The Colon Club

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.

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.

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.

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

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.

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.

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.

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.

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

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

I hope your Dad gets good scans!*hugs*

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.

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.....

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.

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