CEA increasing trend

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xxyford
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Joined: Wed Oct 18, 2017 12:09 am

CEA increasing trend

Postby xxyford » Thu May 03, 2018 7:21 pm

I just got my dad's 9-month post surgery blood work result. The CEA level keeps increasing since last checkup.

CEA 1.26 -> 1.84 -> 2.64
C199 4.88 ->6.0 -> 8.26

I have search many post here that has a fault increasing CEA and turned out to be nothing. But none of them has a doubled figure in 6 months. He finished chemo in Jan with 1,26 CEA and not it is more than doubled. Has anyone of you has a similar experience? I am really really worried....

He is going to have a CT today and meet the onc next week. All I can do is pray for a NED.
Caregiver to my dear dad, 56 @ dx.
Dx @ 2017 July. PreOp IIIB(T3n1M0), PostOp IIIA(T2N1M0).

zx10guy
Posts: 162
Joined: Mon Jan 07, 2013 12:54 pm

Re: CEA increasing trend

Postby zx10guy » Fri May 04, 2018 1:18 am

Your dad's CEA is still within normal limits. Wait to see what the results of the CT scan are.

My situation with CEA is worse than your dad's. I went from 5.2 to 15.6 in 3 months. My CEA has averaged around 14-15 for the past year with one reading spiking to 20. Just had a CT done yesterday which came back all clear. I haven't had a CEA done yet to see where things are.

NHMike
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Re: CEA increasing trend

Postby NHMike » Fri May 04, 2018 4:58 am

Mine has doubled in six months. I think that it was 1.4 after surgery and it was 2.8 earlier this week and at the start of my previous XELOX cycle. It has crept up slowly. I'm glad that it's the same this week as last week. Normal range goes up to 3.8. It was 2.7 at diagnosis.
6/17: ER rectal bleeding; Colonoscopy
7/17: Stage 3B rectal. T3N1bM0. 5.2 x 4.5 x 4.3 cm. Lymphs: 6 x 4 mm, 8 x 6, 5 x 5
7/17-9/17: Xeloda +radiation
7/5: CEA 2.7; 8/16: 1.9; 9/8: 1.8; 11/30: 0.6; 12/20 1.4; 1/10 1.8; 1/31 2.2; 2/28 2.6; 4/10 2.8
MSS, KRAS G12D
10/17: 2.7 x 2.2 x 1.6 cm (-90%). Lymphs: 3 x 3 mm (-62.5%), 4 x 3 (-75%), 5 x 3 (-40%). 5.1 CM from AV
10/17: LAR, Temp Ileostomy, Path Complete Response
CapeOx 8 cycles 12/17-6/18

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dianetavegia
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Re: CEA increasing trend

Postby dianetavegia » Fri May 04, 2018 3:55 pm

Mine did and it was a false positive.

A year ago my CEA was around 2.9 or 3.1. It has never been lower than 2.4 in 9 years. Six months later it was 5.8. I'd read that hypothyroid can cause false positives and since my scans were clear, I asked for blood work and sure enough, my TSH showed I was hypothyroid. I went on medication and my CEA five months later had dropped MORE than 50%, back to a low norm for me. I also had a large fluid filled cyst on my thyroid (benign) drained.

https://www.ncbi.nlm.nih.gov/pubmed/6893991

There are MANY articles on this subject.

I had my CEA go to 4.4 with a severe sinus infection and another time, walking pneumonia. Your CEA can change .5 from morning to evening. AGE causes a higher CEA than is found in a young person, too.
Just keep a check on it and as long as his scans are clear, try to not worry too much.

