Should we move the scan up?

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jp81
Posts: 22
Joined: Sun Jun 04, 2017 4:45 am

Should we move the scan up?

Postby jp81 » Mon Apr 29, 2019 3:33 pm

Dear mom has the following increasing CEA trend over the last 6 months. Her case history is in the signature.

Lab 1: 3.6, 4.9, 5.1
Lab 2: 3.6, 3.85, 4.66

The doctor wants to wait for one more month and do another CEA before the scan. But we're worried if that'll lead to wider, inoperable spread.

Any advice is appreciated.
Dear Mom 58yrs, Stage 3 RC (T3CN2M0), CEA 9
MSS, G12D
6.5cm from verge, 30mm in Mesorectal Fascia
Xeloda+Radiation 06/17
Surgery 08/17, CAPOX 5 rounds (planned 6, but blood counts low)
CEA 6, para-aortic node in CT 01/18
CEA 5.6, PET 1 malign para-aortic node 02/18
Pre-op CEA 4.8; Surgery (open) - 1.6 cm Inferior Mesenteric Node - 26/02/18
FOLFIRI+Avastin start 03/18 (12 cyc)
Chemo over - 09/18
Clean PETs - 23/05/18, 06/11/18 (CEA 3.6)
Cap+Avastin Maint (18/11/18)
CEA 3.6 26/01/19, 4.2 02/19, 5.1 11/04/19

stu
Posts: 1132
Joined: Sat Aug 17, 2013 5:46 pm

Re: Should we move the scan up?

Postby stu » Mon Apr 29, 2019 3:59 pm

Hi ,
Having experienced the benefits of early detection I think it’s reasonable with a continuing upward trend to seek a scan .

Saying that a one month delay is nothing over here so I would not get too anxious . That’s the way our healthcare works .

On a reassuring note my mum’s is currently sitting at around 5.2 to 5.4 for the last six months . It suddenly popped up a bit . She had a scanned at the start of the rise. And just had another scan but nothing showing . We are thinking a blood clot is responsible.

Hope it goes well for her .

Take care,
Stu
supporter to my mum who lives a great life despite a difficult diagnosis
stage4 2009 significant spread to liver
2010 colon /liver resection
chemo following recurrence
73% of liver removed
enjoying life treatment free
2016 lung resection
Oct 2017 nice clear scan . Two lung nodules disappeared
Oct 2018. Another clear scan .

jp81
Posts: 22
Joined: Sun Jun 04, 2017 4:45 am

Re: Should we move the scan up?

Postby jp81 » Thu May 02, 2019 3:37 am

Thanks stu. Although I'm a little anxious, I think we'll wait for a month. Best wishes to your mom and family.
Dear Mom 58yrs, Stage 3 RC (T3CN2M0), CEA 9
MSS, G12D
6.5cm from verge, 30mm in Mesorectal Fascia
Xeloda+Radiation 06/17
Surgery 08/17, CAPOX 5 rounds (planned 6, but blood counts low)
CEA 6, para-aortic node in CT 01/18
CEA 5.6, PET 1 malign para-aortic node 02/18
Pre-op CEA 4.8; Surgery (open) - 1.6 cm Inferior Mesenteric Node - 26/02/18
FOLFIRI+Avastin start 03/18 (12 cyc)
Chemo over - 09/18
Clean PETs - 23/05/18, 06/11/18 (CEA 3.6)
Cap+Avastin Maint (18/11/18)
CEA 3.6 26/01/19, 4.2 02/19, 5.1 11/04/19

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juliej
Posts: 2995
Joined: Thu Aug 05, 2010 12:59 pm

Re: Should we move the scan up?

Postby juliej » Thu May 02, 2019 6:35 pm

Both benign (harmless) and malignant (cancerous) conditions can increase the CEA level, so that's something to keep in mind when you have a slow rise like this one. Has she had an infection lately? A cold or a flu?

I think a one month delay for the CT scan is fine since the changes are minor. If the number was doubling on every test, than I would ask for an immediate scan.

