Does chemo regimen have impact on CEA?

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Does chemo regimen have impact on CEA?

Postby ginabeewell » Thu Oct 15, 2020 9:04 pm

My CEA has been a very sensitive marker for me.

The last time I went from 0.8 to 1.3, it was the start of my recurrence.

I did 10 or so rounds of FOLFIRI + VECTIBIX and got my CEA down to 0.7 for 2 or 3 monthly tests in a row. My PET scan showed no active cancer.

When I discontinued Irinotecan, the CEA went to 1.2 for the next two tests.

It’s not increasing, I guess - a good thing. But after 3 tests of 0.7 and 2 of 1.2, I found myself wondering if maybe just taking the Irinotecan had an impact? (Not necessarily that it means cancer is active, just that the “baseline” could be different somehow?)

Have another CT coming up next week and likely a PET after that, so just curious how to think about my CEA.
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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Re: Does chemo regimen have impact on CEA?

Postby CRguy » Thu Oct 15, 2020 10:47 pm

CEA is probably one of the most discussed issues on forum !!!

For me = not a marker ... BUTT ... even within the limits of normal lab levels,
some proportional changes ( e.g. 20% increase from last time, still within lab NORMALS ) can be a significant "marker trend."

I would say IF you see some proportioanl changes, even if actual levels are within "normal" limits,
you and the docs should monitor these.

I share this retrospectively because ALL of my CEA tests are well within the "normal" range
BUTT ... there have been proportional increases which did coincide with chemo response and met activity.
If it kicks up a bit because chemo IS WORKING = YES !!!!

The Docs like to say " Well it is still in the normal range ....."
I would say BUTT ... " Keep an eye on it anyway " and try to correlate any CEA changes with your own situation !

Cheers and best wishes
CRguy on the Journey
Caregiver x 4
Stage IV A rectal cancer/lung met
13 Year survivor
my life is an ongoing totally randomized UNcontrolled experiment with N=1 !
Review of my Journey so far

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Joined: Wed Jan 08, 2020 6:15 pm

Re: Does chemo regimen have impact on CEA?

Postby Monimom » Fri Oct 16, 2020 11:39 am

We will be finding out today ........ my husbands cea has increased , after 3 months of no marker tests it was recently checked and has nearly doubled and is over 1400 now... the only change that was made was switching from 5fu & avastin infusions every other week to xeloda 2weeks and avastin at week 3... I would love to say THATS the reason, but he had begun slight increases before this jump, also had a PET scan that found no changes... today he has an avastin infusion and we will learn the results of a CT scan he had earlier this week
Praying ...
will update when I can
Best wishes
Moni : )
Oct 2019 56 yo Husband DX'd
Stage 4 MCC
Colon thickening w/ apple core 3.9 cm area
Liver mets both lobes 10.4 x 7.6 cm & 9.3 x 7.7cm
innumerable small lesions
Oct 2019 Liver Biopsy
CEA Dec '19 . 3,028
Dec 2019-present 5FU, Avastin & Oxaliplatin
Jan '20. CEA 1861.8
Feb '20 CT mets 9.4cm x 6.5 & 8.0 x 6.7 cm
April '20 CEA 411.1
May '20 CT mets 8.6cm x 6.3 & 5.7 x 6.1 cm
Colon unchanged

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