CEA and scans

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wife2jeff
Posts: 66
Joined: Thu Sep 12, 2019 11:21 pm

CEA and scans

Postby wife2jeff » Sun Nov 24, 2019 4:19 pm

I was wondering when everyone else's oncologist does CEA and scans. They did my husbands CEA after his first chemo and it was 0.7 down from 4.7 at time of diagnosis. However, his oncologist said that they wont test again until after he is finished with chemo and I think she said he will have his first scan also after chemo and colonoscopy at a year from surgery. He will be finished with chemo, if he stays on schedule mid February and his year colonoscopy will be around June or July. I feel like I have read that many others have their CEA check through out chemo, so I was just curious.

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ginabeewell
Posts: 463
Joined: Wed Oct 24, 2018 10:30 am

Re: CEA and scans

Postby ginabeewell » Sun Nov 24, 2019 4:52 pm

I’ve gotten my CEA checked monthly and CT scans every 4-5 cycles (so every 2-3 months).

I’m a little surprised they wouldn’t want a read as he’s going through chemo. I think it’s more typical to be checking throughout treatment. If his CEA is that low however maybe they don’t think it’s a reliable predictor? Depending on the scale used, sometimes under 5 is considered normal. And I do know some doctors are much more careful about the number of CTs they do.

Have you asked why they don’t track more often?
45 YO mom of twins (9) and lucky stepmom of 14/17 year olds
9/17/18 DX stage 4 CRC w inoperable liver mets CEA 931
10/18 FOLFOX + Vectibix
12/18 typhlitis (7 days in hospital) but largest met down to 5 cm.
12/18 CEA 4.6
1/18 Resume chemo (#6-8)
3/19 HAI pump placement / colon resection
4/19 Resume chemo (#9-19) FOLFOX (no OX) + Vectibix
5/19 CEA 1.3
7/19 liver resection
10/19 liver resection
1/20 NED! CEA 0.6
3/20 two new liver mets; FOLFIRI (5) and then add Vectibix (5)
8/20 CEA 0.7
Resection next?

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texmexflute
Posts: 11
Joined: Mon Dec 31, 2018 9:59 pm
Location: Dallas, Texas

Re: CEA and scans

Postby texmexflute » Sun Nov 24, 2019 5:48 pm

I only did 3 months (6 infusions) of chemo after resection and they did scans right after I finished. Found my liver mets. Then while I was on chemo for mets it was after 4 infusions. After I had liver resection and 6 more infusions of mop-up chemo I had another scan that showed NED (no evidence of disease). The plan was scans every 3 months for a while. On the 2nd 3 month scan I had another liver met. So now I'm in a clinical trial and they said protocol is scan every 9 weeks. Also, CEA was once a month while on chemo (and now on the trial) and every 3 months while NED.
62 yo Male (polio survivor) DX 2-2018
2-18 right hemi-colectomy (robotic/minimally invasive)
Stage 3b - T4N1Mx
3-18 thru 8-18 xeloda
9-18 scans indicate 4 liver mets
and possibly in omentum/peritoneum
Upgraded to stage 4
9-18 thru 11-18 4 rounds Folfiri + Avastin, 2 rounds Folfiri only
12-26-18 3 liver mets removed (robotic/minimally invasive) + omentum biopsy (no cancer)
1-19 SBRT remaining 2 liver mets that were hard to reach
2-19 begin 6 rounds of mop-up chemo but folfox this time

wife2jeff
Posts: 66
Joined: Thu Sep 12, 2019 11:21 pm

Re: CEA and scans

Postby wife2jeff » Sun Nov 24, 2019 6:31 pm

Hmmm yea I am a little concerned although she did say she wasn't too worried since his was so low, she did mention that people that smoke (which my husband does not) typically have higher CEA but now I am concerned and wondering if we should have it checked again.

Beckster
Posts: 421
Joined: Thu Jan 12, 2017 3:01 pm
Location: New Jersey

Re: CEA and scans

Postby Beckster » Sun Nov 24, 2019 6:55 pm

wife2jeff wrote:I was wondering when everyone else's oncologist does CEA and scans. They did my husbands CEA after his first chemo and it was 0.7 down from 4.7 at time of diagnosis. However, his oncologist said that they wont test again until after he is finished with chemo and I think she said he will have his first scan also after chemo and colonoscopy at a year from surgery. He will be finished with chemo, if he stays on schedule mid February and his year colonoscopy will be around June or July. I feel like I have read that many others have their CEA check through out chemo, so I was just curious.


