2nd read of PET

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beach sunrise
Posts: 1034
Joined: Thu Mar 05, 2020 7:14 pm

2nd read of PET

Postby beach sunrise » Tue Oct 27, 2020 6:34 pm

Hi all, this is the 2nd reading. I need to make appt with endocrinologist to investigate. Can thyroid make CEA really high? I am about at my wits end with not finding the source of elevated CEA.
1. No convincing evidence of metabolically active tumor.
2. Patchy mild uptake in the anterior abdominal wall and presacral soft tissues, from posttreatment changes.
3. Thyromegaly with suggestion of autoimmune thyroiditis and additional findings as above. Final Report
8/19 RC CEA 82.6 T3N0M0
5FU/rad 6 wk
IVC 75g 1 1/2 wks before surgery. Continue 2x a week
Surg 1/20 -margins T4bN1a IIIC G2 MSI- 1/20 LN+ LVI+ PNI-
pre cea 24 post 5.9
FOLFOX
7 rds 6-10 CEA 11.4 No more
CEA
7/20 11.1 8.8
8/20 7.8
9/20 8.8, 9, 8.6
10/20 8.1
11/20 8s
12/20 8s-9s
ADAPT++++ chrono
CEA
10/23/22 26.x
12/23/22 22.x
2023
1/5 17.1
1/20 15.9
3/30 14.9
6/12 13.3
8/1 2.1
Nodule RML SUV 1.3 5mm
Rolles 3 of 4 lung nodules cancer
KRAS
Chem-sens test failed Not enough ca cells to test

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CRguy
Posts: 10473
Joined: Sun Feb 10, 2008 6:00 pm

Re: 2nd read of PET

Postby CRguy » Tue Oct 27, 2020 7:23 pm

beach sunrise wrote: I need to make appt with endocrinologist to investigate.
THIS is the essential step, as thyroid issues are not always simple.

Can thyroid make CEA really high?
Yes, both HYPO and HYPER thyroid issues have been associated with elevated levels of CEA,
for different reasons .... AND ... many other "inflammations" in the body, especially thoracic, have as well.

Best wishes
Let us know what the specialist says

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

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beach sunrise
Posts: 1034
Joined: Thu Mar 05, 2020 7:14 pm

Re: 2nd read of PET

Postby beach sunrise » Tue Oct 27, 2020 8:44 pm

Thanks, CRguy! I'm on it.
It might be why my IL-8 is so high also.

Expand the bloodwork and keep on looking!!!
8/19 RC CEA 82.6 T3N0M0
5FU/rad 6 wk
IVC 75g 1 1/2 wks before surgery. Continue 2x a week
Surg 1/20 -margins T4bN1a IIIC G2 MSI- 1/20 LN+ LVI+ PNI-
pre cea 24 post 5.9
FOLFOX
7 rds 6-10 CEA 11.4 No more
CEA
7/20 11.1 8.8
8/20 7.8
9/20 8.8, 9, 8.6
10/20 8.1
11/20 8s
12/20 8s-9s
ADAPT++++ chrono
CEA
10/23/22 26.x
12/23/22 22.x
2023
1/5 17.1
1/20 15.9
3/30 14.9
6/12 13.3
8/1 2.1
Nodule RML SUV 1.3 5mm
Rolles 3 of 4 lung nodules cancer
KRAS
Chem-sens test failed Not enough ca cells to test

michelle c
Posts: 1929
Joined: Wed Dec 02, 2009 3:58 am

Re: 2nd read of PET

Postby michelle c » Wed Oct 28, 2020 2:14 am

Hi there,

What are your CEA levels and is it creeping upwards or staying about the same?
May 25 2009 Dx with CC (sigmoid colon) 2 days after my 44th b'day
CEA prior to surgery 4.7
Jun 3 2009 LAR - Stage III 3/10 lymph nodes
Jul 6 - Dec 10 2009 - 12 cycles FOLFIRI
Genetic testing - inconclusive for Lynch
Jul 2012 port removed & hernia repair

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beach sunrise
Posts: 1034
Joined: Thu Mar 05, 2020 7:14 pm

Re: 2nd read of PET

Postby beach sunrise » Wed Oct 28, 2020 12:48 pm

Hi Michelle, it is at 8.9 as of 10-23-20. It was 8.6 before that I believe.
What are you thinking?
8/19 RC CEA 82.6 T3N0M0
5FU/rad 6 wk
IVC 75g 1 1/2 wks before surgery. Continue 2x a week
Surg 1/20 -margins T4bN1a IIIC G2 MSI- 1/20 LN+ LVI+ PNI-
pre cea 24 post 5.9
FOLFOX
7 rds 6-10 CEA 11.4 No more
CEA
7/20 11.1 8.8
8/20 7.8
9/20 8.8, 9, 8.6
10/20 8.1
11/20 8s
12/20 8s-9s
ADAPT++++ chrono
CEA
10/23/22 26.x
12/23/22 22.x
2023
1/5 17.1
1/20 15.9
3/30 14.9
6/12 13.3
8/1 2.1
Nodule RML SUV 1.3 5mm
Rolles 3 of 4 lung nodules cancer
KRAS
Chem-sens test failed Not enough ca cells to test

stu
Posts: 1613
Joined: Sat Aug 17, 2013 5:46 pm

Re: 2nd read of PET

Postby stu » Wed Oct 28, 2020 3:42 pm

Trying to work your CEA out! So it has come down since July but bounces around 8 .

We have now got to consider something else influences my mum’s CEA . On two separate occasions it has bounced up but scanned well on both occasions. Then dropped back down of it’s own accord . The only thing she was complaining about was indigestion. I got her to take anti acids ,even although it was not that bad, before her last CEA and it had all returned to normal . Absolutely no idea if it was influencing it or not . But we know something is . This has happened over a two year period and several scans have all been good !

