Does CEA fluctuate in healthy individuals

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hwr
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Does CEA fluctuate in healthy individuals

Postby hwr » Thu Dec 19, 2019 10:18 am

I'm having my first follow-up CEA test on January 6. My first and only test was .9 in July. Does CEA remain at its base level unless disease progression, or can it fluctuate a little from time to time for no apparent reason? I'm a non smoker and I've read that <2.5 would be normal for me, but is my normal .9 or somewhere in between?

Deb m
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Re: Does CEA fluctuate in healthy individuals

Postby Deb m » Thu Dec 19, 2019 2:55 pm

It is my understanding that it can fluctuate up and down a bit. I think the more cea's you have done, you will see a pattern of fluctuation that just may be normal for you. My husband had his go up on his first re-check and I freaked out. But then over the next five years, looking at his pattern, it was and up and down event the whole way thru, though never going much above the abnormal 3.0. A few times 3.1 and 3.3. We were told by our oncologist that some people have an elevated baseline . The concern is a continuing increase in the numbers. If your having one done for the first time, and it's elevated a bit, it would be hard to say just from that one result if it's an indication of something or just nothing.

CEA's I fine can cause a whole lot of stress, at least it did for us!

Beckster
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Re: Does CEA fluctuate in healthy individuals

Postby Beckster » Thu Dec 19, 2019 3:09 pm

My CEA fluctuates between 2.5 and 3.1. It has been this way for over 3 years. However, the normal range will depend on what type of CEA assay is used in the lab. I go to Lab Corp and they use the Roche assay...anything under 4.7 is normal. The Bayer assay has different ranges,which I think is anything below 2.5 is normal.
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

radnyc
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Re: Does CEA fluctuate in healthy individuals

Postby radnyc » Thu Dec 19, 2019 3:18 pm

CEA again. Yes, it can be all over the place in cancer and non-cancer people. In fact if you would look through a lot of the members on here, their CEAs are really low, like between 1 and 2 and still have pretty advanced cancers. A new, more exact method needs to be developed, I'm sure someone is working on it. It's a source of unnecessary stress for so many people.
DX Jan '10, at 47
Feb - colon resection - 2/17 nodes
April - liver mets - Stage 4
3 months Folfox chemotherapy
August '10 liver resection and HAI pump
7 months chemo FUDR HAI and Folfiri systemic
NED since August 2010
Last treatment April '11
HAI Pump removed Dec '15

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Jacques
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Re: Does CEA fluctuate in healthy individuals

Postby Jacques » Thu Dec 19, 2019 11:56 pm

Deb m wrote:.. . The concern is a continuing increase in the numbers. If your having one done for the first time, and it's elevated a bit, it would be hard to say just from that one result if it's an indication of something or just nothing...

This is so true. In the case of CEA, both elevation and trend are important. If your CEA elevation is in the normal range, there is no particular cause for worry. What is important, though, is the presence or absence of a trend. But you cannot verify a trend with just one or two measurements. You need at least three measurements that increase steadily over a span of time.

If the second measurement turns out to be much higher than the first, they may just wait another few months to see if the third CEA measurement is even higher than the second one. This would help confirm that something is going on.

In the research literature, single elevations of CEA are often called "transient elevations". There are lots of reasons why a CEA measurement might go up temporarily. They usually need to take another measurement several months later to see if the "spike" in CEA was evidence of a trend or if it was just a transient elevation.

zx10guy
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Re: Does CEA fluctuate in healthy individuals

Postby zx10guy » Fri Dec 20, 2019 1:06 am

As radnyc has stated, there needs to be a better test than CEA. There are people who have low CEA numbers but have very advanced disease progression. And then you have those with higher than normal CEA with no evidence of disease found. Ranges of what is normal depends on the lab itself and the type of assay test being used. There are two different ones used for CEA testing. The Bayer Siemens test which is what many typically quote where normal for non smokers is 3 or below. The Roche test has a higher limit for non smokers where some labs it is 5 or below.

If you look at my posts, you'll see I'm the weird anomaly where I've been dealing with a very high CEA number but with no evidence of disease found in any of my scans. CT, MRI, PET. I've done them all multiple times over the 3 years I've been dealing with this CEA weirdness. If my numbers were over the a few months, I'd be on pins and needles wondering when something cancerous would show up on any of the scans. But it's been coming up on 3 years (March 2020 will be 3 years) since the first huge spike occurred. I'm not alone. There's a woman who was tracked with an even wilder CEA trend than mine who was monitored for 5 years with no evidence of disease found.

hwr
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Re: Does CEA fluctuate in healthy individuals

Postby hwr » Fri Dec 20, 2019 6:59 am

Thanks for the replies. I was hoping CEA values were looked at more like CBC numbers in that as long as it's in the normal range, nothing to be concerned about, but looks like it's more like PSA in that it can be "normal" but a rising trend may indicate trouble. I guess I'll have to add CEA to my PSA anxiety testing.

zx10guy
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Re: Does CEA fluctuate in healthy individuals

Postby zx10guy » Fri Dec 20, 2019 10:04 am

My doc said he doesn't treat on a number alone. And that's what CEA is a number. Yes the absolute value and the trend (if it's climbing and how significantly) is important. But he said definitively, he doesn't put anyone on chemo just because their CEA is high. He has to see physical evidence of cancer which would be from scans. Now there are new testing techniques out there such as liquid biopsies which are an additional tool to try to detect any potential cancer before it's large enough to be picked up on scans. I've been pushed to get this done by various friends. I've declined to do it as it's just more anxiety. Had I started this journey now with the unexplained CEA level and no physical evidence on scans, sure I would do the test. But I'm almost 3 years out and nothing has shown up yet. Not even a questionable spot. Also the variable with bias from the same radiologist reviewing my scan images has been eliminated as all the scans I have has been reviewed by at least 3 different doctors. It's gotten to the point I am recognizing the various doctors reviewing my scans by name now. So at this point even if a liquid biopsy comes back as positive, what am I going to do? My doc is still not going to start me on chemo until something shows up on scans. I haven't seen anyone start treatment based on blood work alone. I'm learning to cope with this and to just let it go. I can't keep stressing over every little detail of this horrible journey.

