CEA went from 107 to 3. Update and surgery date.

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JMRWife
Posts: 71
Joined: Mon Oct 05, 2015 9:41 pm

CEA went from 107 to 3. Update and surgery date.

Postby JMRWife » Wed Aug 11, 2021 10:47 am

On the surface of things, this seems good. But I've not had surgery yet and no scan since diagnosis.

I understand that nothing really counts until it's staged, after surgery. What inference can I take from such a drop? I do not hold out false hope and I understand at cea is a significant marker for some and not for others.
Last edited by JMRWife on Thu Aug 26, 2021 4:25 am, edited 1 time in total.
Age 58.
4/27/2021 - Dx obstructing "apple core" sigmoid tumor at 30cm. MMR proficient. 4/28: Diverting colostomy.
Started neoadjuvant Folfox 5/18; CEA 107.
Aug 11: 7 rounds Folfox completed. CEA 3.2.
Pathology: COLON, SIGMOID (COLONOSCOPY): -- INVASIVE ADENOCARCINOMA, MOD DIFFERENTIATED

Clinical stage stage IIA. (negative lymph nodes). By imaging at least clinical stage 3 (abnormal lymph nodes on CT), but given negative mesenteric lymph nodes biopsy - considered at least stage 2.

catstaff
Posts: 127
Joined: Wed Mar 03, 2021 11:37 am

Re: CEA went from 107 to 3. Significance w/o anan or surgery?

Postby catstaff » Wed Aug 11, 2021 12:50 pm

Is this after a chemo series?

107 is significant. (Some patients never have particularly elevated CEA even with mets, which is why they say it's not a good marker for them.) A drop to 3, which is in the normal range albeit a bit high for nonsmokers, is almost certainly significant. But without scans you can't really say how significant. It's almost certainly a positive sign, however.

What it can't really tell you is much about the future, since killing every single cancer cell with chemo happens but is fairly rare. But it's a decent start.
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-

roadrunner
Posts: 162
Joined: Sun Jan 12, 2020 8:46 pm

Re: CEA went from 107 to 3. Significance w/o anan or surgery?

Postby roadrunner » Wed Aug 11, 2021 12:57 pm

This is generally a good prognostic indicator of the effectiveness of first-line therapy, though the papers I’ve read related to FOLFOX plus other agents or were in the context of metastatic disease. The conclusions looked generalizable, however. So thumbs up (but of course fingers crossed).

P.S. You should do a signature. It is hard to be helpful without that context.
7/19: Rectal cancer: Initially staged as IIIA, T2N1M0
Initially approx 4.25 cm, low/mid rectum, mod. well diff. adenocarcinoma
8/22 -10/14 4 rounds FOLFOX neoadjuvant, 3 w/Oxiplatin (lots of side effects/reduced size est. 70-75%)
neoadjuvant chemorad 11/19
4 rounds of FOLFOX July-August 2020
ncCR found 10/20; multiple biopsies negative
TAE 11/20, small amount of tumor removed, lung nodules orig id’d 6/20 stable Nov 2020
Chest CT 3/30/21 small growth in 2 nodules (3 and 5mm)
Stable in 6/28 scan.

JMRWife
Posts: 71
Joined: Mon Oct 05, 2015 9:41 pm

Re: CEA went from 107 to 3. Significance w/o anan or surgery?

Postby JMRWife » Wed Aug 11, 2021 2:09 pm

Profile updated.

Surgeon wants a chemo break after next chemo 8/25. Surgery scheduled for late September, then the remaining 4 rounds after surgery.
Age 58.
4/27/2021 - Dx obstructing "apple core" sigmoid tumor at 30cm. MMR proficient. 4/28: Diverting colostomy.
Started neoadjuvant Folfox 5/18; CEA 107.
Aug 11: 7 rounds Folfox completed. CEA 3.2.
Pathology: COLON, SIGMOID (COLONOSCOPY): -- INVASIVE ADENOCARCINOMA, MOD DIFFERENTIATED

Clinical stage stage IIA. (negative lymph nodes). By imaging at least clinical stage 3 (abnormal lymph nodes on CT), but given negative mesenteric lymph nodes biopsy - considered at least stage 2.

