Stage 2A N0M0 cea rising at four years

[10christa]

in 2020 I had a right side t3 n0 m0 cancer, robotic right hemicolectomy went well home in three days, surgery only and each year my cea was stable in the low 2s. March 2024 it was 2.9 and September 2024 3.5. I have perfect bloodwork, no symptoms, nonsmoker and not in second hand smoke. I am so scared this is cancer back again. I know under 5 is considered normal but my history was stable. I have severe health anxiety and I thought that in 2025 I would be released from care.

56 female
7/2020 T3 N0M0 right side hepatic flexure
Cat scans all clear last one 3/2024
10/2022 Pet scan clear
Moderately differentiated
MSI- H
0/26 lymph nodes
genetic testing no lynch
risk factors
pni and lvi identified

[jts]

Hi 10christa

I'm sorry you are stressing about your CEA. As someone who has spent a lot of time worrying about my CEA: no, I would not worry about a change of 0.6. Supposedly measurements will vary from day to day. Mine goes up or down by 2. The thing to worry about it a longer-term trend.

How often do you have your CEA checked, though? If you are worried about it, you could get it checked more often to watch for a trend.

[10christa]

Hi,
Thank you for your response. I had it checked once a year since 2021 and this last time it was November 2023, March 2024 and Sept 2024 the last two times it was higher then ever my oncology doctor and his nurse are not concerend since I am at 4 years now and cea is under 5, but since it rose .6 in six months I'm thinking if I check again will it be over 4? I know the more time goes by the lower the chance for recurrence. It is very stressful, I was ready to move on next year from doctor appointments every few months.

[O Stoma Mia]

Welcome to the forum. Here is some information on CEA.

A 2019 overview of CEA (Carcinoembryonic Antigen)
https://www.verywellhealth.com/carcinoembryonic-antigen-cea-797561

"In addition, CEA levels may not reflect what is happening with a tumor at the current time.

As cancer cells die, CEA is released into the bloodstream and levels can remain elevated for a few weeks after treatment, even if a tumor is responding well.

For example, CEA results may be very high during and after chemotherapy".

Some false positives for CEA (Carcinoembryonic Antigen) elevation
https://coloncancersupport.colonclub.com/viewtopic.php?t=53135&p=419830#p419830

Some previous CEA (Carcinoembryonic Antigen) threads
https://coloncancersupport.colonclub.com/viewtopic.php?f=1&t=65518&p=508688#p508688

Rule-of-thumb for CEA elevation (stable trend)
https://coloncancersupport.colonclub.com/viewtopic.php?f=1&t=65751&p=509756#p509756

Note: The rule of thumb indicates " 5 ng/mL – 9 ng/mL : slighty above normal – most likely a benign inflammation", however, CEA needs to be checked again to see if it is still rising and if so, how fast, and then another CT scan will eventually be needed in about three months' time to see if anything new shows up. They will not initiate any new treatment until they have positive evidence that this rise is likely due to cancer, since CEA elevations can be due to so many other things, and this elevation might just be a temporary, isolated spike due, for example, to a reaction to a Covid-19 jab, to a recent bad chest cold or bad case of gastroenteritis, or any other recent bad infection. Also there is the potential problem that the CT scanner at your hospital might not be sensitive enough to see small metastases or to see thin metastatic scum along the surface of the abdomen (peritoneum). See post below about CT scanner slices:

https://coloncancersupport.colonclub.com/viewtopic.php?f=1&t=65943&p=510735#p510735

So, what I would recommend is the following:

1. First, get a followup CEA test done at the same lab at least 3 or 4 weeks from the date of last one. This is to see if the 7.0 ng/ml value was a true elevation or just a spike due to some temporary condition. If the follow-up CEA is now at the same level or even higher, then this could indicate a real increase of unknown origin.
2. If the follow-up CEA is still high and increasing, then try to get a new CT scan done (with contrast) at a center that has a high-definition CT scanner with more slices than what your original CT scanner has. This is so that you might be able to detect very small metastases, or peritoneal metastatic slime at an earlier stage than if you just waited around until your local scan center is ready to to do another scan.
3. The above steps might not be covered by insurance or supported by your local hospital procedure, so you might have to pay for them yourself.

====
PS: As a Newly Registered User, you are under probation until you have at least 5 to 10 good posts to the main board. Until then, all of your posts have to go through moderator review before they will appear on the main board and that tskes time, so it is in your best interest to post more messages now so that you will have enough posts to be promoted eventually to status of Regular User.

Reference:
https://coloncancersupport.colonclub.com/viewtopic.php?f=1&t=65967&p=510814#p510814

[Green Tea]

...The thing to worry about is a longer-term trend.

How often do you have your CEA checked, though?

If you are worried about it, you could get it checked more often to watch for a trend...

Yes! It is the rate-of-change in the longer-term trend that is most important, i.e., the speed at which the CEA is increasing over time (snowball effect):

Rate of change of CEA
https://coloncancersupport.colonclub.com/viewtopic.php?f=1&t=53702&p=426284#p426284

[Jacques]

in 2020 I had a right side t3 n0 m0 cancer...

--------------
56 female
7/2020 T3 N0M0 right side splenic flexure
Cat scans all clear last one 3/2024
10/2022 Pet scan clear
Moderately differentiated
MSI- H
0/26 lymph nodes
genetic testing no lynch
risk factors
pni and lvi identified

I don't quite understand. In your post you said that you had a "right side t3 n0 m0 cancer", but in your draft signature you mention "right side splenic flexure". But the splenic flexure is not on the right side: it's on the left-hand side of the body .

