CEA as a marker during chemo?

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Punky44
Posts: 130
Joined: Mon Oct 01, 2018 4:29 pm

CEA as a marker during chemo?

Postby Punky44 » Mon Nov 19, 2018 4:56 pm

I know CEA is a good marker for some to detect recurrence and also to make sure it goes down after surgery, but is it supposed to also go down during chemo if chemo is done BEFORE surgery?

Right before her first chemo it was 18 and now we are sitting at infusion #2 and it’s 17. Is there any relevance to this? Should we be looking for it to go down progressively after each round?

I realize this question may not apply to many since it seems many Stage 3 folks on here are getting adjuvant chemo so they’ve already seen the drop with surgery.
Caregiver to my amazing mom (68)
10/1/18 DX with rectal cancer; CEA 17
MRI/CT/PET puts staging at T3N2M0
Trying total neoadjuvant therapy—chemo first, then short course radiation, then surgery
11/5/18 started Folfox—3 down, 5 to go!

Me: 34, first colonoscopy 11/16/18—normal! Come back in 5 years.

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susie0915
Posts: 872
Joined: Wed Aug 02, 2017 8:17 am
Facebook Username: Susan DeGrazia Hostetter
Location: Michigan

Re: CEA as a marker during chemo?

Postby susie0915 » Mon Nov 19, 2018 4:58 pm

My oncologist told me that CEA can actually go up during chemo. Mine did go up a little but was within normal range. I dont know if it is a marker for me.
58 yrs old Dx @ 55
5/15 DX T3N0MO
6/15 5 wks chemo/rad
7/15 sigmoidoscopy/only scar tissue left
8/15 Pet scan NED
9/15 LAR
0/24 nodes
10/15 Bowel blockage. surgery,early ileo rev, c-diff inf :(
12/15 6 rds of xelox
5/16 Clear CT lung scarring/inflammation
9/16 clear colonoscopy
4/17 CT 4mm lung nod
7/17 no change lung nod
10/17 Clear pel/abd CT
11/17 CEA<.5
1/18 CT/Lung no change in 4mm nodule
5/18 CEA<.5, clear CT pel/abd/lung nod no change
11/18 CEA .6

ginabeewell
Posts: 38
Joined: Wed Oct 24, 2018 10:30 am

Re: CEA as a marker during chemo?

Postby ginabeewell » Mon Nov 19, 2018 6:19 pm

My onc told me that CEA can escalate during first treatment or two. She was pleased to see mine go down slightly.
45 year old mom of twins (7) and lucky stepmom of 13 and 15 year olds
9/11/18 colonoscopy
9/17/18 DX stage 4 CRC with inoperable liver metastasis (largest 11 cm)
9/20/18 CEA 931
10/1/18 FOLFOX + Vectibix planned 12 rounds
10/15/18 CEA 913
11/12/18 CEA 49

teri3
Posts: 396
Joined: Fri Jan 09, 2015 11:03 am

Re: CEA as a marker during chemo?

Postby teri3 » Tue Nov 20, 2018 8:35 am

My CEA dropped from 331 o 7.5 in 4 months while on chemo :). I was very happy with that.
Teri
58 yrs old female
MSS KRAS mutation G12V
adenocarcinoma sigmoid colon dx 11-14
sigmoidectomy 11-14
Stage 3A
3 out of 20 lymph nodes involved
started FolFox 1-27-15
11 rounds FOLFOX last one 6-30-2015
7-29-2015 PET clear
5-14-2016 CT 2 nodules one in each lung
Confirmed pulmonary metastasis stage 4
FOLFIRi + Avistin started 8-16 11 rounds complete 12-16
CT 12-16 nodules shrunk chemo break wait and see :?
CT growth
VATS l lung 4 10 17
VATS r lung 4 24 17
CT 2 nodules r up and l low :(

Cmac1275
Posts: 52
Joined: Mon Aug 06, 2018 4:21 pm

Re: CEA as a marker during chemo?

Postby Cmac1275 » Tue Nov 20, 2018 9:12 am

I was at 2.1 post liver resection. Right after surgery, they found some new spots on my liver. Probably 2 months out. Started chemo immediately. CEA then rose to 3.6 and then 4.0 as 3 weeks ago. Will be getting a CT scan tomorrow. Then followup on Monday where they'll test CEA again.

My oncologist wasn't concerned about the rise at this point.
42 yr, male, husband and father of 3
DX Stage IV Colon Cancer Jan 2018
Multiple liver mets
KRAS G13D / MSS

Jan 2018 Partial colon resection
Mar 2018 FOLFOX + Avastin | CEA 60.1
July 2018 Partial liver resection | CEA 4.7
Sep 2018 Recurrence in liver | CEA 2.9
Oct 2018 FOLFOX + Avastin
Nov 2018 Stopping FOLFOX. New mets | CEA 4.3
Dec 2018 Beginning AbbVie ABT-165 Trial

Deb m
Posts: 447
Joined: Tue Jan 14, 2014 10:08 am

Re: CEA as a marker during chemo?

Postby Deb m » Tue Nov 20, 2018 11:27 am

My husbands went up after starting chemo, then about half way thru it, it started to decline to normal and has remained so. I to have also heard and witnessed it going up during chemo.

Dionca
Posts: 19
Joined: Sat Dec 02, 2017 2:04 am

Re: CEA as a marker during chemo?

Postby Dionca » Tue Nov 20, 2018 11:53 am

The protocol at the hospital where I had chemo was not to test for CEA or have scans, until a few weeks after chemo had ended. The reason being, is that CEA can rise due to inflammation etc and therefore is not always a good indication of what is actually happening.

