CEA Uptick From 3.3 to 3.4……..Any Cause For Alarm?

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prayingforccr
Posts: 213
Joined: Sun Jun 28, 2020 4:44 pm

CEA Uptick From 3.3 to 3.4……..Any Cause For Alarm?

Postby prayingforccr » Thu Jan 06, 2022 9:34 am

Oncologist was very non plussed, but unfortunately I live between scans and blood tests.

Thank you for any input.
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. Possible tumor deposits on latest mri. Biopsy negative for cancer.
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 Will begin immunotherapy/sbrt at weill cornell and nyu/langone in march

JJH
Posts: 352
Joined: Mon Apr 24, 2017 7:26 am

Re: CEA Uptick From 3.3 to 3.4……..Any Cause For Alarm?

Postby JJH » Thu Jan 06, 2022 11:18 am

prayingforccr wrote:Oncologist was very non plussed, but unfortunately I live between scans and blood tests.

Thank you for any input.

This change sounds pretty small to me -- possibly even with the margin-of-error for the assay in question.

In any event, I think it would help to have more information in order to put everything in context, for example:

- What is the time interval between your successive scans -- every three months?
- What were your earlier CEA values, prior to the 3.3?
- What was the lowest CEA value you have ever had, and when was that?
- Which CEA assay is being used now by your lab? Roche? Bayer/Siemens? other? (should be indicated on you lab report)
- What is the normal range for CEA for non-smokers at your lab? (should be indicated on your lab report)
- What is the normal range for CEA for smokers at your lab? (should be indicated on your lab report)
- Are you a smoker or are you a non-smoker?

In general, what matters most is the rate-of-change over time (i.e., the acceleration of CEA level), so you would need to have several readings across several different time points to make an assessment of this. But this level of 3.4 ng/mL (still in the single digit range) is so small that even if it is coming from a metastasis or from several metastases, this might not be large enough to light up on a PET/CT scan or even be identifiable on a regular CT scan. At least that's my personal opinion. (I have never had a lung met, so I can't speak with any authority on this.)
"The darkest hour is just before the dawn" - Thomas Fuller (1650)

prayingforccr
Posts: 213
Joined: Sun Jun 28, 2020 4:44 pm

Re: CEA Uptick From 3.3 to 3.4……..Any Cause For Alarm?

Postby prayingforccr » Thu Jan 06, 2022 1:54 pm

Thank you for your interest and reply, JJH.

Looks like it’s bounced around a bit.

It’s a roche diagnostics

7/20 1.7
9/20 4.0
1/21 1.4
5/21 2.6
11/22 3.3
1/22 3.4

My ldh is low at 120 (which I believe is a good thing.
And weirdly enough CA19-9 tumbled back to 13 after a one time spike to 59 in august.
Ferritin, iron, and b12 are consistently low.

Other than that, bloods look good and annual physical went very well.

Weight is stable at 192.

Not sure what to expect/hope for in the coming year.
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. Possible tumor deposits on latest mri. Biopsy negative for cancer.
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 Will begin immunotherapy/sbrt at weill cornell and nyu/langone in march

User avatar
beach sunrise
Posts: 581
Joined: Thu Mar 05, 2020 7:14 pm

Re: CEA Uptick From 3.3 to 3.4……..Any Cause For Alarm?

Postby beach sunrise » Thu Jan 06, 2022 11:07 pm

Impressive ca19-9 decline. What do you think did it?
Good LDH number. Do you also have the subsets 1-5?
As for dang CEA, first scary onc told me up to .5 increase is no big deal. It could be caused from stress, a headache, variation in test, ect.
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"


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