CEA and scans

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wife2jeff
Posts: 65
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: 404
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 year old mom of twins (8) and lucky stepmom of 14 and 16 year olds
9/17/18 DX stage 4 CRC w inoperable liver mets
9/20/18 CEA 931
10/1/18 FOLFOX + Vectibix planned 12 rounds
12/12/18 CT scan showed typhlitis (7 days in hospital) but largest met down to 5 cm. Chemo holiday.
12/26/18 CEA 4.6
1/14/18 Resume chemo (#6-8)
3/27/19 HAI pump placement / colon resection
4/8/19 Resume chemo (#9-19) FOLFOX (no OX) + Vectibix
5/20/19 CEA 1.3
7/19/19 1st liver resection
10/16/19 2nd liver resection

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texmexflute
Posts: 10
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: 65
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: 414
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
Clear Colonoscopy 10/17, 11/19 :D

Punky44
Posts: 437
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)
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
CEA 2.1; 1.9; 2.6; 2.8
6/28/19 Reversal and port out
10/22/19: CT showed new nodules
1/28/20: CT showed nodules shrinking

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

Rock_Robster
Posts: 474
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
Male 38; Australia
10/2018 Dx 3.5cm RC adenocarcinoma, 12cm from AV
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
11/18- FOLFOX x6
3/19- Liver resection
5/19- 25 x pelvic VMAT radiation; complete metabolic response
07/19- ULAR (robot), temp ileo, 1/27 LN
08/19- Missed a liver spot
08-11/19- FOLFOX x1, FOLFOXIRI x1, FOLFIRI x5
12/19- Liver resection #2
02/20- Ileostomy reversed
03/20- PET & MRI = NED!

Deb m
Posts: 557
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: 301
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 radiation 04/18, SBRT 02/19
Resection small intestine 05/18 (no cancer found - Crohn's)
Failed adjuvant Xelox
Folfiri + Avastin since 03/19
6.7 cm left adrenal mass 03/19, 3.67 cm 12/19, successful resection 02/20
CEA since 03/19: high 58, low 3.2, now 7.6
Scan 03/19: Multiple small lung nodules up to 5mm
Scan 12/19: 2 calcified granulomas, one 1mm stable nodule


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