liver and CEA results-ultrasound ordered

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Lotus
Posts: 53
Joined: Thu Mar 29, 2018 10:03 pm

liver and CEA results-ultrasound ordered

Postby Lotus » Wed May 26, 2021 3:30 am

Dear friends,
I've been having CEA checked every six months since my surgery. Last week it increased from previous <0.5 to 1.1 and the liver test showed the following:
AST. 34 U/L. 0-31
ALT. 39 U/L. 0-31
Alk 115 U/L. 35-104

We recently moved twice and changed practices so doctor said that could be reason for blood results to change.
Doctor is concerned that CEA increased to 1.1 from <0.5 and liver function is elevated. So he ordered stomach ultrasound to check liver. I recently saw a naturopath who gave me several new supplements to take. I am now taking a total of 20 supplements and I'm wondering if that may have caused my liver numbers to go up. Also had both Pfizer vaccines and can't help but wonder if the vaccine may be the cause.
Has anyone had these type results? and needed ultrasound? He explained NOTHING so I have no idea what he's looking for in an ultrasound to check my liver. So my imagination is running wild. If anyone can shed any light or share your experience, it would be greatly appreciated, thank you.
female age 74
3/21/18Colonoscopy. Dx "rectal mass" colonic adenocarcinoma
3/22/18 Ct scan no metastatic disease
4/1/18 MRI shows left lateral wall thickening of the rectosigmoid junction originating app 13 cm. from the anal verge. Overall lesion 3.5 cm. No progressive adjacent adenopathy.
Depth T2 no lymph node spread.
Stage 1 t2n0
4/16/18 Robotic LAR
2019 colonoscopy normal
5/21 CEA 1.1, up from .8, .9, <0.5 liver enzymes elevated, ultrasound no cancer

catstaff
Posts: 85
Joined: Wed Mar 03, 2021 11:37 am

Re: liver and CEA results-ultrasound ordered

Postby catstaff » Wed May 26, 2021 6:11 am

A *lot* of supplements can cause liver injury. Too much green tea extract can do it, for example.
D/H Dx 10/2019 RC age 61
Clinical T4bN2M1a (common iliac and para-aortic lymph nodes)
MSS KRAS G12D
CRT 11/19-1/20 FOLFOX 3/20-7/20
Pelvic exenteration w/LAR 8/20
ypT4bN0Mx G3 0/14 nodes LVI not seen PNI-
CEA 10/19:20, 1/20-11/20:1.6, 4.3, 3.4, 2.7, 2/21:9.0 3/21:18,40 4/21:28,19, 5/21:13.3,8.6
PET 3/21 recurrence in distal nodes, L5 vertebra, pelvis
FOLFIRI+bev 3/21-

Claudine
Posts: 524
Joined: Tue Mar 12, 2019 2:41 pm
Location: Montana

Re: liver and CEA results-ultrasound ordered

Postby Claudine » Wed May 26, 2021 10:32 am

It's interesting that your normal ranges differ from those listed on my husband's chart: his has AST normal = 5 to 40, ALT normal = 6 to 50, and Alkaline normal = 38 to 110. Which would pretty much put you in the normal range; upper part (especially for Alk) but close. I'm wondering if normal ranges differ between men and women?
Are your liver functions higher than they were previously?
Wife of Dx 04/18 (51 yo). MSS, KRAS G12A
No primary (involuted?)
Lytic tumor L4 vertebrae, EBRT 04/18, SBRT 02/19
Resect small intestine 05/18 (no cancer - Crohn's)
Failed adjuvant Xelox
Folfiri + Avastin 03/19 to 01/20
6.7 cm left adrenal mass 03/19, successful resection 02/20
CEA since 03/19: high 58, low 3.2, now 75.5
Scan 03/19: Multiple small lung nodules, now gone/calcified
PET 04/20 uptake by L4
L3-L4-L5 fusion surgery and partial corpectomy 05/20
Scan 06/17/2021: stable

catstaff
Posts: 85
Joined: Wed Mar 03, 2021 11:37 am

Re: liver and CEA results-ultrasound ordered

Postby catstaff » Wed May 26, 2021 11:04 am

May be a difference in lab standards. The range cited by Claudine seems to be more typical, but there can be variations.