I happened to have a scan for an unrelated condition, halfway through chemo, which showed a nodule on the liver, so I started having CEA tests after that point. My CEA did rise during chemo, but went down after it ended. The nodule hasn't changed, so probably is benign.

If you look at my signature, you will see that my CEA rose from 1.2 to 4.6 during chemo. My onc considers 5.0 to be the upper limit for normal, so was not concerned about this (although at the time, I certainly was).
May 2015 right hemi CC cecum
removed terminal ileum, illeocecal valve, appendix, cecum, ascending colon, omentum
stage 3b T3 N1b MX 2/27 nodes (isolated tumour cells in 1 add'l node)
moderately differentiated
PNI - positive
LVI - positive
Folfox 12 sessions (oxi discontinued for 11 & 12)
Neulasta with 3-12 due to low WBC count
CEA at diagnosis 8.6
CEA after surgery 1.2
CEA during chemo 4.6 / 3.3 / 2.3
CEA after chemo 1.5 / 1.2 / 1.2 /1.2 /1.2 / 1.4 / 1.1 / 1.2 / 1.9 / 1.3 / 1.6 /1.4
neuropathy

SGNYC
Posts: 22
Joined: Mon Sep 03, 2018 9:20 pm

Re: CEA as a marker during chemo?

Postby SGNYC » Wed Nov 21, 2018 3:25 pm

Hi,

DH’s CEA started at 25 at Dx. After 5 rounds of neo-adj folfox it was just above 10 and three weeks after surgery/resections it was in normal range at 3. MSK did several tests throughout neo-adj and I expect that to continue as he wraps up adjuvant and continues to be monitored since directionally it has been a good marker for him.

Eleda
Posts: 197
Joined: Thu Dec 28, 2017 2:28 am
Facebook Username: adele Morgan
Location: Ireland

Re: CEA as a marker during chemo?

Postby Eleda » Wed Nov 21, 2018 3:47 pm

My CEA was 4.4 at DX and now after radiation resection and adjuvant chemotherapy still only sits at 4.1
So not a marker for me,, only bounced between 4.4 and 4.1 all throughout
MY CA19/9 had increased from 6 to 17
That's concerning to me but not to the oncologist ( apparently still within normal range,) but so was my CEA at DX so not a marker for me either

ADELE X
SWF, 47
Mom to 3 sons 6/8/12
Dec4th 2017 colonoscopy for minor intermittent rectal bleeding during Summer
CEA 4.4
DX T3 L3C M0 2.5/3 cm above AV.
JAN 3RD started 1650mg Zelda 2xday, with 28 radiation
Did tagamet 800mg daily and 75mg IV VIT C WEEKLY UNTIL SURGERY and
Tumor reduce by 80% 1 LN still remaining
TATME May10th, temp illeostomy
10/07/2018 CEA 3
MMR INTACT
Began FOLFOX July 10th
24/08/2018 Allergic reaction so next infusion lucovorin and 5fu
CEA 4
Second attempt with oxi aug 12th

Punky44
Posts: 130
Joined: Mon Oct 01, 2018 4:29 pm

Re: CEA as a marker during chemo?

Postby Punky44 » Mon Dec 03, 2018 1:18 pm

Just got her results after 2 chemos while we prepare for the 3rd. CEA went from 17 to 15. I was hoping for more. NP said she considers it stable and said that’s normal and we will likely see more of a drop after radiation and surgery. What do you guys think?
Caregiver to my amazing mom (68)
10/1/18 DX with rectal cancer; CEA 17
MRI/CT/PET puts staging at T3N2M0
Trying total neoadjuvant therapy—chemo first, then short course radiation, then surgery
11/5/18 started Folfox—3 down, 5 to go!

Me: 34, first colonoscopy 11/16/18—normal! Come back in 5 years.

rp1954
Posts: 1393
Joined: Mon Jun 13, 2011 1:13 am

Re: CEA as a marker during chemo?

Postby rp1954 » Thu Dec 06, 2018 8:43 pm

Eleda wrote:...My CA19/9 had increased from 6 to 17

Eleda, if cost is an issue, I'd suspend CA199 until 6+ months after Folfox stops, maybe get one more near the end of Folfox just to see the approximate peak.
watchful, active researcher and caregiver for stage IVb/c CC since early 2010. 8 yrs immuno-Chemo for mCRC, now no chemo
most of 2010 Life Extension recommendations and possibilities + more, some (much) higher

Eleda
Posts: 197
Joined: Thu Dec 28, 2017 2:28 am
Facebook Username: adele Morgan
Location: Ireland

Re: CEA as a marker during chemo?

Postby Eleda » Sun Dec 09, 2018 4:36 pm

RP, cost is not an issue because is a regular blood test here I can request through my GP whenever I wish, she suggested leaving a 3 month gap and recheck again later
I'm now 6 weeks finished folfox, and secduled reversal for and Jan
ADELE X
SWF, 47
Mom to 3 sons 6/8/12
Dec4th 2017 colonoscopy for minor intermittent rectal bleeding during Summer
CEA 4.4
DX T3 L3C M0 2.5/3 cm above AV.
JAN 3RD started 1650mg Zelda 2xday, with 28 radiation
Did tagamet 800mg daily and 75mg IV VIT C WEEKLY UNTIL SURGERY and
Tumor reduce by 80% 1 LN still remaining
TATME May10th, temp illeostomy
10/07/2018 CEA 3
MMR INTACT
Began FOLFOX July 10th
24/08/2018 Allergic reaction so next infusion lucovorin and 5fu
CEA 4
Second attempt with oxi aug 12th


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