How Often Should My CEA Be Tested?

Please feel free to read, share your thoughts, your stories and connect with others!
testing765
Posts: 306
Joined: Tue Aug 19, 2014 9:41 am

How Often Should My CEA Be Tested?

Postby testing765 » Tue Apr 18, 2017 3:23 am

Hi. I saw my oncologist for a quarterly follow up recently. He switched me from quarterly follow ups to semi-annual follow ups. These follow ups include recording vitals, physical exam and review of blood work including CEA. I had surgery in 9/14 and I finished folfox chemotherapy toward the end of 3/15. My CEA has been within the normal range since it was first recorded in 9/14.

So I am now at two years since I completed chemotherapy. I just wanted to know whether a switch to semi-annual oncologist follow ups is considered medical standard of care based on my factual circumstances. Part of me feels positive that my oncologist is confident enough in my condition to expand the timing of my follow up visits but another part of me is concerned that I may miss a sign of a problem (ie. elevated CEA) as soon as possible. So is the expanded time between testing of my CEA appropriate at this juncture? Thank you for your insight.
male-age 44 at diagnosis
8/14-clnscopy
8/14-CT scan,no mets
9/14-left colectomy,CEA 2.2 before surgery
pT2pN2bpM0
3 cm tumor in dscnding colon
7/23 pos LNs
low grade MSI stable
10/14-start folfox
1/15-CT & PET scan and sigmdoscopy- no mets
3/15-finish folfox
9/15- colonoscopy- 3 polyps removed
10/15- CT scan, NED
10/16- CT scan, NED, CEA 1.6
10/14 1.9; 4/15 2.8; 5/15 2.4; 9/15 2.8; 12/15 3.1; 1/16 3.0; 4/16 2.5; 7/16 2.5; 10/16 1.6; 1/17 1.9

Jacques
Posts: 408
Joined: Sun Dec 28, 2014 10:38 am

Re: How Often Should My CEA Be Tested?

Postby Jacques » Tue Apr 18, 2017 3:41 am

testing765 wrote:Hi. I saw my oncologist for a quarterly follow up recently. He switched me from quarterly follow ups to semi-annual follow ups. These follow ups include recording vitals, physical exam and review of blood work including CEA. I had surgery in 9/14 and I finished folfox chemotherapy toward the end of 3/15. My CEA has been within the normal range since it was first recorded in 9/14.

So I am now at two years since I completed chemotherapy. I just wanted to know whether a switch to semi-annual oncologist follow ups is considered medical standard of care based on my factual circumstances. Part of me feels positive that my oncologist is confident enough in my condition to expand the timing of my follow up visits but another part of me is concerned that I may miss a sign of a problem (ie. elevated CEA) as soon as possible. So is the expanded time between testing of my CEA appropriate at this juncture? Thank you for your insight.

There are several members here who think that a more frequent testing of CEA and the use of additional biomarkers is a better way to go than just blindly following the "medical standard".

Here is one post, for example:
http://coloncancersupport.colonclub.com/viewtopic.php?f=1&t=52174&p=408261#p408261
DX(2012): RC
Stage IIc,T4b N0 M0 L0 PN1 H0 D0 P0 I1
LAR
MSI: not tested
Chimio-radiothérapie
Chimiothérapie adjuvante : capécitabine + oxaliplatine
CEA < 1.0,
5 years NED,
End of 6-month follow-ups: 7/2017
----
Info links:
Create Your Signature
How to Select a Surgeon
List of Forum Features
Colorectal Cancer Stages (TNM)

jhocno197
Posts: 809
Joined: Mon May 11, 2015 9:33 pm

Re: How Often Should My CEA Be Tested?

Postby jhocno197 » Tue Apr 18, 2017 9:11 am

It seems like CEA may not be a good marker for you, anyway. I would not rely on CEA testing to try to catch a recurrence.
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

Thetoad
Posts: 132
Joined: Mon Nov 23, 2015 2:46 am
Location: New Zealand

Re: How Often Should My CEA Be Tested?

Postby Thetoad » Tue Apr 18, 2017 7:17 pm

I was 3 monthly CEA to begin but now 6 monthly with yearly consultations. I am a worrier though and my Dr allows a CEA test if I can't wait the 6 months. It takes the anxiety away.
Emergency extended right hemicolectomy November 2013.
Complete blockage, small perforation well away from tumour.
Stage 2a.
T3N0M0
22 Lymph nodes clear.
No bag.
All CEA tests, CT scans and follow up colonoscopy ok.
Now on yearly appts and 6 monthly CEA tests.
Large incisional hernia repaired with mesh Nov. 2014.
Cellulitus bottom of scar.
CEA 1.4 on 28/7/17
Almost 48 months since surgery! (November 13, 2013.) All good so far.
27/5/17. Gallbladder removed, open surgery.
Pleasing consultation Feb. 2017

Jacques
Posts: 408
Joined: Sun Dec 28, 2014 10:38 am

Re: How Often Should My CEA Be Tested?

Postby Jacques » Thu Apr 20, 2017 4:40 am

testing765 wrote:... I just wanted to know whether a switch to semi-annual oncologist follow ups is considered medical standard of care based on my factual circumstances...

According to the ASCO 2009 guidelines for Stage III followup, the standard is to have quarterly follow-ups for the first three years after the Date of Surgery (DOS), and then semi-annual followups during the fourth and fifth years post surgery.

You can see the standard by downloading and viewing the ASCO followup form. If your date of surgery was 9/2014, then your three years of quarterly followups would end in 9/2017. According to the standard, then, you should be having another 3-month followup in June and a final one in Septermber. Beginning in September, the followups would be every 6 months for the next two years (year 4 and year 5).

COLON CANCER FOLLOW – UP SHEET
http://www.asco.org/sites/default/files/fillable_colon_survivorship_plan_v3_102009.doc

I am not saying that you should follow this standard. I am just giving information about what ASCO says their standard is.
DX(2012): RC
Stage IIc,T4b N0 M0 L0 PN1 H0 D0 P0 I1
LAR
MSI: not tested
Chimio-radiothérapie
Chimiothérapie adjuvante : capécitabine + oxaliplatine
CEA < 1.0,
5 years NED,
End of 6-month follow-ups: 7/2017
----
Info links:
Create Your Signature
How to Select a Surgeon
List of Forum Features
Colorectal Cancer Stages (TNM)


Return to “Colon Talk - Colon cancer (colorectal cancer) support forum”



Who is online

Users browsing this forum: CLCardinal84, stu, susie0915, Yahoo [Bot] and 39 guests