Hope you get to the bottom of it .
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 .

michelle c
Posts: 1929
Joined: Wed Dec 02, 2009 3:58 am

Re: 2nd read of PET

Postby michelle c » Thu Oct 29, 2020 3:13 am

beach sunrise wrote:Hi Michelle, it is at 8.9 as of 10-23-20. It was 8.6 before that I believe.
What are you thinking?


Hi,

Ok, this is what I think. I admit 8 is quite high but it might not be high for you. I see from your signature that it is generally around this figure, sometimes a little higher, sometimes a little lower. The fact that it is not trending up is very good. So maybe 8 is your normal. Oncologists look for an upward trend but yours is stable around 8. My oncologist told me that if bloods are done in the morning and again in the evening, the result would be different. No two tests are rarely the same and ok to bounce around - Any deviation to the right of the decimal point is ok.

Mine is around one. It bounces from 0.5 to 1 point something and back down again. Yours bounces around 8. If mine went to 8 it would be concerning but yours is consistently around this figure. An upward trend and I mean upward, jumping higher and higher, that would be concerning.

I’m sure that if your cancer was growing your CEA would be trending up. It could be your normal or something non-cancer related is making it sit around 8. Try not to worry.

Best wishes
May 25 2009 Dx with CC (sigmoid colon) 2 days after my 44th b'day
CEA prior to surgery 4.7
Jun 3 2009 LAR - Stage III 3/10 lymph nodes
Jul 6 - Dec 10 2009 - 12 cycles FOLFIRI
Genetic testing - inconclusive for Lynch
Jul 2012 port removed & hernia repair

claudine
Posts: 809
Joined: Tue Mar 12, 2019 2:41 pm
Location: Montana

Re: 2nd read of PET

Postby claudine » Thu Oct 29, 2020 10:01 am

I agree with Michelle; a CEA around 8 might be your new "normal", I would worry a lot more if it was trending upwards... Still worth keeping an eye on and investigating, of course. It's great that there's no evidence of active tumor!
Wife of Dx 04/18 (51 yo). MSS, KRAS G12A, no primary

Tumors: L4 04/18; left adrenal gland & small lung nodules 03/19
rectum 02/22 (pT3 pN0 stage 2A); L3 09/22

Surgeries: intestinal resect. 05/18 (no cancer - Crohn's); adrenalectomy 02/20
L3-L4-L5 fusion and corpectomy 05/20; LAR 04/22; ileo reversal 09/22
L2-L3 fusion and corpectomy 09/22

Treatments: EBRT 04/18; SBRT 02/19; Failed adjuvant Xelox ; Folfiri/Avastin 03/19 - 01/20
adjuvant chemorad (Xeloda) 06/22; SBRT 11/22; Xeloda/Avastin since 01/24

boxhill
Posts: 789
Joined: Fri Apr 06, 2018 11:40 am

Re: 2nd read of PET

Postby boxhill » Thu Oct 29, 2020 2:35 pm

My CEA was 3 at diagnosis, when I had an obstructing colon tumor, 11 malignant lymph nodes, a matted clump of 5 malignant mesenteric lymph nodes, and a liver met.

It has never been that low since. I am now NED, and have been for probably more than a year, and it has been around 6-8 ever since I started chemo in 2018. Weird. But it is officially not a marker for me, so who knows what is going on. Something around 8 might be your new normal. Try not to get too worried about it in the absence of any evidence to the contrary. :)
F, 64 at DX CRC Stage IV
3/17/18 blockage, r hemi
11 of 25 LN,5 mesentery nodes
5mm liver met
pT3 pN2b pM1
BRAF wild, KRAS G12D
dMMR, MSI-H
5/18 FOLFOX
7/18 and 11/18 CT NED
12/18 MRI 5mm liver mass, 2 LNs in porta hepatis
12/31/18 Keytruda
6/19 Multiphasic CT LNs normal, Liver stable
6/28/19 Pause Key, predisone for joint pain
7/31/19 Restart Key
9/19 CT stable
Pain: all fails but Celebrex
12/23/19 CT stable
5/20 MRI stable/NED
6/20 Stop Key
All MRIs NED

User avatar
beach sunrise
Posts: 1034
Joined: Thu Mar 05, 2020 7:14 pm

Re: 2nd read of PET

Postby beach sunrise » Fri Oct 30, 2020 9:44 am

Good morning and TGIF!
Big thanks to you all for replying. It helped me formulate questions to ask my surgeon at appt this morning.
He is setting me up with an endocrinologist. He hasn't came across a patient so far with thyroid suspect. We talked about whether it could be the driver of CEA and IL-8. He said its interesting and we will get to the bottom of it.
So, we will see what him and endocrinologist find out.
I will have a CAP CT done early Dec and a thyroid ultrasound on the same day.
8/19 RC CEA 82.6 T3N0M0
5FU/rad 6 wk
IVC 75g 1 1/2 wks before surgery. Continue 2x a week
Surg 1/20 -margins T4bN1a IIIC G2 MSI- 1/20 LN+ LVI+ PNI-
pre cea 24 post 5.9
FOLFOX
7 rds 6-10 CEA 11.4 No more
CEA
7/20 11.1 8.8
8/20 7.8
9/20 8.8, 9, 8.6
10/20 8.1
11/20 8s
12/20 8s-9s
ADAPT++++ chrono
CEA
10/23/22 26.x
12/23/22 22.x
2023
1/5 17.1
1/20 15.9
3/30 14.9
6/12 13.3
8/1 2.1
Nodule RML SUV 1.3 5mm
Rolles 3 of 4 lung nodules cancer
KRAS
Chem-sens test failed Not enough ca cells to test


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