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

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JJH
Posts: 408
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)
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beach sunrise
Posts: 1034
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
5FU/rad 6 wk
IVC 75g 1 1/2 wks before surgery. Continue 2x a week
Surg 1/20 -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
CEA
7/20 11.1 8.8
8/20 7.8
9/20 8.8, 9, 8.6
10/20 8.1
11/20 8s
12/20 8s-9s
ADAPT++++ chrono
CEA
10/23/22 26.x
12/23/22 22.x
2023
1/5 17.1
1/20 15.9
3/30 14.9
6/12 13.3
8/1 2.1
Nodule RML SUV 1.3 5mm
Rolles 3 of 4 lung nodules cancer
KRAS
Chem-sens test failed Not enough ca cells to test

Koreysue
Posts: 258
Joined: Mon Apr 30, 2018 2:36 pm

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

Postby Koreysue » Thu Feb 24, 2022 10:36 pm

My CEA loves to bounce around. It has since early on. It drives me crazy...however, I just passed four years cancer free.
Check out my signature to see what I mean about the cea changes.

Ksue
Dx: 6/2017 stage 3 CC
Sigmoid, 2 nodes
CEA at dx: 6.1
Sigmoid Colectomy/folfox (last chemo (1/31/18)
CEA 4/2018: 2.4
CEA 7/2018: 3.7
Colonoscopy 8/18 clean
PET scan 8/20/18 NED
CEA 11/2018: 3.8
CEA 2/2019: 3.2
CT NED 6/18/19 / 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
CEA 5/21 4.2
CEA 10/21 3.4
colonoscopy 10/21 10mm polyp
CEA 4/22 3.7
CEA 7/22 3.8
CEA 12/22 4
CEA 1/22 3.2 and NED 5yr scan

NHMike
Posts: 2555
Joined: Fri Jul 21, 2017 3:43 am

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

Postby NHMike » Fri Feb 25, 2022 6:31 pm

Mine rose through adjuvant chemo and I think that it was correlated with exercise. The oncologist did order a scan at the end of chemo as he was a little concerned, and there was nothing. It went down slowly after the end of chemo - my walking declined with time as well.
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

claudine
Posts: 809
Joined: Tue Mar 12, 2019 2:41 pm
Location: Montana

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

Postby claudine » Fri Mar 04, 2022 3:19 pm

I've always read that it becomes really worrisome when numbers get into the double digits; but I can totally relate to your anxiety with this higher value (compared to what you are used to). When is your scan? I hope it brings reassuring news XXXXX
Wife of Dx 04/18 (51 yo). MSS, KRAS G12A, no primary

Tumors: L4 04/18; left adrenal gland & small lung nodules 03/19
rectum 02/22 (pT3 pN0 stage 2A); L3 09/22

Surgeries: intestinal resect. 05/18 (no cancer - Crohn's); adrenalectomy 02/20
L3-L4-L5 fusion and corpectomy 05/20; LAR 04/22; ileo reversal 09/22
L2-L3 fusion and corpectomy 09/22

Treatments: EBRT 04/18; SBRT 02/19; Failed adjuvant Xelox ; Folfiri/Avastin 03/19 - 01/20
adjuvant chemorad (Xeloda) 06/22; SBRT 11/22; Xeloda/Avastin since 01/24

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beach sunrise
Posts: 1034
Joined: Thu Mar 05, 2020 7:14 pm

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

Postby beach sunrise » Sat Mar 05, 2022 8:08 pm

I pray your scan is clear!
8/19 RC CEA 82.6 T3N0M0
5FU/rad 6 wk
IVC 75g 1 1/2 wks before surgery. Continue 2x a week
Surg 1/20 -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
CEA
7/20 11.1 8.8
8/20 7.8
9/20 8.8, 9, 8.6
10/20 8.1
11/20 8s
12/20 8s-9s
ADAPT++++ chrono
CEA
10/23/22 26.x
12/23/22 22.x
2023
1/5 17.1
1/20 15.9
3/30 14.9
6/12 13.3
8/1 2.1
Nodule RML SUV 1.3 5mm
Rolles 3 of 4 lung nodules cancer
KRAS
Chem-sens test failed Not enough ca cells to test

Rikimaroo
Posts: 436
Joined: Tue Dec 20, 2016 8:48 pm
Location: Florida

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

Postby Rikimaroo » Sun Mar 06, 2022 1:12 pm

My CEA is 68 fluctuated from around your number and up all the time. Usually anytime it starts going up there is activity, but scans is more important then CEA and at your number its not an issue typically. Are you on any type of chemo? You should go on maintenance chemo if your cancer is not curable. That is what I am doing.

