Rise in CEA

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doctorsuma
Posts: 2
Joined: Tue Dec 28, 2021 9:45 pm

Re: Rise in CEA

Postby doctorsuma » Tue Dec 28, 2021 9:51 pm

Hi did u get an update on ur wife .I am in the same situation with my husband.He had 11 rounds of chemo had a clear pet scan except for a minor light up in his colon .The colorectal surgeon did a colonoscopy and saw a stricture which he dilated .cea was 2.4 at that time .now his cea after 3 months is 5.6! Worried about this now

ecretriever6
Posts: 16
Joined: Fri Oct 22, 2021 5:48 pm

Re: Rise in CEA

Postby ecretriever6 » Sun Jan 02, 2022 1:39 pm

going in for scheduled CT scan later this month. I will update after results come back.
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: 16
Joined: Fri Oct 22, 2021 5:48 pm

Re: Rise in CEA

Postby ecretriever6 » Fri Jan 14, 2022 4:37 pm

Just got new CEA results and CEA has dropped to 5.X. So happy can't remember the X. This was one month from the last one that was 9.6. CT scan here soon. So happy to get these results. I know it doesn't mean anything positive, but we will take it as a good report.
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

prayingforccr
Posts: 368
Joined: Sun Jun 28, 2020 4:44 pm

Re: Rise in CEA

Postby prayingforccr » Fri Jan 14, 2022 4:57 pm

ecretriever6 wrote:Just got new CEA results and CEA has dropped to 5.X. So happy can't remember the X. This was one month from the last one that was 9.6. CT scan here soon. So happy to get these results. I know it doesn't mean anything positive, but we will take it as a good report.


Great news.

I’ve been stressing over my rise, but as my oncologist said, “We don’t treat blood tests. We treat scans.”
11/19: colonoscopy
12/19: diagnosed with stage 3 rectal cancer 6+cm tumor
1-3/20: 20 sessions of radiation, mon-fri capecetibine+clinical trial drug m3814
7/20: 8 treatmentsFOLFOX
11/20: Primary tumor had complete response.
5/21: Multiple lung nodules (3-6mm) on ct scan
10/21: md anderson gives me 1 year without treatment/3 years with folfiri/avastin (refused)
3/22 No growth in nodules 6 months
8/22 beginning sbrt and immunotherapy
10/22 TIL Therapy

ecretriever6
Posts: 16
Joined: Fri Oct 22, 2021 5:48 pm

Re: Rise in CEA

Postby ecretriever6 » Wed Jan 26, 2022 10:43 am

So CT scan results came in today and all was clear!

Some of the lung spots observed in last CT disappeared and some remained, however; they did not grow. ONC thinks it may be inflammation and was happy that CEA went down. Another CT in 3 months just to observe.

Prayers answered!!
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

MadMed
Posts: 166
Joined: Sun May 02, 2021 5:52 pm
Location: Massachusetts

Re: Rise in CEA

Postby MadMed » Wed Jan 26, 2022 11:12 am

Outstanding, glad it was just inflammation. Prayer works :D
52M DX: RC lower rectum, guessing now 2cm from AV 4/27/2021
T3N0M0 adenocarcinoma with signet ring cell features
Tumor size 30mm
Tumor grade: G3
Baseline CEA 1.0
MSI status: MSS pMMR
Started Folfox 5/12/2021
Switched to FOLFIRINOX from session 2. 8 rounds total.
CT+MRI tumor contained shrunk 80%, no spread to other organs.
CRT started xeloda + 28 days Radiation 9/27-11/04
NED as of 4/06 CT/MRI/sigmoidoscopy
On W&W 04/06/2022

prayingforccr
Posts: 368
Joined: Sun Jun 28, 2020 4:44 pm

Re: Rise in CEA

Postby prayingforccr » Wed Jan 26, 2022 5:10 pm

ecretriever6 wrote:So CT scan results came in today and all was clear!

Some of the lung spots observed in last CT disappeared and some remained, however; they did not grow. ONC thinks it may be inflammation and was happy that CEA went down. Another CT in 3 months just to observe.

Prayers answered!!


That’s fantastic!