Diane
Stage IIIB cc surgery 1/7/09. 5/17 nodes. 12 tx FOLFOX
Stage IVa 2/15/12. CEA 6.4 PET = 1.5cm liver met. HR 4/11/12 No chemo

Nine years 6 months since my original dx and Six years post liver resection.
NED April 2018!
“O Lord my God, I cried out to You, And You healed me.”
Psalms 30:2

rp1954
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Joined: Mon Jun 13, 2011 1:13 am

Re: CEA increasing trend

Postby rp1954 » Fri May 04, 2018 10:47 pm

CEA and CA199 before the first treatment are still important data for clues along with other panels, coupled with scans and/or surgical masses.

Radiation and heavy chemo distort the blood panels during and after treatment for months, each panel with individual trajectory, but they typically trail off to a new normal. Inflammation sources (ESR, hsCRP, ferritin) , high blood sugar (FBG, HgbA1C) and hypothyroid (TSH, fT3) are potential elevation or instability problems for CEA and CA199 that we can track (with blood panels). In our case, we could control these well with low carb diet and supplements. Celecoxib and (bi)weekly IV vitamin C were heavy hitters on inflammation tests but all are important, dessicated natural thyroid for TSH. CA199 was the measurement more sensitive to "background noise" but it has worked well with supportive treatments and data panels.

zxguy is your statistical "hope case" for others persistently at CEA ~15 and over. When things got about that high, some months after a dose reduction in our case, it required mild but better chemo and major surgery to fix. The longer and higher CEA rises, the more likely medical action will be needed. I have to admit I am curious what other factors or anomalies might show up in zxguys extended bloodwork. In active cancer, usually there are patterns that can be watched and factored with multiple panels, rather than just use a nuclear alarm on one marker with a single, artificial threshold.

It is important to keep cool and take useful, calculated actions over the months that this plays out. We have found that we could target, manipulate, limit spread, and even shrink or necrose flagrantly metastatic colon cancer with additions and changes in supplements and mild drugs. Even further with a mild oral 5FU drug, of course.

I strongly believe that extra homework, started early, can gain extra chances. It is shrugs, slips, interference and pratfalls that cost us time (both ways) and money.
watchful, active caregiver for stage IVb CC since early 2010. immuno"Chemo forever," for mCRC

hopeful1
Posts: 4
Joined: Wed Jan 21, 2015 5:39 am

Re: CEA increasing trend

Postby hopeful1 » Sat May 05, 2018 7:53 am

dianetavegia wrote:Mine did and it was a false positive.

A year ago my CEA was around 2.9 or 3.1. It has never been lower than 2.4 in 9 years. Six months later it was 5.8. I'd read that hypothyroid can cause false positives and since my scans were clear, I asked for blood work and sure enough, my TSH showed I was hypothyroid. I went on medication and my CEA five months later had dropped MORE than 50%, back to a low norm for me. I also had a large fluid filled cyst on my thyroid (benign) drained.

https://www.ncbi.nlm.nih.gov/pubmed/6893991

There are MANY articles on this subject.

I had my CEA go to 4.4 with a severe sinus infection and another time, walking pneumonia. Your CEA can change .5 from morning to evening. AGE causes a higher CEA than is found in a young person, too.
Just keep a check on it and as long as his scans are clear, try to not worry too much.

Diane


Thanks for posting this Diane. My husband has had CEA rises with clear scans that has left us scratching our heads. I mentioned this to him tonight and he admitted he had not been taking his thyroid tablets regularly. :shock:
Husband diagnosed with stage III a 2013.
Bowel resection and Folfox 2013/14. CEA less than 3.
Reversal ileostomy 2014.
6 monthly CT's NED 3 monthly CEA's slow increase to 5's.
PET scan no bowel cancer. Early stage thyroid cancer.
Thyroidectomy 2015. CEA's still in 5's. NED on CT.
2017 small liver mass. CEA 35.Liver resection and Folfox CEA less than 3.
2018 NED on CT. CEA 8.2.