I suppose if the doctor is concerned he must work with the narrower range. The CEA rise doesn't seem that big either, and it's still well within normal, but perhaps worth a look.
D/H Dx 10/2019 RC age 61
Clinical T4bN2M1a (common iliac and para-aortic lymph nodes)
MSS KRAS G12D
CRT 11/19-1/20 FOLFOX 3/20-7/20
Pelvic exenteration w/LAR 8/20
ypT4bN0Mx G3 0/14 nodes LVI not seen PNI-
CEA 10/19:20, 1/20-11/20:1.6, 4.3, 3.4, 2.7, 2/21:9.0 3/21:18,40 4/21:28,19, 5/21:13.3,8.6
PET 3/21 recurrence in distal nodes, L5 vertebra, pelvis
FOLFIRI+bev 3/21-

Lotus
Posts: 53
Joined: Thu Mar 29, 2018 10:03 pm

Re: liver and CEA results-ultrasound ordered

Postby Lotus » Wed May 26, 2021 12:49 pm

Yes the liver numbers are higher than they were previously but those were done at a different lab...and the doc did say that it's like comparing apples with oranges. My ultrasound is scheduled for tomorrow. It's abdominal....he said they will be looking at my liver.
female age 74
3/21/18Colonoscopy. Dx "rectal mass" colonic adenocarcinoma
3/22/18 Ct scan no metastatic disease
4/1/18 MRI shows left lateral wall thickening of the rectosigmoid junction originating app 13 cm. from the anal verge. Overall lesion 3.5 cm. No progressive adjacent adenopathy.
Depth T2 no lymph node spread.
Stage 1 t2n0
4/16/18 Robotic LAR
2019 colonoscopy normal
5/21 CEA 1.1, up from .8, .9, <0.5 liver enzymes elevated, ultrasound no cancer

Lotus
Posts: 53
Joined: Thu Mar 29, 2018 10:03 pm

Re: liver and CEA results-ultrasound ordered

Postby Lotus » Wed May 26, 2021 12:57 pm

There is green tea extract in one of my many supplements. My b12 is also elevated which is a possible indicator of liver damage, says Mr. Google. I had also added vitamin b12 as directed by naturopath. I will discontinue all supplements for now.
female age 74
3/21/18Colonoscopy. Dx "rectal mass" colonic adenocarcinoma
3/22/18 Ct scan no metastatic disease
4/1/18 MRI shows left lateral wall thickening of the rectosigmoid junction originating app 13 cm. from the anal verge. Overall lesion 3.5 cm. No progressive adjacent adenopathy.
Depth T2 no lymph node spread.
Stage 1 t2n0
4/16/18 Robotic LAR
2019 colonoscopy normal
5/21 CEA 1.1, up from .8, .9, <0.5 liver enzymes elevated, ultrasound no cancer

Lotus
Posts: 53
Joined: Thu Mar 29, 2018 10:03 pm

Re: liver and CEA results-ultrasound ordered

Postby Lotus » Wed May 26, 2021 3:03 pm

Ok found last liver test....the normal parameters are different so don't really understand how to compare the two.

Nov. 2021
AST. 20 U/L. 10-35
ALT. 17 U/L. 6-29
Alk. 84 U/L. 37-153

Current
AST. 34 UL 0-31
ALT. 39 UL 0-31
Alk. 115 UL 35-104

I understand why it's comparing apples to oranges. Any insights?

I just received call back from Doctor's nurse....she said that yes I am taking three supplements that could affect the liver results. I asked her about Pfizer vaccine, she said not likely to affect liver but I have my doubts. We really don't know much about side effects or long term effects of these vaccines.
female age 74
3/21/18Colonoscopy. Dx "rectal mass" colonic adenocarcinoma
3/22/18 Ct scan no metastatic disease
4/1/18 MRI shows left lateral wall thickening of the rectosigmoid junction originating app 13 cm. from the anal verge. Overall lesion 3.5 cm. No progressive adjacent adenopathy.
Depth T2 no lymph node spread.
Stage 1 t2n0
4/16/18 Robotic LAR
2019 colonoscopy normal
5/21 CEA 1.1, up from .8, .9, <0.5 liver enzymes elevated, ultrasound no cancer

