Rise in CEA

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ecretriever6
Posts: 7
Joined: Fri Oct 22, 2021 5:48 pm

Rise in CEA

Postby ecretriever6 » Fri Oct 22, 2021 5:54 pm

This is my first time here. My wife had CRC in june 2020 and had surgery. CEA before surgery was 2.0. After 12 rounds of chemo, it was usually between 1.5 - 1.7. After last bloodwork, it went to 7. ONC said not to worry as her last CT scan, 3 months ago, was completely clear. I am pretty worried and I hope it is nothing. Has anyone experienced this? I know her CEA is not a good marker as she was diagnosed as a 3c. Completed chemo in 12/20 and has had clear CT scans and bloodwork has been wonderful. Thanks to all in advance.
surgery 06/20
chemo 7/20 - 12/20
CEA 2.0
LNI: 17/38
Stage 3c
Wife: 47 at time of DX
Diagnosed: 05/20
Surgery: 06/20
Left Sigmoid
Lymph Nodes: 18/37
Chemo: 07/20 - 12/20 (12 rounds 5fu/oxi)
Clear CT: 12/20, 07/21 (CEA1.2)
CEA pre-surgery: 2
CEA post: 1.2 - 1.9
Stage: 3c
Colonoscopy: 05/21 - 1 polyp removed

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O Stoma Mia
Posts: 1691
Joined: Sat Jun 22, 2013 6:29 am
Location: On vacation. Off-line for now.

Re: Rise in CEA

Postby O Stoma Mia » Sat Oct 23, 2021 6:39 am

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.

ecretriever6
Posts: 7
Joined: Fri Oct 22, 2021 5:48 pm

Re: Rise in CEA

Postby ecretriever6 » Sat Oct 23, 2021 6:43 am

Thank you so much for the information. I am just worried so I thought I would reach out for some advice. Her ONC is scheduling a new CT scan next week to get it done ASAP. The ONC is just wanting to be cautious. Don't know what type of CT scan it was but we will check. Other than the CEA, all of her blood work has been great! Her last CT Scan in July 2021, was described as "boring" with nothing marked to watch. Hoping it is just a spike for an uninvolved reason. Prayers to all and I am glad to be part of this support forum.
Wife: 47 at time of DX
Diagnosed: 05/20
Surgery: 06/20
Left Sigmoid
Lymph Nodes: 18/37
Chemo: 07/20 - 12/20 (12 rounds 5fu/oxi)
Clear CT: 12/20, 07/21 (CEA1.2)
CEA pre-surgery: 2
CEA post: 1.2 - 1.9
Stage: 3c
Colonoscopy: 05/21 - 1 polyp removed

ecretriever6
Posts: 7
Joined: Fri Oct 22, 2021 5:48 pm

Re: Rise in CEA

Postby ecretriever6 » Sat Oct 23, 2021 8:43 am

Also thank you for the info on being a new user and poster.
Wife: 47 at time of DX
Diagnosed: 05/20
Surgery: 06/20
Left Sigmoid
Lymph Nodes: 18/37
Chemo: 07/20 - 12/20 (12 rounds 5fu/oxi)
Clear CT: 12/20, 07/21 (CEA1.2)
CEA pre-surgery: 2
CEA post: 1.2 - 1.9
Stage: 3c
Colonoscopy: 05/21 - 1 polyp removed

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O Stoma Mia
Posts: 1691
Joined: Sat Jun 22, 2013 6:29 am
Location: On vacation. Off-line for now.

Re: Rise in CEA

Postby O Stoma Mia » Sat Oct 23, 2021 1:16 pm

Another point: You should create a proper signature to go at the bottom of each of your future posts so that people can see the history and status without having to scroll back to previous posts where the details were originally mentioned. Signatures are limited to 512 characters, including spaces.

Here is a previous post that explains why this is so important:

https://coloncancersupport.colonclub.com/viewtopic.php?f=1&t=60899&p=482486#p482486

User avatar
O Stoma Mia
Posts: 1691
Joined: Sat Jun 22, 2013 6:29 am
Location: On vacation. Off-line for now.

Stage III-C: Recent rise in CEA

Postby O Stoma Mia » Sat Oct 23, 2021 1:38 pm

ecretriever6 wrote:... Also, are there any recent survival statistics or recurrence rates that have been posted? Sorry for the questions but as most people have commented, just worried...

There are many Stage III-B patients here who successfully managed to avoid recurrences. They followed the Three Pillars of Survivorship very diligently for many years and are still cancer free. Two of these Stage III survivors are : lpas and testing765, but there are many others..

======
Note: Your wife is 20 years younger than the average CRC patient, so the survival statistics do not represent her situation very well. She is an outlier in the overall patient population and she is much younger than the average, and is apparently in good health apart from the cancer diagnosis, so whatever statistics you find will not be very appropriate for her. She is not a statistic; she is a person. In my opinion, it is best to just ignore the statistics because they are mostly out-of-date and do not fit your wife's situation. A majority of the patients in the CRC population are older, have multiple co-morbidities and multiple health problems that impact survival and that serve to skew the data markedly.

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O Stoma Mia
Posts: 1691
Joined: Sat Jun 22, 2013 6:29 am
Location: On vacation. Off-line for now.

Stage III-C: Recent rise in CEA

Postby O Stoma Mia » Sat Oct 23, 2021 11:31 pm

Thank you for setting up a signature page. That should help.