From your signature was surgery/chemoradiation not an option for you? I don't see any surgery in your signature, chemo/radiation, typical standard of care for rectal cancer, I do see you had some radiation, how come they didn't do any surgery?
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.

roadrunner
Posts: 460
Joined: Sun Jan 12, 2020 8:46 pm

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

Postby roadrunner » Sun Mar 06, 2022 1:50 pm

I respect your taking responsibility for your approach. IMO no one should judge how a patient with a challenging diagnosis addresses it. That is personal, and information without judgment is the only helpful way. One point I want to make though, in case you haven’t considered it: As you likely know, chemo like FOLFIRI can dramatically slow the progress of pulmonary CRC mets (there are also some rare resulting NEDs). It appears that MD Anderson has already advised you of this. While chemo in such a situation might be viewed solely as a delay tactic, and a difficult one at that, it just may be a bridge to new, more effective therapies. Three years (which your signature says they projected with chemo) is a long time, particularly with the current pace of cancer treatment advances. (I just posted a link to a promising new approach to metastatic CRC at Rice/MD Anderson a few days ago that will go to human trial in the fall).

I firmly believe that huge advances in the treatment of metastatic CRC are coming in the next 10-15 years. If you agree, it means there will be in the near future a large group of patients who go from a terminal diagnosis to cure, or at least much longer survival. It may be that many of us are just a bit too far along to be in that group, but trying to give oneself the best chance to be in that group may be a big factor to consider. As always, good luck with the scan and your approach!
7/19: RC: Staged IIIA, T2N1M0
approx 4.25 cm, low/mid rectum, mod. well diff.; lung micronodule
8/19-10/19 4 rds.FOLFOX neoadjuvant, 3 w/Oxiplatin (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 growth in 2 nodules (3 and 5mm)
VATS 12/8/21 sub-pleural met 7mm.
SBRT nodule 1/22
6/20/22 TAE rectal polyp benign)
NED from 3/22 - 3/23
4 cycles FOLFIRI
LUL VATS lobectomy for radio resistant met 7/7/23

Rikimaroo
Posts: 436
Joined: Tue Dec 20, 2016 8:48 pm
Location: Florida

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

Postby Rikimaroo » Sun Mar 06, 2022 1:55 pm

I understand where your coming from, but did your doctors specifically tell you that SOC treatments wouldn't cure you? It's always a chance that something won't work, in my case that was the situation. I did however make the mistake of not doing surgery after chemo and radiation and I thought I was cured cause cancer was gone, but it came back and I didn't listen to my doctors and 3 other people in the same exact predicament as me did what there doctor said (SOC) and are cured now.

SOC is currently the only chance of curing cancer, all that other natural stuff, mumbo jumbo doesn't work. There are millionaires that are dying from cancer who has more options available to them on both front them me or you do.

We are both in a tough situation, my cancer is not cured, and I am on maintenance chemo, is there a particular reason your not on any type of chemo therapy? If anything people treat cancer like a chronic disease, might as well do the proven methods vs the natural methods that have no statistic behind them.

Rikimaroo
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.

User avatar
JJH
Posts: 408
Joined: Mon Apr 24, 2017 7:26 am

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

Postby JJH » Sun Mar 06, 2022 3:25 pm

Question: What kind of scan(s) are you having this month, and do you know anything about the scanning power of the machine(s) that will be used?

For example, if you are having an MRI, how many Tesla is the machine rated as, and does the machine come with multiparameter AI software especially designed for imaging? See post below for additional information on LI-RAD scans and LUNG-RAD scans.

https://coloncancersupport.colonclub.com/viewtopic.php?f=1&t=66112&p=511850#p511850
"The darkest hour is just before the dawn" - Thomas Fuller (1650)
●●●

Rikimaroo
Posts: 436
Joined: Tue Dec 20, 2016 8:48 pm
Location: Florida

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

Postby Rikimaroo » Sun Mar 06, 2022 3:33 pm

I am still trying to wrap my head around your cancer situation. It says in your signature your Stage 3 which is still highly curable with SOC. I never heard of SBRT in the rectum and you already had radiation in the rectum from your signature, radiation is not or doesn't seem like at option for me since I already had it down there twice now per Cleveland Clinic doctors. Immunotherapy only works for MSI patients not MSS from my understanding or if you have high tumor mutation burden and is MSS then you can do Immunotherapy.