User avatar
beach sunrise
Posts: 457
Joined: Thu Mar 05, 2020 7:14 pm

Re: liver and CEA results-ultrasound ordered

Postby beach sunrise » Wed May 26, 2021 4:55 pm

Hmm, my panel ranges are AST 0-40, ALT 0-32, ALP 39-117 IU/L
8/19 RC CEA 82.6 T3N0M0
Neoadj 5FU/rad 6 wk
High dose IVC 1 1/2 wks before surgery. Continue still twice a week
Surg 1/20 APR - 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
7/20 CEA 11.1, 8.8
8/20 CEA 7.8
9/20 CEA 8.8, 9, 8.6
10/20 CEA 8.1
11/20 CEA 8's
12/20 CEA 8's & 9's
ADAPT+++ TM drug
MHL1+
PMS2+
MSH2+
MSH6+
POLD1 , KRAS Q61H
Chem-sens test NCI "Test failed, neo adj CR worked. Not enough ca cells to test"

Koreysue
Posts: 207
Joined: Mon Apr 30, 2018 2:36 pm

Re: liver and CEA results-ultrasound ordered

Postby Koreysue » Wed May 26, 2021 10:36 pm

I read a study last week, that stated that covid patients can have CEA elevations, so perhaps the inflammation response from the shot doing it’s job could be having a similar effect. I have had some little rises in CEA, one recently in fact...they always really get me stressed, but have always led to nothing - it lowers the next time. Mine is always at the high range of normal which I don’t love, but they look for a continued upward trend. If this is the first elevation for you, perhaps they are just being extra thorough which is great. Hoping for a clean ultrasound for you, and that the supplements are to blame for the liver numbers.
Ksue
Diagnosed: June 2017 stage 3 colon cancer
Sigmoid colon, 2 nodes affected
CEA at diagnosis: 6.1
Sigmoid Colectomy and folfox (chemo complete January 31, 2018)
CEA 4/2018: 2.4
CEA 7/2018: 3.7
Colonoscopy 8/2018 clean
PET scan 8/20/18 NED
CEA 11/2018: 3.8
CEA 2/2019: 3.2
CT NED 6/18/2019 / CEA : 3.4
CEA 10/21/19: 3.2
CEA 3/9/20: 3.8
CT NED /CEA 6/17/20: 3.8
CEA 11/4/20 4.6 <——— whyyyy? (will retest in a few weeks)
CT NED 12/1/20 CEA: 3.5 (happy to see a lower number)
CEA 5/17/21 4.2

Lotus
Posts: 53
Joined: Thu Mar 29, 2018 10:03 pm

Re: liver and CEA results-ultrasound ordered

Postby Lotus » Thu May 27, 2021 5:33 pm

So I had the ultrasound today and results already as follows:

Hepatic steatosis. Otherwise unremarkable examination.

Doc said it is fatty liver and supplements may have caused that result. He said there is no sign of cancer in this result.
He ordered another CEA test for two months from now because that went up slightly .....he said he would not have ordered the ultrasound on the merits of the CEA increase alone but still wants it checked sooner than 6 months. He wants me to use the same lab to be sure that they have a more accurate picture of what is going on. I'm very grateful to have found a doctor who seems to know what he is doing. We moved to Pittsburgh last year from Greenville, SC and I had great doctors there and hoped to find good ones here. I never realized the importance of using the same lab for blood work until now. I hope this information may be useful to someone out there reading this.

Thank you all for hanging in there with me.
female age 74
3/21/18Colonoscopy. Dx "rectal mass" colonic adenocarcinoma
3/22/18 Ct scan no metastatic disease
4/1/18 MRI shows left lateral wall thickening of the rectosigmoid junction originating app 13 cm. from the anal verge. Overall lesion 3.5 cm. No progressive adjacent adenopathy.
Depth T2 no lymph node spread.
Stage 1 t2n0
4/16/18 Robotic LAR
2019 colonoscopy normal
5/21 CEA 1.1, up from .8, .9, <0.5 liver enzymes elevated, ultrasound no cancer

Nor Cal
Posts: 17
Joined: Sun Dec 06, 2020 8:18 pm

Re: liver and CEA results-ultrasound ordered

Postby Nor Cal » Thu May 27, 2021 6:54 pm

Good news - now you just have to treat that fatty liver. My labs vary quite a bit between the main hospital and the cancer center. Luckily haven't had to use a completely independent lab since I was diagnosed.
Dx June 2020, stage IV, w liver mets in both lobes. M, age 50. Right-sided colon tumor. BRAF mutation. CEA 120
7-12/20 9 cycles FOLFOXIRI (plus Avastin cycles 2-6)
CEA 2.9
12/20 radioembolization (right lobe) cea 2.0
1/21 chemoembolization (left lobe)
2/21 chemoembolization (left lobe)
1-6/21 6 cycles FOLFIRI + Avastin