JMRWife
Posts: 71
Joined: Mon Oct 05, 2015 9:41 pm

Re: CEA went from 107 to 3. Significance w/o anan or surgery?

Postby JMRWife » Wed Aug 11, 2021 2:12 pm

Also just wanted to thank everyone for responding. I truly appreciate your Insight.
Age 58.
4/27/2021 - Dx obstructing "apple core" sigmoid tumor at 30cm. MMR proficient. 4/28: Diverting colostomy.
Started neoadjuvant Folfox 5/18; CEA 107.
Aug 11: 7 rounds Folfox completed. CEA 3.2.
Pathology: COLON, SIGMOID (COLONOSCOPY): -- INVASIVE ADENOCARCINOMA, MOD DIFFERENTIATED

Clinical stage stage IIA. (negative lymph nodes). By imaging at least clinical stage 3 (abnormal lymph nodes on CT), but given negative mesenteric lymph nodes biopsy - considered at least stage 2.

Rikimaroo
Posts: 353
Joined: Tue Dec 20, 2016 8:48 pm
Location: Florida

Re: CEA went from 107 to 3. Significance w/o anan or surgery?

Postby Rikimaroo » Thu Aug 12, 2021 2:08 pm

When I was diagnosed by CEA was 32. After radiation and chemo pills I think it went down. I didn't do surgery because i madea mistake and my cea went to 500 and then to 620. I started FOLFOX and after about six rounds I was down to 2 digits. After surgery I was down to .8.....So Chemo can make a significant impact on CEA which is a good sign and good response to treatment although treatment sucks!!
RC T3N1M0 12/16
MSS - NRAS Mutation
Chemo Rad, CCR - W&W 5/2017
Recurrence 11/2017
CT Scan 11/2017 Liver Met 5.5cm Stable, Stage IV
LAR/Liver Resect 4/2018
Reversal 10/18
CEA highest 500, lowest .8 throughout process, waiting for latest
Recurrence left vesical/pelvic sidewall - 10/7/2019 resect perm bag,
CEA rise Feb/May 3.7, 8.8, 30, Recurrence in Pelvic
CEA 40 right now, but was 57, so folfiri to beat it back down.
Lots of chemo for the past 4 years.

JMRWife
Posts: 71
Joined: Mon Oct 05, 2015 9:41 pm

Re: CEA went from 107 to 3. Significance w/o anan or surgery?

Postby JMRWife » Wed Aug 25, 2021 7:58 pm

I had a follow up with both surgeon and oncologist. One more chemo on 9/8, a break, and surgery on 10/5.

Surgeon ordered CAT scan on 9/27 to see what's up.

When I asked about significance of the CEA drop, he said it was very positive. But he also said we wont know anything really until scan, and that it is possible for spread to occur during chemo.

Man, I hope not. I'm not overly anxious but genuinely curious about how spread can occur when you're doing your utmost to poison it with chemo drugs.

Did anyone here ever have CEA drop during chemo, only to find the cancer has spread?
Age 58.
4/27/2021 - Dx obstructing "apple core" sigmoid tumor at 30cm. MMR proficient. 4/28: Diverting colostomy.
Started neoadjuvant Folfox 5/18; CEA 107.
Aug 11: 7 rounds Folfox completed. CEA 3.2.
Pathology: COLON, SIGMOID (COLONOSCOPY): -- INVASIVE ADENOCARCINOMA, MOD DIFFERENTIATED

Clinical stage stage IIA. (negative lymph nodes). By imaging at least clinical stage 3 (abnormal lymph nodes on CT), but given negative mesenteric lymph nodes biopsy - considered at least stage 2.

JMRWife
Posts: 71
Joined: Mon Oct 05, 2015 9:41 pm

Re: CEA went from 107 to 3. Significance w/o anan or surgery?