I’m dealing with the same issue and starting to get some serious scanxiety about march :(
11/19: colonoscopy
12/19: diagnosed with stage 3 rectal cancer 6+cm tumor
1-3/20: 20 sessions of radiation, mon-fri capecetibine+clinical trial drug m3814
7/20: 8 treatmentsFOLFOX
11/20: Primary tumor had complete response.
5/21: Multiple lung nodules (3-6mm) on ct scan
10/21: md anderson gives me 1 year without treatment/3 years with folfiri/avastin (refused)
3/22 No growth in nodules 6 months
8/22 beginning sbrt and immunotherapy
10/22 TIL Therapy

ecretriever6
Posts: 16
Joined: Fri Oct 22, 2021 5:48 pm

Re: Rise in CEA

Postby ecretriever6 » Mon Jul 25, 2022 6:44 pm

So update here:

New Dr at MD Anderson. Had scan for routine check. One spot on lung grew 1-1.5 mm. Don’t know what to think about this. All other areas, including liver were all clear. Dr thought they could do a biopsy but said it would be maybe 50% effective to get a good portion. This was to be overly cautious. The growth worries me. No other symptoms at all. She did have Covid-19 at the beginning of June. Does anyone else have any experience in a small growth on the liver? Any input is appreciated. Prayers for all continue.
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

skb
Posts: 96
Joined: Tue Mar 28, 2017 2:00 pm

Re: Rise in CEA

Postby skb » Mon Jul 25, 2022 11:02 pm

I was in a similar situation in 2019. A solitary lung spot was growing 1 to 2 mm every few months. I had it biopsied, confirmed it was cancer and had it removed through a VATS wedge resection. By the time it was removed, the lung nodule was 1.2 cm in diameter. However my CEA did not rise at all during the growth of lung nodule

The VATS lung surgery was much easier than the abdominal surgery I recently had.
3/21/17: Dx T3N0M0-mid rectal 4.5cm tumor
4/18 to 5/22/17: chemoradiation- Xeloda and daily radiation (25 doses)
6/28/17: clean biopsy, clean scans
8/09/17: MRI - no evidence of tumor, no surgery, starts wait and watch
8/17/17 to 12/1/17: adjuvant chemo with Folfox
8/19 VATS wedge on 1cm lung nodule
7/17/21- Clean CT, MRI, CEA 15.6 !
8/24/21- PET , biopsy finds metastasis along obturator lymph nodes
10/1/21- Surgery to remove metastasis , 12 rounds of FOLFIRI
4/15/22- Clean scan, normal CEA

ecretriever6
Posts: 16
Joined: Fri Oct 22, 2021 5:48 pm

Re: Rise in CEA

Postby ecretriever6 » Tue Jul 26, 2022 7:51 am

SKB
Thank you for the info. If you don’t mind, did you also have to do chemo/radiation and if so how long was this? Since it is only 1.5mm, we are not sure id they can get a good sample at this time. Going to talk to Dr this week. Again, thank you!
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

skb
Posts: 96
Joined: Tue Mar 28, 2017 2:00 pm

Re: Rise in CEA

Postby skb » Tue Jul 26, 2022 9:02 am

Hi,
After my VATS surgery to remove a solitary lung nodule in August 2019, I did not do a follow up radiation or chemo. Mayo said that some chemo is recommended but my oncologist at University of Minnesota was not insistent upon it. Fortunately I had no lung issues since then.
However, two years later, in 2021, some metastasis was found in my abdomen. When I met with the oncologist regarding that, he reminded me that I had skipped chemo in 2019!. That remark made me double think my decision.

There is another patient in this forum who goes by the userid of Atoq. She lives in Europe (Scandinavia, I think). There, there is no chemo recommended after a solitary lung nodule removal. She had no recurrences since her VATS surgery. I was inspired by her story.
Last edited by skb on Tue Jul 26, 2022 11:37 am, edited 1 time in total.
3/21/17: Dx T3N0M0-mid rectal 4.5cm tumor
4/18 to 5/22/17: chemoradiation- Xeloda and daily radiation (25 doses)
6/28/17: clean biopsy, clean scans
8/09/17: MRI - no evidence of tumor, no surgery, starts wait and watch
8/17/17 to 12/1/17: adjuvant chemo with Folfox
8/19 VATS wedge on 1cm lung nodule
7/17/21- Clean CT, MRI, CEA 15.6 !
8/24/21- PET , biopsy finds metastasis along obturator lymph nodes
10/1/21- Surgery to remove metastasis , 12 rounds of FOLFIRI
4/15/22- Clean scan, normal CEA

roadrunner
Posts: 272
Joined: Sun Jan 12, 2020 8:46 pm

Re: Rise in CEA

Postby roadrunner » Tue Jul 26, 2022 9:57 am

There are a few issues here:

(1) ecretriever: You say above that it’s a lung nodule but then ask about a “small growth on the liver.” Was that just a mistake?