Hope this puts your mind at ease!
Juliej
Stage IV, liver/lung mets 8/4/2010
Xelox+Avastin 8/18/10 to 10/21/11
LAR, liver resec, HAI pump 11/11
Double lung surgery + ileo reversal 2/12
Adjuvant Xeloda 3-9/12
VATS rt. lung 12/21/12 - benign granuloma!
NED 3/17/12 to 3/18/2019, CEA<1

jp81
Posts: 22
Joined: Sun Jun 04, 2017 4:45 am

Re: Should we move the scan up?

Postby jp81 » Mon May 06, 2019 11:42 pm

Thanks Julie. Scan is coming up 4 weeks from now. Hoping for the best.
Dear Mom 58yrs, Stage 3 RC (T3CN2M0), CEA 9
MSS, G12D
6.5cm from verge, 30mm in Mesorectal Fascia
Xeloda+Radiation 06/17
Surgery 08/17, CAPOX 5 rounds (planned 6, but blood counts low)
CEA 6, para-aortic node in CT 01/18
CEA 5.6, PET 1 malign para-aortic node 02/18
Pre-op CEA 4.8; Surgery (open) - 1.6 cm Inferior Mesenteric Node - 26/02/18
FOLFIRI+Avastin start 03/18 (12 cyc)
Chemo over - 09/18
Clean PETs - 23/05/18, 06/11/18 (CEA 3.6)
Cap+Avastin Maint (18/11/18)
CEA 3.6 26/01/19, 4.2 02/19, 5.1 11/04/19

fumaros
Posts: 260
Joined: Sat Jul 02, 2016 10:26 pm
Location: Syracuse, NY
Contact:

Re: Should we move the scan up?

Postby fumaros » Tue May 07, 2019 5:16 am

Had a similar issue. Of course in hindsight I wish I had moved up my scan. But even after the scan, things still moved slowly or shall I say not fast enough to satisfy me. So in some ways, waiting a month might not make to much of a difference, but it can be comforting to say you listened to your instincts if it turns out to be significant.
Diagnosed 4/8/16, age 29
Colectomy 4/20/16
Stage III, T4bN1 Tumor 7x6.5x2. Muscinous Adenocarcinoma with SRC features
2/16 lymph nodes
Stage IV, Peri mets 5/2019
CEA 4/14/16 - 16.8
CEA 6/2/16 - 1.9
CEA 6/17/16 - 0.87, 7/16 - 1.33, 12/16 - 1.14, 4/17 - 0.6, 7/17 - 0.5, 10/17 - 0.9, 3/19 -5.8, 4/19 -10
FOLFOX began 6/24/16 - 11/25/16, FOLFIRI - 5/10/19
10 round FOLFOX, 2 round 5-FU & Leucovorin, 1 round FOLFIRI
MRI & CT 8/16 - NED, CT 12/16 - 10/17 - NED

NHMike
Posts: 1997
Joined: Fri Jul 21, 2017 3:43 am

Re: Should we move the scan up?

Postby NHMike » Tue May 07, 2019 2:39 pm

I had a rising CEA through Adjuvant Chemo and it went above normal so the oncologist ordered a scan which showed nothing (though it's a relief). It turned out to be exercise related as I increased my exercise regularly while I was undergoing chemo. I think that there are a few known things that aren't cancer-related that can push it up. My oncologist said that he didn't really start worrying until the high-teens.
6/17: ER rectal bleeding; Colonoscopy
7/17: 3B rectal. T3N1bM0. 5.2 4.5 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; 11/30: 0.6; 12/20 1.4; 1/10 1.8; 1/31 2.2; 2/28 2.6; 4/10 2.8; 5/1 2.8; 5/29 3.2; 7/13 4.5; 8/9 2.8, 2/12 1.2
MSS, KRAS G12D
10/17: 2.7 2.2 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) 12/17-6/18
7/18: Reversal, Port Removal
2/19: Clean CT

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LPL
Posts: 649
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Location: Europe

Re: Should we move the scan up?