ASTEPHENS33
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Re: CEA increasing trend

Postby ASTEPHENS33 » Sat May 05, 2018 5:36 pm

I am not sure why the Cologaurd test is not used in these situations. Cologuard is used for general colon screening. You send in your poop and it measures the DNA to say if there is cancer in your system. For high risk people, its not a good way to screen, as once cancer is detected its not good. But once you have cancer, to see if it is still in your system, like your Dad's case, I would think it could be a helpful indicator. You might as the doctor and if you get more information, maybe let us all know.

As for elevated CEA in general, mine CEA was normal, but went up during chemo. (Apparently this is common.) However, it did not go back down for over a year.

mobrouser
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Location: Ontario

Re: CEA increasing trend

Postby mobrouser » Sat May 05, 2018 8:51 pm

Thank you for posting the question as I am in a similar situation.
My CEA level was 2.4 prior to starting folfox and had risen to 6.3 prior to my 6th treatment last week.
My oncologist told me that chemo will affect CEA levels, and it is not really a good indicator. Of course I was left wondering then why it's being tested for if it isn't reliable?
I will ask again at my appointment next week and see what answers I get.
CC Dx Oct 2017 @ age 58
Laparoscopic hemi-colectomy Dec 2017
Adenocarcinoma ascending colon – 6cm x 6cm x 2cm, Low Grade, penetrates to peritoneum
T4a N2a M0, Stage IIIC
lymph nodes 6 positive out of 18
FOLFOX started Jan 16 2018

ASTEPHENS33
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Re: CEA increasing trend

Postby ASTEPHENS33 » Sat May 05, 2018 11:42 pm

My oncologist tested my cea each time they did blood work during chemo. I think it often goes up during chemo as the cells are giving off antigens. It’s measured as an indicator not as an absolute diagnostic. My cea got up to about 7 and it stayed up longer than is normal. It’s now under 1 and I’ve been Ned since 2005. I took xeloda for 6months

Strong
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Re: CEA increasing trend

Postby Strong » Sun May 06, 2018 11:42 am

ASTEPHENS33 wrote:I am not sure why the Cologaurd test is not used in these situations. Cologuard is used for general colon screening. You send in your poop and it measures the DNA to say if there is cancer in your system. For high risk people, its not a good way to screen, as once cancer is detected its not good.


My (limited) understanding of Cologuard is that it's a good test for a primary tumor in the colon or rectum but it won't indicate post-treatment metastisis since the sample is taken from cells within the G.I. tract.

Isn't the CEA test strictly for mets? My CEA was 1.1 with my primary rectal tumor intact. Since finishing treatment it's been between 0.6 and 0.9. Since it was within normal limits even when my stage 3 tumor was present, I've always assumed it wasn't an effective test for anything below stage 4.

My CEA wasn't tested during chemo, only once before treatment and beginning a few months after chemo ended.

John
47 year old male, DX at 44
10/15 DX rectal tumor T3N1M0
11/16 6 weeks chemo-radiation
2/16 LAR and ileostomy
3/16 intestinal blockage and abscess
5/16 8 folfox treatments, (3 w/ ox, 5 w/o)
9/16 ostomy reversal
CEA <1.0 and clear scans since

DarknessEmbraced
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Facebook Username: Riann Fletcher
Location: New Brunswick, Canada

Re: CEA increasing trend

Postby DarknessEmbraced » Sun May 06, 2018 1:47 pm

I hope your Dad gets good scans!*hugs*
Diagnosed 10/28/14, age 36
Colon Resection 11/20/14, LAR (no illeo)
Stage 2a colon cancer, T3NOMO
Lymph-vascular invasion undetermined
0/22 lymph nodes
No chemo, no radiation
Clear Colonoscopy 04/29/15
NED 10/20/15
Ischemic Colitis 01/21/16
NED 11/10/16
CT Scan moved up due to high CEA 08/21/17
NED 09/25/17

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dianetavegia
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Re: CEA increasing trend

Postby dianetavegia » Mon May 07, 2018 3:14 pm

Strong wrote:My (limited) understanding of Cologuard is that it's a good test for a primary tumor in the colon or rectum but it won't indicate post-treatment metastisis since the sample is taken from cells within the G.I. tract.