However, there are some important items missing in your initial signature, namely:

Tumor type:, Adenocarcinoma; villous adenoma; signet ring-cell carcinoma, etc.
Tumor size (in mm or cm)
Tumor grade:
    G1: Well differentiated (low grade)
    G2: Moderately differentiated (intermediate grade)
    G3: Poorly differentiated (high grade)
    G4: Undifferentiated (high grade)
Lymphovascular invasion (LVI) (if known):, present vs. absent
Perineural invasion (PNI) (if known):, present vs. absent
Surgical margins:, clear or involved
MSI status (Required for all CRC patients, regardless of stage)

This information should be in the pathology report from the surgery.

When updating your signature be sure not to exceed the 512-character limit. You may need to abbreviate some items in order to shorten the signature sufficiently. For example, type DX Instead of Diagnosis, etc.

Here is a link to update your signature page:
https://coloncancersupport.colonclub.com/ucp.php?i=ucp_profile&mode=signature

Koreysue
Posts: 229
Joined: Mon Apr 30, 2018 2:36 pm

Re: Rise in CEA

Postby Koreysue » Sun Oct 24, 2021 8:04 pm

ecretriever6 wrote:This is my first time here. My wife had CRC in june 2020 and had surgery. CEA before surgery was 2.0. After 12 rounds of chemo, it was usually between 1.5 - 1.7. After last bloodwork, it went to 7. ONC said not to worry as her last CT scan, 3 months ago, was completely clear. I am pretty worried and I hope it is nothing. Has anyone experienced this? I know her CEA is not a good marker as she was diagnosed as a 3c. Completed chemo in 12/20 and has had clear CT scans and bloodwork has been wonderful. Thanks to all in advance.
surgery 06/20
chemo 7/20 - 12/20
CEA 2.0
LNI: 17/38
Stage 3c


Hello,
Has she been ill (especially anything with chest congestion)? Had a recent vaccine?
CEA drives me absolutely bonkers, but I do think it can be elevated for other reasons.
Perhaps the doc will let her retest in a few weeks to alleviate the worry ?

Ksue
Dx: 6/2017 stage 3 colon cancer
Sigmoid, 2 nodes
CEA at dx: 6.1
Sigmoid Colectomy/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
CEA 10/18/21 3.4
colonoscopy 10/2021 10mm polyp

ecretriever6
Posts: 7
Joined: Fri Oct 22, 2021 5:48 pm

Re: Rise in CEA

Postby ecretriever6 » Mon Oct 25, 2021 5:41 am

She had a tooth filling that same morning. Was given a shot to numb tooth and had cavity filled is the only think we thought of. Hope it was just a one time spike. Thank you for your response.
Wife: 47 at time of DX
Diagnosed: 05/20
Surgery: 06/20
Left Sigmoid
Lymph Nodes: 18/37
Chemo: 07/20 - 12/20 (12 rounds 5fu/oxi)
Clear CT: 12/20, 07/21 (CEA1.2)
CEA pre-surgery: 2
CEA post: 1.2 - 1.9
Stage: 3c
Colonoscopy: 05/21 - 1 polyp removed

ecretriever6
Posts: 7
Joined: Fri Oct 22, 2021 5:48 pm

Re: Rise in CEA

Postby ecretriever6 » Fri Oct 29, 2021 4:58 pm

UPDATE
Had CT scan today. Some spots on lungs that radiologist believes is an infection. Getting antibiotic. Another CES test next week to see if level drops. Other than this, all clear. Hoping it is infection and CEA drops to normal.
Wife: 47 at time of DX
Diagnosed: 05/20
Surgery: 06/20
Left Sigmoid
Lymph Nodes: 18/37
Chemo: 07/20 - 12/20 (12 rounds 5fu/oxi)
Clear CT: 12/20, 07/21 (CEA1.2)
CEA pre-surgery: 2
CEA post: 1.2 - 1.9
Stage: 3c
Colonoscopy: 05/21 - 1 polyp removed

User avatar
CRguy
Posts: 10346
Joined: Sun Feb 10, 2008 6:00 pm

Re: Rise in CEA

Postby CRguy » Fri Oct 29, 2021 7:42 pm

Inflammation anywhere in the body can elevate CEA ... BUTT ...
especially in the lungs
SO
glad they are thinking NOT cancer BUTT still looking for causes and getting to a diagnostic / therapeutic resolution !!!

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

Koreysue
Posts: 229
Joined: Mon Apr 30, 2018 2:36 pm

Re: Rise in CEA

Postby Koreysue » Fri Nov 05, 2021 9:46 am

ecretriever6 wrote:UPDATE
Had CT scan today. Some spots on lungs that radiologist believes is an infection. Getting antibiotic. Another CES test next week to see if level drops. Other than this, all clear. Hoping it is infection and CEA drops to normal.


Hoping so too!
Keep us posted.

Ksue
Dx: 6/2017 stage 3 colon cancer
Sigmoid, 2 nodes
CEA at dx: 6.1
Sigmoid Colectomy/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
CEA 10/18/21 3.4
colonoscopy 10/2021 10mm polyp

ecretriever6
Posts: 7
Joined: Fri Oct 22, 2021 5:48 pm

Re: Rise in CEA

Postby ecretriever6 » Tue Nov 16, 2021 6:16 pm

So bloodwork came in today. CEA lowered to a 6. I hope this is good news but would have liked to have seen it back to normal. I don’t know how long it would take to lower if it was due to an infection. Waiting to hear from Dr. thank you to all that have responded. This was right at 4 weeks after previous blood draw. Prayers continue for everyone.
Wife: 47 at time of DX
Diagnosed: 05/20
Surgery: 06/20
Left Sigmoid
Lymph Nodes: 18/37
Chemo: 07/20 - 12/20 (12 rounds 5fu/oxi)
Clear CT: 12/20, 07/21 (CEA1.2)
CEA pre-surgery: 2
CEA post: 1.2 - 1.9
Stage: 3c
Colonoscopy: 05/21 - 1 polyp removed


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