As has been mentioned, CEA to me is a horrible test. Too many variables that affect it's accuracy.

hwr
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Re: Does CEA fluctuate in healthy individuals

Postby hwr » Fri Dec 20, 2019 3:40 pm

I've been doing some more reading about CEA and unless I've misunderstood, CEA in a healthy adult should be zero or very low. What exactly is very low? Since <2.5 is considered normal, does that mean any number from zero to 2.5 is considered very low? So what does my .9 mean?

I dont recall any of my doctors at the time giving me any indication that they thought the number was worrisome. I mentioned that I was glad it was normal and they didnt correct me, but that was before I knew it's supposed to be ~zero.

Deb m
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Re: Does CEA fluctuate in healthy individuals

Postby Deb m » Fri Dec 20, 2019 4:28 pm

I really don't agree that in a healthy person, your CEA should be 0 or very low. I know very healthy people who have slightly elevated CEA's . I really don't even think there is such a thing as a CEA level of 0.

zx10guy
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Re: Does CEA fluctuate in healthy individuals

Postby zx10guy » Fri Dec 20, 2019 4:50 pm

You need to ask what the normal range for the lab your doctor uses is. This will also give you an indication on the assay method that particular lab is using. As I said typically for the Bayer Siemens test normal for a non smoker is 3 and below. For the Roche test, normal is about 5 and below.

Your .9 is well within what is consider normal. But again as has been stated by others, there are those with extensive tumor loading in their bodies and present with a very low CEA number. Some have had no change in their CEA number even with a recurrence. The recurrence was caught through scans. This is why I feel CEA is a terrible test. It's another tool to help a doctor form a picture of what is going on with you. But by itself doesn't mean anything. Even if your CEA were to start climbing, your doctor is going to order scans to see if something can be seen. Absent of anything visual, the doctor will not do anything and will wait for another checkup interval and redo all the tests to see if anything has changed.

If you haven't searched for my threads on CEA, I consider myself pretty healthy. My last CEA number was 44.4 which is well outside of any normal range. I've gone through all the different scan techniques and nothing was found. I don't have any symptoms and I regularly work out at the gym. In fact, I have a mental ego about my physical fitness where I'm not overweight and at the age of 49 can lift as much as many of the "kids" that are half my age. My max at bench pressing is 245lbs and I'm shooting to get to 255 lbs in the next month. I raised my max on bicep curls to 135lbs. All at a current body weight of 194 lbs.

hwr
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Re: Does CEA fluctuate in healthy individuals

Postby hwr » Fri Dec 20, 2019 4:58 pm

From MedlinePlus:

"CEA stands for carcinoembryonic antigen. It is a protein found in the tissues of a developing baby. CEA levels normally become very low or disappear after birth. Healthy adults should have very little or no CEA in their body."

zx10guy
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Re: Does CEA fluctuate in healthy individuals

Postby zx10guy » Fri Dec 20, 2019 6:36 pm

Normally this is the case that people should have very low levels of CEA. But there are exceptions. And so far I'm one of them. But it seems you're intent on trying to prove a point so I've said my peace.

hwr
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Re: Does CEA fluctuate in healthy individuals

Postby hwr » Sat Dec 21, 2019 5:32 am

Zx10, my apologies to you and others if I my last post may have been inferred as argumentative. It was intended only to provide the source for some reading material I had referenced in an earlier post, not as a persuasive argument. I appreciate you and others taking the time to respond to my question. I’m on edge right now with many tests coming in the next 2 weeks.

zx10guy
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Re: Does CEA fluctuate in healthy individuals

Postby zx10guy » Sat Dec 21, 2019 8:52 am

No worries. It's just one of the things you have to just try to relax on. Your CEA number is fantastic taking into account from my understanding you are NED. There are many who would kill for that number. I know for me it would be awesome since before my weird CEA elevation, I've always been on the other side of the high normal for CEA. I've only tested once below the upper limit for normal CEA.

As has been mentioned CEA can be affected by a variety of reasons. Many of which are non cancerous. Here are some articles about CEA and why I feel it's a horrible test by itself and why no doctor will use it alone as an indicator of cancer detection.

https://www.ascopost.com/issues/august- ... al-cancer/

https://www.verywellhealth.com/carcinoe ... cea-797561

The article immediately above gives a list of some benign conditions which can raise CEA levels along with inflammation.

And here is a medical paper written up about a Taiwanese woman who presented with a very extreme CEA history but no cancer was found after being tracked for 5 years. Her CEA shot up to the 1000 range and bounced around a range of the 60s into the hundred. I find it curious that no further research has been done to figure out what was going on in her situation. While my situation is not as extreme, I'm presenting in the same manner. The only thing absent from her follow up monitoring was a PET scan of which I had one which showed all clear. I suspect there are more people like us out there than the medical professionals are reporting. Another poster here said her mother also presented the same way. She responded in one of my threads about my crazy CEA numbers.

https://academic.oup.com/jjco/article/36/12/811/874390


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