The Colon Club

The oncologist indicated that things that can affect CEA levels and cause them to fluctuate include exposure to cigarette smoke.

Has anyone else heard this before? Are there any other things that can cause CEA levels to fluctuate similarly to how cigarette smoke does?

The other questions are: as a colon cancer
patient who completed chemotherapy about 3 years ago and is currently NED, does having gone through chemotherapy contribute to an acceleration of tooth decay and bone loss and bone decay in general across the body? A front tooth fell out about a year-and-a-half or about 2 years after 6 months of chemo was completed at the age of 67 and just a few days ago one of the wisdom teeth started to become loose at 69, making it hard to chew on that side of the mouth.

And is it possible that going to see the dentist and having a loose tooth extracted or other dental work done can impact one's CEA levels?

Thanks in advance for your feedback.

FindTheBestHelp wrote:The oncologist indicated that things that can affect CEA levels and cause them to fluctuate include exposure to cigarette smoke.

Has anyone else heard this before? Are there any other things that can cause CEA levels to fluctuate similarly to how cigarette smoke does?

The other questions are: as a colon cancer
patient who completed chemotherapy about 3 years ago and is currently NED, does having gone through chemotherapy contribute to an acceleration of tooth decay and bone loss and bone decay in general across the body? A front tooth fell out about a year-and-a-half or about 2 years after 6 months of chemo was completed at the age of 67 and just a few days ago one of the wisdom teeth started to become loose at 69, making it hard to chew on that side of the mouth.

And is it possible that going to see the dentist and having a loose tooth extracted or other dental work done can impact one's CEA levels?

Thanks in advance for your feedback.

Yes and yes,

Cigarette smoking will cause your CEA to be higher.

And yes, chemo will hurt your teeth. I had a total of 4 teeth pulled. 2 chewing teeth, one on top of other. When I woke up, surgeon told me I did nothing wrong. He said he has seen this before. Chemo related. 6 month later, I would get 2 wisdom teeth pulled, again one on top of other. We thought we could save those, but within a few months it was clear these teeth were also going south. I now get my teeth cleaned every 4 months. The best news, no more tooth loss.

And I have some bone loss in my radiated hip area.

Good luck, sorry the news is not any better.

Lee

Thanks for your reply. A few other questions:

What do you do to preserve or strengthen the bones you have left?

Did you get caps put in or teeth replacements?

What other things aside from second hand cigarette smoke causes CEA to go up?

CEA elevation can be caused by infections/ inflammation. Polyps can raise CEA. Obstruction can elevate CEA. Even fibrocystic breast can cause a minor elevation. I had a reading of 4.4 and then my scan came back that I had walking pneumonia. It went down to normal after 2 weeks on antibiotics.

A benign cause is virtually never the cause of a CEA reading of 10 or higher. CEA can rise up to 8 months before a met is large enough to be seen on a CT /PET scan.

CEA's can jump all over the place. Make sure you're well hydrated before blood work. If you're sick, reschedule the blood work.

As an aside, as we age, our CEA will be slightly higher. In some countries, Roche Labs has changed the reading norms according to age. I wrote last year to ask when that will be noted in the U.S. and I got a long explanation blaming the FDA and AMA. An obese woman / man has a lower CEA than a slim/ normal sized person.

I've lost 3 molars to chemo and don't have the money to put in implants so .....

Our experience has been that nutrients associated with collagen and bone formation slow or reverse bone and tooth loss while on metronomic chemo. Perhaps supportive supplementation in general is beneficial too since lack of salivation with too much chemo damage, aids tooth decay. These nutrients include: vitamins C, D3, and K2 as menatetrenone; glucosamine; magnesium and perhaps calcium (if you take enough vitamins C/D3/K2, less supplemental calcium is needed if at all). Also the commonly recommended RDA amounts for non-minerals are too low, sometimes way too low, to be effective. Also since high dose C/D3/K2 have been associated with improved chemo performance, biomarker improvement and outright scan changes in our efforts, we don't perceive a "vitamin conflict" with 5FU.

Below some point of nutrient additions, the dental visits start to increase...

Thanks for your replies. Just wondering because of the below CEA history. As you can see, it seemed pretty stable at 1.9 except for a dip down to 1.6 and 1.7 during the first 5 quarterly blood tests - nothing over 2.0. Then on the 6th quarterly blood test 2.1. The oncologist said that there's no need for alarm unless you reach 5.0 and that if it ever reached 10.0 an immediate CT scan would be ordered rather than waiting for what is now supposed to be an annual CT scan after 3 years of clear bi-annual scans.

Then on blood tests 7 and 8, it jumped to 3.0 and 3.1, respectively. It didn't seem to stick around in 2.x range at all and went straight to 3.x, which is causing some personal concern, even though it's still below 5.0. And the trend for the past 4 quarterly blood tests has been upward, with no dips that were seen previously in earlier history you see.

10/31/15 - 1.9
1/26/16 - 1.6
4/30/16 - 1.9
7/28/16 - 1.9
10/29/16 - 1.7
1/28/17 - 2.1
4/29/17 - 3.0
7/29/17 - 3.1

Aside from perhaps a lost tooth and some pain in a wisdom tooth, there were no infections or exposure to cigarette smoke right before the last two blood tests that can be recalled. Just trying to make sense of this and determine if there is justification for concern.