Either way I am glad your Oncologists were able to get insurance to cover your for Immunotherapy even if you don't meet the requirements. I want you to know I am just trying to help you because I been in this situation for 5 years now, and I don't want you to make the same mistakes I made with decision making.

You seem to want cure (don't we all), but I am concern you are leaving options on the table that might get you there because of colostomy or something else, I am not clear.
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.

Rikimaroo
Posts: 436
Joined: Tue Dec 20, 2016 8:48 pm
Location: Florida

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

Postby Rikimaroo » Sun Mar 06, 2022 3:51 pm

Got it!! SBRT should and will work my friend!! :) Hoping for the best
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.

User avatar
beach sunrise
Posts: 1034
Joined: Thu Mar 05, 2020 7:14 pm

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

Postby beach sunrise » Sun Mar 06, 2022 3:57 pm

Things I've researched for TP53; high dose IVC, high dose niacin, high dose pomegranate. It's all about reducing oxidative stress. These three only work in high doses for TP53 from what I've read. I take all 3.
8/19 RC CEA 82.6 T3N0M0
5FU/rad 6 wk
IVC 75g 1 1/2 wks before surgery. Continue 2x a week
Surg 1/20 -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
CEA
7/20 11.1 8.8
8/20 7.8
9/20 8.8, 9, 8.6
10/20 8.1
11/20 8s
12/20 8s-9s
ADAPT++++ chrono
CEA
10/23/22 26.x
12/23/22 22.x
2023
1/5 17.1
1/20 15.9
3/30 14.9
6/12 13.3
8/1 2.1
Nodule RML SUV 1.3 5mm
Rolles 3 of 4 lung nodules cancer
KRAS
Chem-sens test failed Not enough ca cells to test

User avatar
beach sunrise
Posts: 1034
Joined: Thu Mar 05, 2020 7:14 pm

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

Postby beach sunrise » Mon Mar 07, 2022 3:59 pm

Just to throw out here, Dr. Dach might be a good one to consult also. He is a world wide researcher oncologist.
8/19 RC CEA 82.6 T3N0M0
5FU/rad 6 wk
IVC 75g 1 1/2 wks before surgery. Continue 2x a week
Surg 1/20 -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
CEA
7/20 11.1 8.8
8/20 7.8
9/20 8.8, 9, 8.6
10/20 8.1
11/20 8s
12/20 8s-9s
ADAPT++++ chrono
CEA
10/23/22 26.x
12/23/22 22.x
2023
1/5 17.1
1/20 15.9
3/30 14.9
6/12 13.3
8/1 2.1
Nodule RML SUV 1.3 5mm
Rolles 3 of 4 lung nodules cancer
KRAS
Chem-sens test failed Not enough ca cells to test

Tomaz26
Posts: 13
Joined: Fri Feb 04, 2022 12:10 pm
Facebook Username: tomaz.korosec1

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

Postby Tomaz26 » Thu Mar 10, 2022 4:48 am

RikiMaroo:

what kind of chemo are you on now?

I am in the same position as you two guys.. After SOC rectal tumor gone, placed on W&W instead of surgery and it was a wrong decisio. 9 months later a recurrence in rectum plus 6 lung mets scattered across lungs.. Placed on CAPIRI and Cetuximab but canceled both after only 1 round as I had nasty side effects. I had dysarthria which also happened on last rounds CAPOX during 2020 and ugh, its worrisome. You feel like having a stroke. Cannot pronounce words..
Now I also question my way of trying to "cure" it with diet tweaks, 50+ supplements etc and no chemo. I am only on capecitabine now and lowered it to 50% of the dose prescribed which I dont think will do anything.. Capecitabine alone anyway
even in high dose would probable not do much, and is quite toxic too. No option of SBRT or any surgery for me as those lung mets are all across in all lobes.. The only hope for me is laser surgery in Germany which treats many people coming from Canada and US too who were told no surgery option.. That or back to CAPIRI + Cetuxi which would probably work for sometime, but I just hate hate hate being nausseated and in bed all the time while on chemo. This is no life for me.. What good is it to problong life for 6 months if those 6 months are spent in bed.. But on the other hand a lot of people were in the same boat as me and got to surgery with SOC so even if chemo does not cure you if it gets you to resection it is worth while so I must start thinking this way, if not too late alredy (last scan in dec showed some progression on lung mets but also something happening in peritoneum with some large lymph nodes increase)..


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