The Colon Club

Just a quick back ground. My wife was DX on 3/3/17 with large tumor in rectum and iliac node. At that time her CEA was 26. She had the classic signs of cancer and also had tail bone pain which is due to the size and location of the tumor in rectum. Prior to radiation her CEA went to 29. After 30 session of radiation it drop down to 2.1. She rested for two months prior to surgery, but the week before the surgery a CAT found three 5mm spots on the liver which are called suspicious. Surgery was cancelled and we went to chemo. At that time the CEA went to 2.9. Now after 4 rounds of FOLFOX + avistian the CEA has stuck up to 3.1. We have a CAT scheduled in October after two more rounds of chemo. This week she has noticed a dull pain back in her tail bone. Naturally we are worried that the tumor is growing. It had shrunk more than 50% after radiation. The ONC thinks that the pain is from the shots to boost the WBC, but with the CEA edging up we are both worried. I am curious what peoples thoughts are? I have read that CEA naturally can increase while on chemo is that true? What does it measure, cancer cell growth proteins or dead cancer cell proteins/stuff?

If we can get a clean liver scan in October we will go to surgery and clean out the pelvic region than back to chemo for four months than look at liver resection of the right lobe area that had these tiny spots on it.

Thanks for your responses.

I am sorry to hear that. I have also heard that chemo may lead to CEA increase. As long as it is within normal range, it may not indicate any growth or mets of cancer. As for the bone pain, I guess it is better to ask your onco and see what are the possible explanations. It can be some side effects of the chemo? I guess my thought is not to panic and live a healthy and normal lifestyle before further scanning on Oct. God bless.

My husbands cea rose while he was on chemo, then went back down to normal a few week after completing chemo. He also had tailbone pain and pain in his legs and joints when he had the neup. shots to boost his wbc counts. Many people experience bone pain in different parts of their body with these shots. It sounds like your doc may be correct in his thinking.

Hope your future set of scans show good news,

deb m

Mercy110 wrote:I am sorry to hear that. I have also heard that chemo may lead to CEA increase. As long as it is within normal range, it may not indicate any growth or mets of cancer. As for the bone pain, I guess it is better to ask your onco and see what are the possible explanations. It can be some side effects of the chemo? I guess my thought is not to panic and live a healthy and normal lifestyle before further scanning on Oct. God bless.

Simple question what is a normal range?

tater wrote:

Mercy110 wrote:I am sorry to hear that. I have also heard that chemo may lead to CEA increase. As long as it is within normal range, it may not indicate any growth or mets of cancer. As for the bone pain, I guess it is better to ask your onco and see what are the possible explanations. It can be some side effects of the chemo? I guess my thought is not to panic and live a healthy and normal lifestyle before further scanning on Oct. God bless.

Simple question what is a normal range?

You can search it online. Our onco here in HK suggests less than 5 would be the normal range.

BEFORE we go quoting specific ranges people ... please know that there are different monitoring methodologies.

Ask your own Onc and make sure the lab reports "normal" ranges for the particular methodology they use.... they sometimes vary with age/gender/smoker vs non-smoker and other existing comorbidities ( infection or inflammation anywhere BUTT especially in the chest )
..... THEN discuss any discrepancies or questions with the Onc, 'cos they should know the specifics of your wife's situation.

sometimes trends are more significant than actual values, especially if all values are in the "normal" range
I am Stage IV and my CEA was NEVER above the lab "normal" range

The Onc's first response should be :
do a follow up CEA at about 4 weeks to confirm the increase,
look for anomalies,
assess for complicating factors,
check for lab error,
consider alternate / ancillary blood work or imaging .. etc.

Best wishes
CRguy

Chemo can increase the CEA levels.
Mine started 2.7 at surgery and dropped to 1.9 my first chemo treatment and 1.7 following,
but then jumped back up to to 2.6 then 2.9 then 3.1 and my last session 3.9.

That's a bit concerning too me, but the oncologist said he's not concerned unless it jumps up to double digits.
He said that most people experience miner increases in CEA while on chemo. The Zarxio or neupgen shots - whatevere WBC growth factor he's on could also cause slight elevation.
Especially if he experiences bone pain - some inflammation may be occurring and causing the increase. Or could be dying cancer cells excreting some.
I'd agree with the onc about miner pain in the tailbone. That's the first place pain comes on for me with the growth factor shots.

I've had tons of zarxio and a couple granix shots.
I noticed after introducing the Zarxio I had a loss of RBC and decreased platelets.
This time I only had one zarxio day before treatment and again saw a slight drop in RBC - platelets are back to normal.

So I wouldn't be overly concerned with slight elevation of CEA - pretty normal even up into the 6-7 range.

That kind of CEA increase during the first four rounds of Chemo is normal. Mine went from 2.8 up to 4.9 after round 2 or 3 and then back down again to 2.3 after 6months FolFox and one month 5fu+Avastin.

That number should not worry you at all at this point and there are some studies showing it is an indicator that Chemo is working.

Normal range for CEA varies slightly depending on Testing method (Roche, Bayer or Semeins). Ignore most of the general 'Medical' Sites on the internet telling you values should be under 2.5.

For example Roche/Cobas online documentation lists:
Expected values 20 - 69 years (for 95% of the results)
- non-smokers: 3.8 ng/mL
- smokers: 5.5 ng/mL

The BC cancer agency reference documentation lists normal range to be <5 ng/ml

Hope that helps

thank you everyone for your comments. The Onc. called her and told her to settle down that a flare or spike in CEA while on chemo is normal and necessary a bad thing. He than took the opportunity again to tell her to starting eating a lot more simple proteins and get her weight back up, he is more concerned about that and I'm happy that she is hearing it from someone else other than me.

She gets the WBC shots every other session. She did not get one this time, but on the day she gets unhooked from the pump and the day after she gets a ton of lower back pain. Not sure why, I wonder if it is the oxypalatin causing it.