Next quarterly blood test is later this month of October, towards end of month.

dianetavegia wrote:CEA elevation can be caused by infections/ inflammation. Polyps can raise CEA. Obstruction can elevate CEA. Even fibrocystic breast can cause a minor elevation. I had a reading of 4.4 and then my scan came back that I had walking pneumonia. It went down to normal after 2 weeks on antibiotics.

A benign cause is virtually never the cause of a CEA reading of 10 or higher. CEA can rise up to 8 months before a met is large enough to be seen on a CT /PET scan.

CEA's can jump all over the place. Make sure you're well hydrated before blood work. If you're sick, reschedule the blood work.

As an aside, as we age, our CEA will be slightly higher. In some countries, Roche Labs has changed the reading norms according to age. I wrote last year to ask when that will be noted in the U.S. and I got a long explanation blaming the FDA and AMA. An obese woman / man has a lower CEA than a slim/ normal sized person.

I've lost 3 molars to chemo and don't have the money to put in implants so .....

In your 2nd paragraph, when you say that CEA can rise up to 8 months before a met is large enough to be seen, do you mean that in the context of readings 10.0 or higher? Or does it apply even to lower CEA readings if they are trending upwards over 8 months?

Also, did you take vitamin supplements and what not to counter the bone loss that occurs during chemo? If you did, I guess even that didn't help enough to avoid tooth decay and loss.

Just got results for the latest quarterly blood test and CEA was 4.2 , so in updating the results history and looking at the trending, it was up and down for the first 5 quarters. Since 1/28/17 it's been a clear trending upwards again.. or could say even since 1/29/16. From 1.7 to 4.2. Dentist said there was an infection, due to gingivitis and maybe exposed gums from lost teeth. Dentist is going to give antibiotics to treat that infection. Heard that inflammation could impact CEA levels. Wondering if the CEA trending upwards can be attributed to infection in the mouth causing inflammation?

10/31/15 - 1.9
1/26/16 - 1.6
4/30/16 - 1.9
7/28/16 - 1.9
10/29/16 - 1.7
1/28/17 - 2.1
4/29/17 - 3.0
7/29/17 - 3.1
11/1/17 - 4.2

FindTheBestHelp wrote:Thanks for your replies. Just wondering because of the below CEA history. As you can see, it seemed pretty stable at 1.9 except for a dip down to 1.6 and 1.7 during the first 5 quarterly blood tests - nothing over 2.0. Then on the 6th quarterly blood test 2.1. The oncologist said that there's no need for alarm unless you reach 5.0 and that if it ever reached 10.0 an immediate CT scan would be ordered rather than waiting for what is now supposed to be an annual CT scan after 3 years of clear bi-annual scans.

Then on blood tests 7 and 8, it jumped to 3.0 and 3.1, respectively. It didn't seem to stick around in 2.x range at all and went straight to 3.x, which is causing some personal concern, even though it's still below 5.0. And the trend for the past 4 quarterly blood tests has been upward, with no dips that were seen previously in earlier history you see.

10/31/15 - 1.9
1/26/16 - 1.6
4/30/16 - 1.9
7/28/16 - 1.9
10/29/16 - 1.7
1/28/17 - 2.1
4/29/17 - 3.0
7/29/17 - 3.1

Aside from perhaps a lost tooth and some pain in a wisdom tooth, there were no infections or exposure to cigarette smoke right before the last two blood tests that can be recalled. Just trying to make sense of this and determine if there is justification for concern.

Next quarterly blood test is later this month of October, towards end of month.

I'm sorry that I didn't see the question earlier. About the CEA rise 4 to 8 months before a met can be found, mine had gone to 3.9 to 4.1, then 6.4 when my liver met was found. It was 8.5 on the day of my hepatic resection.

Please be checked for hypothyroid. My CEA jumped to 5.8 this past Oct. and all scans were clear. I read that thyroid problems could be the cause and asked my onc to check with blood work. Sure enough, my thyroid was underactive. I started on levothyroxine and five months later my CEA had dropped more than 50% to below my usual norm. We're still trying to level out my thyroid and I read it can take 4 to 9 months after the thyroid is 'normal' for CEA and cholesterol to return to true values. (I forgot to mention my cholesterol had crazy readings at the same time.)

My bones are strong even for my age. Chemo (5FU) is terrible on all the moist areas of your body including the mouth. My 3 molars cracked along the gum line. So far so good for four plus years now with my teeth.

I have not lost any teeth but have cracked a tooth and got deep cavities in another two.
Dentist says it is due to reduced salivation and wanted root canal. But Med oncologist has forbidden the same.
Thankful to have survived with a couple of lost teeth and occasional bone and muscle pain.

On the subject of dentistry, has anyone gotten their teeth cleaned while on chemo?

I really needed a cleaning before this started, but I failed to get it done. I guess I will discuss it with my onc tomorrow, but I'm wondering if anyone else has experience to share.

henry123 wrote:I have not lost any teeth but have cracked a tooth and got deep cavities in another two.
Dentist says it is due to reduced salivation and wanted root canal. But Med oncologist has forbidden the same.
Thankful to have survived with a couple of lost teeth and occasional bone and muscle pain.

The reason for not allowing root canal is that Oncologist does not want to shock the immune system while I am on Opdivo.