What was his staging? I was Stage 2 and they did not test CEA or scan until after I was finished chemo. I think it depends on the initial staging and pathology.
57/F
DX:(CC) 10/19/16
11/4/16- Lap right hemi(cecum)
CEA- Pre Op (1.9), Pre Chemo (2.5)
Type: Adenocarcinoma
Tumor size:3.5 cm x 2.5 x 0.7 cm
Grade: G3 (path) G2 (pre-op)
TNM: T3N0M0/IIA
LN: 0/24
LVI present
Surgical margins: clear
MSS
12/27/2016 - Capeox, anaphylactic reaction
1/2/17 to 6/9/17- Xeloda monotherapy
6/17,12/17,6/18,12/18, 6/19, 12/19 CT Scan NED :D
CEA- 6/17- 3.6, 9/17- 2.8 12/17-2.8, 3/18-3.1, 6/18-3.0, 9/18 2.8, 12/18 2.5 3/19 3.1 6/19 3.1 9/19 2.6 12/19 2.8 6/20 3.0
Clear Colonoscopy 10/17, 11/19 :D

Punky44
Posts: 446
Joined: Mon Oct 01, 2018 4:29 pm

Re: CEA and scans

Postby Punky44 » Sun Nov 24, 2019 11:32 pm

My mom had her CEA tested before each chemo, a mid chemo scan and a post-chemo scan.
Caregiver to my amazing mom (68 at dx)
10/1/18 DX with rectal cancer; CEA 17
T3N2M0
Total neoadjuvant therapy:
8 rounds Folfox 11/5/18 - 2/11/19
Short course radiation 3/14/19 - 3/20/19
Robotically assisted laparoscopic LAR 3/21/19
Pathology report says yT2N0M0 with 0/38 nodes
6/28/19 Reversal and port out
CEA 2.1; 1.9; 2.6; 2.8; 2.3; 2.4
Latest update: 6/20–Clear CT; 9/22—CEA 2.4

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

Rock_Robster
Posts: 517
Joined: Thu Oct 25, 2018 5:27 am
Location: Melbourne, Australia

Re: CEA and scans

Postby Rock_Robster » Sun Nov 24, 2019 11:54 pm

Mine doesn’t test between every chemo round, as he says results bounce around a lot and aren’t clinically relevant that frequently, as you wouldn’t change treatment. In particular he won’t test during the first 4 rounds as he says the results are just likely to cause more anxiety. We tend to test around every 4-6 rounds, or with scans, after surgery or other milestones. That said, mine was 12-14 initially, dropped too 2.x fairly quickly, and has been <2 ever since. I think for surveillance I’ll want to do monthly for at least the first couple of years (I suspect he might say quarterly but we’ll have that debate).

Cheers
Rob
38M Australia
10/2018 Dx RC, 12cm high
Mod diff, EMVI+ LVI+. 4 liver mets
pT3N1aM1a Stage IVa. MSS NRAS G13R
CEA: Oct-18= 12; Nov-18= 14, Mar-19= 2.4, Aug-19 <2.0, Mar-20=2.2, May-20=1.9, Jun-20=2.1, Sep-20: 2.1
11/18 FOLFOX x6
3/19 Liver resect
5/19 25x pelvic radiation; complete met. response
07/19 ULAR w ileo, 1/27 LN+
08/19 Found liver spot
08/19 FOLFOX x1, FOLFOXIRI x1, FOLFIRI x5
12/19 Liver resect
02/20 Ileo reversed
03/20 NED (PET+MRI)
06/20 NED (CT+MRI)
07/20 Clear scope
09/20 NED (PET)

Deb m
Posts: 558
Joined: Tue Jan 14, 2014 10:08 am

Re: CEA and scans

Postby Deb m » Mon Nov 25, 2019 10:13 am

My husband was a stage IIbT4a and he had his CEA with scan every three months during treatments and for the first year and a half after treatments finished. The was followed every 6 months with CEA and scan for another two years, then just once a year. Now coming up on our 9 year anniversary from the start of all this (surgery) he just gets a scope every three years.

Yes, you should be getting surveillance CEA's and scans even when your still going thru chemo. Things can still progress and grow despite treatments sometimes. This was all recommendations and follow up per MDA.

Claudine
Posts: 432
Joined: Tue Mar 12, 2019 2:41 pm
Location: Montana

Re: CEA and scans

Postby Claudine » Mon Nov 25, 2019 2:19 pm

When DH was doing adjuvant chemo, they never looked at his CEA. Now that he's doing second line for mets, he gets his CEA measured before each infusion (so, twice a week); and a scan every 6 cycles - next one is December 6th, I'm stressing out already, especially since his CEA values have been steadily creeping up (he's a 6.something today). In his case, it may mean that Folfiri + Avastin have stopped working, so he's getting the scan before his 6th infusion - no point in hammering his body if he's developed resistance to the treatment; we'll have to see with his oncologist what happens if that's the case - the goal was tumor shrinkage before radiation or surgery. In his case, since CEA levels have been good markers so far, it's important to get them taken regularly, but I guess each case is different.
Wife of Dx 04/18 (51 yo). MSS, KRAS G12A
No primary (involuted?)
Lytic tumor L4 vertebrae, EBRT 04/18, SBRT 02/19
Resect small intestine 05/18 (no cancer - Crohn's)
Failed adjuvant Xelox
Folfiri + Avastin 03/19 to 01/20
6.7 cm left adrenal mass 03/19, successful resection 02/20
CEA since 03/19: high 58, low 3.2, now 24.1
Scan 03/19: Multiple small lung nodules up to 5mm
PET 04/20 uptake by L4
L3-L4-L5 fusion surgery and residual tumor removal 05/20
Scan 09/20: nothing to report


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