Postby LPL » Wed May 08, 2019 8:21 am

NHMike wrote:I had a rising CEA through Adjuvant Chemo and it went above normal so the oncologist ordered a scan which showed nothing (though it's a relief). It turned out to be exercise related as I increased my exercise regularly while I was undergoing chemo. I think that there are a few known things that aren't cancer-related that can push it up. My oncologist said that he didn't really start worrying until the high-teens.

NHMike, have you seen any reseach papers about this, that exercise can give ’false’ high cancer marker test results?
DH @ 65 DX 4/11/16 CC recto-sigmoid junction
Adenocarcenoma pt 35x15x9mm G3(biopsi) G1(surgical)
Mets 3 Liver resectable
T4aN1bM1a Stage IVa 2/9 LN
MSS, KRAS-mut G13D
CEA & CA19-9: 5/18 2.5 78 8/17 1.4 48 2/14/17 1.8 29
4 Folfox 6/15-7/30 (b4 liver surgery) 8 after
CT: 8/8 no change 3/27/17 NED->Jan-19 mets to lung
:!: Steroid induced hyperglycemia dx after 3chemo
Surgeries 2016: 3/18 Emergency colostomy
5/23 Primary+gallbl+stoma reversal+port 9/1 Liver mets
RFA 2019: Feb lung met

NHMike
Posts: 1997
Joined: Fri Jul 21, 2017 3:43 am

Re: Should we move the scan up?

Postby NHMike » Wed May 08, 2019 8:25 am

LPL wrote:
NHMike wrote:I had a rising CEA through Adjuvant Chemo and it went above normal so the oncologist ordered a scan which showed nothing (though it's a relief). It turned out to be exercise related as I increased my exercise regularly while I was undergoing chemo. I think that there are a few known things that aren't cancer-related that can push it up. My oncologist said that he didn't really start worrying until the high-teens.

NHMike, have you seen any reseach papers about this, that exercise can give ’false’ high cancer marker test results?


I have not seen any research on it. I only noticed the correlation when I charted the CEA and compared it to a chart of my physical activity.

I would doubt that there would be any research given that my demographic doesn't ramp up their exercise levels through chemo. Most people don't exercise. I would guess that people exercise less as they move through chemo as the side-effects get worse.
6/17: ER rectal bleeding; Colonoscopy
7/17: 3B rectal. T3N1bM0. 5.2 4.5 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; 11/30: 0.6; 12/20 1.4; 1/10 1.8; 1/31 2.2; 2/28 2.6; 4/10 2.8; 5/1 2.8; 5/29 3.2; 7/13 4.5; 8/9 2.8, 2/12 1.2
MSS, KRAS G12D
10/17: 2.7 2.2 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) 12/17-6/18
7/18: Reversal, Port Removal
2/19: Clean CT

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LPL
Posts: 649
Joined: Fri Apr 22, 2016 12:49 am
Location: Europe

Re: Should we move the scan up?

Postby LPL » Wed May 08, 2019 8:32 am

NHMike wrote:
LPL wrote:
NHMike wrote:I had a rising CEA through Adjuvant Chemo and it went above normal so the oncologist ordered a scan which showed nothing (though it's a relief). It turned out to be exercise related as I increased my exercise regularly while I was undergoing chemo. I think that there are a few known things that aren't cancer-related that can push it up. My oncologist said that he didn't really start worrying until the high-teens.

NHMike, have you seen any reseach papers about this, that exercise can give ’false’ high cancer marker test results?


I have not seen any research on it. I only noticed the correlation when I charted the CEA and compared it to a chart of my physical activity.

I would doubt that there would be any research given that my demographic doesn't ramp up their exercise levels through chemo. Most people don't exercise. I would guess that people exercise less as they move through chemo as the side-effects get worse.

