? how the cancer cells from lymph nodes are removed? by chemo or others?", here goes ":-

I started chemo 3 weeks after surgery (12 rounds of oxaliplaton, 5 F-U and leucovorin) but after 8 rounds my CEA started to rise and a scan at the end of those 12 rounds revealed distant lymph node metastasis to lymph nodes in my abdomen and neck. The following 12 rounds of irinotecan and avastin took care of them after radiation for the neck lymph node and I was NED for 5 months last summer before activity in another lymph node popped up in my sternum, had that radiated with SBRT and was very much hoping that was an oligo metastasis (albeit the 2nd) as everything I have read about that and my radiation oncologist has told me, could be a one off and getting rid of it could mean a cure.

My oncologists at Greenwich Hospital and MSK say that distant lymph node metastasis is very rare as spread to liver and lungs is way more likely but that hasn't been my path so far. (Colon Talk refers to those with distant lymph node metastasis as Olypmians). I think the truth is mine is somewhat aggressive as Folfox failed to work but I'm taking the wack a mole approach and am hoping I can stay ahead and that the cancer eventually gives up!

The reappearance of my cancer in lymph nodes appears to directly correlate with my rise in CEA so am watching that very closely. I'm hoping my recent rise in CEA is related to the inflammation in my chest caused by the neulasta, so will get another blood test next week to check that, fingers crossed.

Somewhat pinning my hopes that the trails for Pembrolizumab will prove my cure in the months to come if Avastin which I am also super confident with doesn't do the trick.

How wonderful to have been NED for a year now, your wife sounds like she have been extremely lucky to have knocked it on the head, am so happy for you both.

Is she still on chemo now?

Shân
Dx 3/14. Stage 111b. Aged 51 Mother of 4
3/14 Sigmoidectomy (6 positve lymph nodes out of 15)
12 rounds of oxaliplaton, 5 F-U and leucovorin
9/14 PEP scan tumor in superaclavicular lymph node
Stage IV
10/14 Radiation,
1/15 PEP activity in the lymph nodes in abdomen.
12 rounds irinotecan and avastin
4/15 NED
9/15 PEP activity in the lymph nodes in sternum
10/15 Radiation SBRT
1/16 PEP activity in another 2 superaclavicular lymph nodes
2/16 irinotecan and avastin
3/16 NED but CEA 6.1

bluebird
Posts: 7
Joined: Sat Feb 20, 2016 4:23 pm

Re: NED but rising CEA

Postby bluebird » Mon Apr 04, 2016 4:25 am

Thanks Shan!

She is doing chemo now, just finished 6 of 12 cycles, last CT result looks promising, but no detailed info for small turmors like lymph...


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