(2) It’s unclear to me whether the nodule is 1-1.5mm in diameter or whether it *grew* 1-1.5mm. In one place you say it “grew 1-1.5mm,” but in another you say it “is only 1.5mm.” This is crucial for several reasons. 1-1.5mm is very small, and that affects the likelihood of it being a met significantly. It is impossible (or nearly so) to evaluate by scans or biopsy at that size as well. If it *grew* by 1-1.5mm, then what size is it and how fast did it grow? The key issue there is volume “doubling time.” Grossly, this can be determined by the diameter. A .26x increase in diameter means the nodule has doubled in volume. There are time periods for doubling of CRC pulmonary mets, but I *think* it’s usually 30-120 days. (Somebody can check me on that.) Too slow/fast and it’s not likely a met.

But further, if it’s 1-1.5mm or thereabouts, all of that is pretty useless. You cannot really see diagnostic characteristics at that size, and observer (radiologist) error/variation in size is about 1.72mm. So we’re back to the question of size vs. growth.

Next, you need to look at your scan history (that should be obvious from the above). When were the scans that showed the growth (if any)?

Finally, as to chemo after pulmonary metasectomy: This is a debated issue. The available studies I’ve seen show benefit in PFS (progression-free survival) but not OS (overall survival). The trouble is that chemo doesn’t usually eradicate lung mets. 10-year survival can approach 30%, though of course YMMV (e.g., longer disease-free interval means you’re better off, as would extensive pre-treatment and lack of other known mets (e.g., liver)). Size also matters.

IF you have a pulmonary micronodule (1-1.5mm), I think everybody is going to advise you to watch and wait ‘til it declares itself one way or the other. It will need to be substantially larger than 1-1.5mm to resect and test, in any event.

Hope this is helpful.
7/19: Rectal cancer: Staged IIIA, T2N1M0
approx 4.25 cm, low/mid rectum, mod. well diff.; lung micronodule
8/22 -10/14 4 rounds FOLFOX neoadjuvant, 3 w/Oxiplatin (side effects/reduced 70-75%)
neoadjuvant chemorad 11/19
4 rounds FOLFOX July-August 2020
ncCR 10/20; biopsies neg
TAE 11/20, tumor cells removed
Chest CT 3/30/21 small growth in 2 nodules (3 and 5mm)
VATS 12/8/21 sub-pleural met 7mm.
SBRT nodule 1/22
CT 3/22: Clear
Thoracic CT 5/19/22 Clear
6/20/22 TAE rectal polyp benign

roadrunner
Posts: 272
Joined: Sun Jan 12, 2020 8:46 pm

Re: Rise in CEA

Postby roadrunner » Tue Jul 26, 2022 10:59 am

skb: I wouldn’t feel too bad about your decision, btw. The fact that OS is not increased by chemo following CRC pulmonary metasectomy suggests that chemo is just delaying things, not eliminating future disease. Certainly, what you gave up on—beyond the delay piece—was just the possibility that chemo would have *eradicated* the metastasis. That was *possible*, of course, but seems pretty darn unlikely when you look at FOLFIRI’s effect on known mets. It is possible that a micromet might have been actually eliminated, but that small path was all you gave up on (other than delay). And note that (1) the chemo hit you hard, and you likely had a good two years off chemo, and (2) it is to be hoped that you still caught things in time. It’s certainly too hard on yourself to think that your current troubles would have been likely avoided with additional chemo after metasectomy. And in my view it was VERY bad form for the Mayo oncologist to say “I told you so!” In that context. Very disappointing comment, and not based on the science. Just seems like an insensitive expression of ego. Just my 2 cents, of course.
7/19: Rectal cancer: Staged IIIA, T2N1M0
approx 4.25 cm, low/mid rectum, mod. well diff.; lung micronodule
8/22 -10/14 4 rounds FOLFOX neoadjuvant, 3 w/Oxiplatin (side effects/reduced 70-75%)
neoadjuvant chemorad 11/19
4 rounds FOLFOX July-August 2020
ncCR 10/20; biopsies neg
TAE 11/20, tumor cells removed
Chest CT 3/30/21 small growth in 2 nodules (3 and 5mm)
VATS 12/8/21 sub-pleural met 7mm.
SBRT nodule 1/22
CT 3/22: Clear
Thoracic CT 5/19/22 Clear
6/20/22 TAE rectal polyp benign