Thanks for your reply. I was just thinking if ’no exercising’ would be recommended (a specific time) before check up blood tests (when not on chemo/treatments).
DH @ 65 DX 4/11/16 CC recto-sigmoid junction
Adenocarcenoma pt 35x15x9mm G3(biopsi) G1(surgical)
Mets 3 Liver resectable
T4aN1bM1a Stage IVa 2/9 LN
MSS, KRAS-mut G13D
CEA & CA19-9: 5/18 2.5 78 8/17 1.4 48 2/14/17 1.8 29
4 Folfox 6/15-7/30 (b4 liver surgery) 8 after
CT: 8/8 no change 3/27/17 NED->Jan-19 mets to lung
:!: Steroid induced hyperglycemia dx after 3chemo
Surgeries 2016: 3/18 Emergency colostomy
5/23 Primary+gallbl+stoma reversal+port 9/1 Liver mets
RFA 2019: Feb lung met

Brearmstrong
Posts: 82
Joined: Sun Mar 26, 2017 3:24 pm
Location: CT

Re: Should we move the scan up?

Postby Brearmstrong » Sun Jul 07, 2019 8:10 pm

Hi Jp,

How did your mom’s scan turnout? I am also in the same situation as my CEA jumped from 1.0 to 2.3 in three months and my next CT scan isn’t until Aug 15th. I know that worrying doesn’t help but my CEA is a good marker. I am very scared. Hope her scan went well.

Brenda
45 F Jan 17 2 sons
tumor appendix/colon
Muc Adeno 4cm
mod diff G2 T4aN2
nodes 8/50
CEA 4.6 after surgery <.05
KRAS G12D MSS
FOLFOX Apr-sep 17
Clean CT Jul 2017lung 4mm, clean CT oct 17, CEA 3.4, nov 17 8.1. May 18 2.3 Jul 18 1.0 oct 18 1.3 Jan 19 1.3 Mar 19 1.0 jul 19 2.3
Oct 2017 clean CT
Nov 17 PET para aortic nodes Stage IV
Folfori w/avastin Dec 17 CEA 7.1
May 18- surgery to remove nodes- 5 positive xeloda continues
Aug 18-CT NED Nov 18 CT clear, Feb 19 CT clear, May 19 CT clear

jp81
Posts: 22
Joined: Sun Jun 04, 2017 4:45 am

Re: Should we move the scan up?

Postby jp81 » Tue Jul 09, 2019 1:11 pm

Hi Brenda,

My mom did not have a scan - our doctor recommended that it's not necessary for now since the CEA has not shown an increase (It is currently 4.2). My mom's CEA has always been a little high, varying from 3.6 to 5.1.
Her last scan was in November 2018. The plan is to do the scan three months from now. I have always been worried about CEAs, but it seems that it does jump around quite a bit due to inflammation. So as long as they're within range, it seems alright. Your reading of 2.3 is certainly within range. (My dad's CEA is 3.3 for instance - he doesn't have cancer.) In this forum, dianetavegia had previously mentioned that she often had borderline high CEAs - but her only recurrence happened only when it jumped to 6.x.

My mom's been doing well otherwise (I just took her out on vacation, and made her walk around quite a bit). Recently she had once instance of hypertension. It's probably from the avastin she takes; so we might cut that out at some point.

Try not to worry - I've enquired with multiple doctors about CEA numbers. 2.3 is well within range.
Dear Mom 58yrs, Stage 3 RC (T3CN2M0), CEA 9
MSS, G12D
6.5cm from verge, 30mm in Mesorectal Fascia
Xeloda+Radiation 06/17
Surgery 08/17, CAPOX 5 rounds (planned 6, but blood counts low)
CEA 6, para-aortic node in CT 01/18
CEA 5.6, PET 1 malign para-aortic node 02/18
Pre-op CEA 4.8; Surgery (open) - 1.6 cm Inferior Mesenteric Node - 26/02/18
FOLFIRI+Avastin start 03/18 (12 cyc)
Chemo over - 09/18
Clean PETs - 23/05/18, 06/11/18 (CEA 3.6)
Cap+Avastin Maint (18/11/18)
CEA 3.6 26/01/19, 4.2 02/19, 5.1 11/04/19


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