Postby JMRWife » Wed Aug 25, 2021 8:04 pm

Fun fact when I asked my surgeon to explain how big the tumor was in real life term, he said it was the size of a fist. Wow.
Age 58.
4/27/2021 - Dx obstructing "apple core" sigmoid tumor at 30cm. MMR proficient. 4/28: Diverting colostomy.
Started neoadjuvant Folfox 5/18; CEA 107.
Aug 11: 7 rounds Folfox completed. CEA 3.2.
Pathology: COLON, SIGMOID (COLONOSCOPY): -- INVASIVE ADENOCARCINOMA, MOD DIFFERENTIATED

Clinical stage stage IIA. (negative lymph nodes). By imaging at least clinical stage 3 (abnormal lymph nodes on CT), but given negative mesenteric lymph nodes biopsy - considered at least stage 2.

catstaff
Posts: 127
Joined: Wed Mar 03, 2021 11:37 am

Re: CEA went from 107 to 3. Update and surgery date.

Postby catstaff » Thu Aug 26, 2021 1:54 pm

I suppose the apparently large size of the tumor might explain why your initial CEA was so high with no evidence of mets. Usually such a high CEA is indicative of metastasis.

Good luck with the scan and surgery!
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-

JMRWife
Posts: 71
Joined: Mon Oct 05, 2015 9:41 pm

Re: CEA went from 107 to 3. Update and surgery date.

Postby JMRWife » Thu Aug 26, 2021 4:45 pm

Thanks!
Age 58.
4/27/2021 - Dx obstructing "apple core" sigmoid tumor at 30cm. MMR proficient. 4/28: Diverting colostomy.
Started neoadjuvant Folfox 5/18; CEA 107.
Aug 11: 7 rounds Folfox completed. CEA 3.2.
Pathology: COLON, SIGMOID (COLONOSCOPY): -- INVASIVE ADENOCARCINOMA, MOD DIFFERENTIATED

Clinical stage stage IIA. (negative lymph nodes). By imaging at least clinical stage 3 (abnormal lymph nodes on CT), but given negative mesenteric lymph nodes biopsy - considered at least stage 2.

NHMike
Posts: 2549
Joined: Fri Jul 21, 2017 3:43 am

Re: CEA went from 107 to 3. Update and surgery date.

Postby NHMike » Sun Sep 05, 2021 12:12 am

My CEA was never above six but it dropped a lot after surgery. I recall getting the size of my tumor from the pre-surgery MRI.

Cancer markers going down substantially should be a good sign. It means that the marker works well for you too.
6/17: ER rectal bleeding; Colonoscopy
7/17: 3B rectal. T3N1bM0. 5.2 4.5 4.3 cm. Lymphs: 6 x 4 mm, 8 x 6, 5 x 5
7/17-9/17: Xeloda radiation
7/5: CEA 2.7; 8/16: 1.9; 11/30: 0.6; 12/20 1.4; 1/10 1.8; 1/31 2.2; 2/28 2.6; 4/10 2.8; 5/1 2.8; 5/29 3.2; 7/13 4.5; 8/9 2.8, 2/12 1.2
MSS, KRAS G12D
10/17: 2.7 2.2 1.6 cm (-90%). Lymphs: 3 x 3 mm (-62.5%), 4 x 3 (-75%), 5 x 3 (-40%). 5.1 CM from AV
10/17: LAR, Temp Ileostomy, Path Complete Response
CapeOx (8) 12/17-6/18
7/18: Reversal, Port Removal
2/19: Clean CT

JMRWife
Posts: 71
Joined: Mon Oct 05, 2015 9:41 pm

Re: CEA went from 107 to 3. Update and surgery date.

Postby JMRWife » Wed Sep 08, 2021 9:55 am

At my last chemo before surgery right now. CEA dropped again to 2.1, within normal limits.

Scan is 9/27. I don't have Scanxiety. I am just REALLY curious to know what the scan shows.
Age 58.
4/27/2021 - Dx obstructing "apple core" sigmoid tumor at 30cm. MMR proficient. 4/28: Diverting colostomy.
Started neoadjuvant Folfox 5/18; CEA 107.
Aug 11: 7 rounds Folfox completed. CEA 3.2.
Pathology: COLON, SIGMOID (COLONOSCOPY): -- INVASIVE ADENOCARCINOMA, MOD DIFFERENTIATED

Clinical stage stage IIA. (negative lymph nodes). By imaging at least clinical stage 3 (abnormal lymph nodes on CT), but given negative mesenteric lymph nodes biopsy - considered at least stage 2.


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