Why are you mentioning "splenic flexure"?

[10christa]

Thanks for bringing it to my attention, yes hepatic flexure. Anxiety is making me think wrong.

[Pagola44]

Did you do chemo?

[utahgal7]

10christa,

I think most of us on this forum have worried about rising CEA from time to time. As far as CEA goes, my former oncologist said that he wasn't worried about rising CEA until it goes over 10. Other oncologists' opinions may differ.

Have you had your vitamin D levels checked recently? The reason I ask is because my CEA will go up as my vitamin D levels go down. I am not saying that your rising CEA is directly correlated to your vitamin D level, but you never know. If you are deficient in vitamin D, that is something you would definitely want to discuss with your doctor.

Take care and keep us posted,

Paige

[Green Tea]

Welcome to the ColonTalk forum, where there are over 700 CEA threads existing as of today.

Threads here with CEA in the title

The thread that you just started on the topic Stage 2A N0M0 cea rising at four years was the 704th CEA thread here. If you are looking for support from other "T3 N0 M0 surgery-only (no chemo) members you can probably find what you're looking for here.

Actually, there is a current Stage 2A member who started a CEA thread here almost 3 years after her 2014 surgery. Her screen name is DarknessEmbraced and her CEA thread is here:

High CEA reason for ct scans being moved up
https://coloncancersupport.colonclub.com/viewtopic.php?f=1&t=58670&p=462080&hilit=cea#p462080

This thread was a long one with over 40 replies. It turned out that her high CEA had nothing to do with a possible CRC recurrence.

If you check back here in a few weeks you might find that she has posted a reply on your thread. She's still around, but nowadays she only checks in here once or twice a month.

[10christa]

Hi,
Thank you so much for helping me with other threads. Doing research on the internet sometimes puts me into heavy anxiety and I end up giving myself all kinds of diseases. I was ready to not go back to the cancer center of hospital. I have been through the colon cancer then the scans when there was ground glass nodules, lung dr appointment.. then a breast mri with a sternum lesion, atypical cell and lumpectomy. PET scan...high risk for breast cancer now.
I am getting scans every 6 months for that. Now this again. People who have not been through cancer and the stuff that comes with it have no idea what we go through.
I am grateful I found this site and joined. Thank you!!

[Green Tea]

Hi,
Thank you so much for helping me with other threads. Doing research on the internet sometimes puts me into heavy anxiety and I end up giving myself all kinds of diseases. I was ready to not go back to the cancer center of hospital. I have been through the colon cancer then the scans when there was ground glass nodules, lung dr appointment.. then a breast mri with a sternum lesion, atypical cell and lumpectomy. PET scan...high risk for breast cancer now.
I am getting scans every 6 months for that. Now this again. People who have not been through cancer and the stuff that comes with it have no idea what we go through.
I am grateful I found this site and joined. Thank you!!

Thank you for your reply and for bringing us up to date on your various medical challenges. It must be very stressful for you to have to shuttle between various appointments and hospital visits for a wide range of medical conditions involving multiple doctors and multiple medical staff. Not to mention all the various lab reports and scan reports that have to be interpreted, understood and then filed away in an orderly fashion for future reference. I'm not sure that I would be able to cope very well with such a complex, changing, medical situation.

From what you say, it looks like your main concerns right now are in the gynecological area and will involve keeping up with the various screenings, staging and monitoring requirements there.

Can I ask how recently the lumpectomy procedure was done? And did the lumpectomy pathology report give any information on gene mutations found in the specimen, e.g., BRACA1, BRACA2, etc.? What's next on the agenda there now -- radiation therapy or some sort of adjuvant chemotherapy? And what about other possible tumor-marker blood tests, like CA15-3, CA27.29, ESR1, HER2, PIK3CA, 70-Gene signature (Mammaprint), 21-Gene signature (Oncotype DX), Urokinase plasminogen activator (uPA), etc.?

Anyway, my current speculation right now about your recent CEA results is that they might have been influenced by the inflammation and swelling that results from a lumpectomy procedure. Do you think that might be a possibility?

Lumpectomy
https://my.clevelandclinic.org/health/procedures/12962-lumpectomy#overview

[10christa]

Hi,
When I had the colon cancer I had genetic testing done because of my age. I do not have any of the mutations. The lumpectomy was atypia and that puts me at high risk but it was not cancerous and it was in 2022 so I don't think it would be that. But I go every 6 months for breast mri, US and mammograms, that is how they saw the sternal lesion, I had a PET 2022 and all good.

[10christa]

I had new nodules this April and a needle biopsy but I don't see how that would cause a cea rise though.

[Green Tea]

Question about follow-up colonoscopy.

So far you haven't mentioned anything about colon cancer screening tests that you did or colonoscopies that you did. So, I have a few questions.

When were you first screened for colon cancer? What kind of screening test was used at that time?

When did you have your first colonoscopy?

Have you had any follow-up colonoscopies after your right hemicolectomy surgery? If so, when were they done and what was the outcome?

The reason I ask is because the NCCN guidelines say that you should have at least one colonoscopy in the five-year follow-up period to see if any new polyps have appeared so that they can be removed before they cause any problem.

I'm sorry to bother you with this question because I know your medical calendar for the year must already be pretty full, but the follow-up colonoscopy is really something that needs to be done eventually.