skb
Posts: 96
Joined: Tue Mar 28, 2017 2:00 pm

Re: Rise in CEA

Postby skb » Tue Jul 26, 2022 11:34 am

Thank you for your reassurances, roadrunner. It was not the Mayo oncologist but the one at University at Minnesota (my primary oncologist) who made the 'I told you so' comment. I was upset by it because in 2019, he had given me the option to decide whether I wanted to do chemo or not after lung VATS. It is all right, these oncologists see numerous patients and being mindful of one's language day in and day out must be difficult. A surgeon who implanted a port on my chest for my recent chemo remarked before the procedure- " I see from your chart that you were here few years ago and we gave you couple of years. Hope we can give you some more years with this implant' :-) To me, the words implied that I have only few more years..LOL and I was upset. It is in my interpretation, perhaps. He was probably trying to be friendly but it was not helpful.

I agree with you in that chemo rarely 'eradicates' cancer - mets or local. It just delays things.
3/21/17: Dx T3N0M0-mid rectal 4.5cm tumor
4/18 to 5/22/17: chemoradiation- Xeloda and daily radiation (25 doses)
6/28/17: clean biopsy, clean scans
8/09/17: MRI - no evidence of tumor, no surgery, starts wait and watch
8/17/17 to 12/1/17: adjuvant chemo with Folfox
8/19 VATS wedge on 1cm lung nodule
7/17/21- Clean CT, MRI, CEA 15.6 !
8/24/21- PET , biopsy finds metastasis along obturator lymph nodes
10/1/21- Surgery to remove metastasis , 12 rounds of FOLFIRI
4/15/22- Clean scan, normal CEA

roadrunner
Posts: 272
Joined: Sun Jan 12, 2020 8:46 pm

Re: Rise in CEA

Postby roadrunner » Tue Jul 26, 2022 1:37 pm

Even worse! And you’re nicer than I am. I would not have been forgiving about that chemo comment. The fact is that you had tons of chemo, and it still came back. Would more have cured you? As I said before, anything is possible, but the science supports PFS not OS advantage. That said, my comments were very specific to pulmonary mets from CRC. Chemo is a great tool and works differently on different tumors and mets. And I fully understand the conservative (try to “nuke it”) route—it’s definitely right for some people. No disrespect to them or that decision.

As far as the port comment goes, I’d rate that as insensitive, but I agree with you that it was probably meant well and not a dark implication. I don’t know if you remember back before cancer, but we were all immortal then, right? :wink: My team has been incredibly positive and sensitive AND very attentive to the way I like to be communicated with, but if a doctor ever dropped a bomb like that on me: (1) I’d give myself a few minutes to reflect on the fact that they will be in my shoes before too long, one way or the other (because none of us IS immortal, really); and (2) console myself with the fact that even if it is just a few years, that few years might well bridge me to the next treatment (lots of promising therapies now). And will be a darn good few years, if I have anything to say about it!
7/19: Rectal cancer: Staged IIIA, T2N1M0
approx 4.25 cm, low/mid rectum, mod. well diff.; lung micronodule
8/22 -10/14 4 rounds FOLFOX neoadjuvant, 3 w/Oxiplatin (side effects/reduced 70-75%)
neoadjuvant chemorad 11/19
4 rounds FOLFOX July-August 2020
ncCR 10/20; biopsies neg
TAE 11/20, tumor cells removed
Chest CT 3/30/21 small growth in 2 nodules (3 and 5mm)
VATS 12/8/21 sub-pleural met 7mm.
SBRT nodule 1/22
CT 3/22: Clear
Thoracic CT 5/19/22 Clear
6/20/22 TAE rectal polyp benign


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