Isn't the CEA test strictly for mets? My CEA was 1.1 with my primary rectal tumor intact. Since finishing treatment it's been between 0.6 and 0.9. Since it was within normal limits even when my stage 3 tumor was present, I've always assumed it wasn't an effective test for anything below stage 4.

John


That's correct about Cologuard, John. People misunderstand. Also a FOBT can be perfect and not show cancer. Mine was always clear and I had a 2 cm cancerous polyp when I was dx'd 9 years four months ago.

Having a low CEA at dx is actually a good sign. Chances of a cure are much higher than even a reading of 15 or so. At Stage IV with a small liver met, my CEA jumped to 8.5 the day before my HP and has never been lower than 2.4 but we also didn't know I was hypothyroid.
Stage IIIB cc surgery 1/7/09. 5/17 nodes. 12 tx FOLFOX
Stage IVa 2/15/12. CEA 6.4 PET = 1.5cm liver met. HR 4/11/12 No chemo

Nine years 6 months since my original dx and Six years post liver resection.
NED April 2018!
“O Lord my God, I cried out to You, And You healed me.”
Psalms 30:2

xxyford
Posts: 4
Joined: Wed Oct 18, 2017 12:09 am

Re: CEA increasing trend

Postby xxyford » Mon May 14, 2018 1:42 pm

We meet with the oncology last Thursday and got the scan result back.
CT scan shows thickness on the surgery site and the oncology thinks it is damage from radiation therapy. The actual term he used is "radiation enteritis".
As for CEA, we can do nothing but wait for another 3 months for the next scan. It is so anxious waiting.....
Caregiver to my dear dad, 56 @ dx.
Dx @ 2017 July. PreOp IIIB(T3n1M0), PostOp IIIA(T2N1M0).

tater
Posts: 55
Joined: Wed Jul 19, 2017 5:53 pm

Re: CEA increasing trend

Postby tater » Mon May 14, 2018 4:53 pm

This is interesting to read. I'm trying to figure out what's happening with my wife. Three months ago we got a CEA of 2.1 which was elevated from the ones taken last fall before and after surgery. We are trying to get a reversal surgery scheduled as her scans have been clean but the surgeon wanted to wait till he say the blood work. At the same time we did not know but the oncologist took her CEA in April so about three weeks ago when they serviced her port. Today we go the results. Her CEA from April was 1.3 from yahoo, than from last week it was 2.3. The oncologist isn't worried and said that its still within the normal range and that the test that resulted from the surgeons visit of 2.3 was from a different lab. Does the lab matter on this, is it a standard test? I'm not sure what to think about this.
DH to 38 wife w/kids
Stage 3C DX 3/3/17 CEA 29
5-fu and radiation ended May 17, 2017
Stage 4 External iliac node July 17, 2017
FOLFOX + Avistan July 18 2017 CEA 2.3
Nov 9, 2017 LAR, Hysterectomy & External Nodes Removed W/ileostomy
CEA 1.5 12/30/17, 2.1 2/5/18
Clear CT and MRI on 2/5/2018

Strong
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Joined: Sat May 05, 2018 8:56 am

Re: CEA increasing trend

Postby Strong » Wed May 23, 2018 8:27 pm

I've been told by folks in my support group that the lab does matter, although I've got no evidence to back that up. My last scan also showed some thickening at my surgery site, and that was two years after radiation. I assumed it was scar tissue and paid it no attention. I may be misinformed but my concern lies outside my colon as far as a recurrence goes.

John
47 year old male, DX at 44
10/15 DX rectal tumor T3N1M0
11/16 6 weeks chemo-radiation
2/16 LAR and ileostomy
3/16 intestinal blockage and abscess
5/16 8 folfox treatments, (3 w/ ox, 5 w/o)
9/16 ostomy reversal
CEA <1.0 and clear scans since


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