Claudine
Posts: 524
Joined: Tue Mar 12, 2019 2:41 pm
Location: Montana

Re: liver and CEA results-ultrasound ordered

Postby Claudine » Fri May 28, 2021 9:57 am

Fantastic! Anything is better than cancer IMO!
Wife of Dx 04/18 (51 yo). MSS, KRAS G12A
No primary (involuted?)
Lytic tumor L4 vertebrae, EBRT 04/18, SBRT 02/19
Resect small intestine 05/18 (no cancer - Crohn's)
Failed adjuvant Xelox
Folfiri + Avastin 03/19 to 01/20
6.7 cm left adrenal mass 03/19, successful resection 02/20
CEA since 03/19: high 58, low 3.2, now 75.5
Scan 03/19: Multiple small lung nodules, now gone/calcified
PET 04/20 uptake by L4
L3-L4-L5 fusion surgery and partial corpectomy 05/20
Scan 06/17/2021: stable

boxhill
Posts: 719
Joined: Fri Apr 06, 2018 11:40 am

Re: liver and CEA results-ultrasound ordered

Postby boxhill » Fri May 28, 2021 12:33 pm

20 supplements?? Your system has to clear all of that stuff. I freely admit that I am skeptical of naturopaths, but stopping all that at least for now was probably a wise move on your part.

I'd find it very hard to believe that a vaccination could harm your liver, especially since EVERY potentially serious health occurrence of vaccinated people is being watched like a hawk, even when the incidence is no higher than expected in the population. On the other hand, inflammation causes CEA to rise, so a desirable immune response to a vaccination could easily bump it up a bit.

Happy to hear it's not cancer.
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
5/19 MRI stable/NED
Stop Key
All MRIs NED

catstaff
Posts: 85
Joined: Wed Mar 03, 2021 11:37 am

Re: liver and CEA results-ultrasound ordered

Postby catstaff » Sat May 29, 2021 12:19 pm

I am more than skeptical of naturopaths. 20 supplements is excessive and nearly certain to cause interactions. A lot of herbals are metabolized by the same liver enzymes as drugs, which can make the blood concentration of the drugs become unpredictable. Or they interfere with the metabolization of each other. It can happen with "ordinary" plant substances as well--grapefruit contains furanocoumarins which occupy one of the CYP enzymes and interfere with the breakdown of many drugs. I admit I have looked into supplements and bought many, but mostly haven't given any to DH since I don't want to risk interactions with chemo, and I'd like some evidence they do anything in humans. Even mice trials can be misleading. (This is certainly true for would-be pharmaceuticals as well, which is why small molecules keep breaking our hearts--they may work well in cells or even mice, then fail a Phase III trial in humans.) Some mushroom extracts may have some clinical trials data that's not too unreliable. I'm not convinced of anything else. For instance, there was a real clinical trial in Korea of curcumin+folfori/bev versus folfiri/bev alone, which was completed a year ago but I can't find a writeup. One can usually find a writeup of results by googling the name of the principle investigator+trial ID and they normally write something in English. So far nothing on this one. Doesn't mean it was negative, but I'd like to know the outcome.

Plus the bioavailability of most supplements is low and unpredictable. That's one of the main issues in drugs, is getting it to the target in sufficient and standardized quantity without a lot of "collateral damage." That's nearly impossible with supplements. E.g. irinotecan is derived from a botanical, it actually did come out of traditional Chinese medicine, but it's been chemically altered to isolate and improve the active ingredient--camptothecin, the natural product, has low solubility and a lot of adverse effects.

Inflammation from a vaccine could account for the CEA rise but it may also have been nothing at all. CEA fluctuations of "normal" people isn't particularly well characterized as far as I know, and 1.1 is well within normal for nonsmokers.
D/H Dx 10/2019 RC age 61
Clinical T4bN2M1a (common iliac and para-aortic lymph nodes)
MSS KRAS G12D
CRT 11/19-1/20 FOLFOX 3/20-7/20
Pelvic exenteration w/LAR 8/20
ypT4bN0Mx G3 0/14 nodes LVI not seen PNI-
CEA 10/19:20, 1/20-11/20:1.6, 4.3, 3.4, 2.7, 2/21:9.0 3/21:18,40 4/21:28,19, 5/21:13.3,8.6
PET 3/21 recurrence in distal nodes, L5 vertebra, pelvis
FOLFIRI+bev 3/21-


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