Stage 2A N0M0 cea rising at four years

[10christa]

Question about follow-up colonoscopy.

So far you haven't mentioned anything about colon cancer screening tests that you did or colonoscopies that you did. So, I have a few questions.

When were you first screened for colon cancer? What kind of screening test was used at that time?

When did you have your first colonoscopy?

Have you had any follow-up colonoscopies after your right hemicolectomy surgery? If so, when were they done and what was the outcome?

The reason I ask is because the NCCN guidelines say that you should have at least one colonoscopy in the five-year follow-up period to see if any new polyps have appeared so that they can be removed before they cause any problem.

I'm sorry to bother you with this question because I know your medical calendar for the year must already be pretty full, but the follow-up colonoscopy is really something that needs to be done eventually.

2020 was my first and found the cancer. I had a colonoscopy 2021 and 2022 all good. I am going this October for an endoscopy and colonoscopy, just had my blood work done which was all good except for high cholesterol.

[10christa]

10christa,

I think most of us on this forum have worried about rising CEA from time to time. As far as CEA goes, my former oncologist said that he wasn't worried about rising CEA until it goes over 10. Other oncologists' opinions may differ.

Have you had your vitamin D levels checked recently? The reason I ask is because my CEA will go up as my vitamin D levels go down. I am not saying that your rising CEA is directly correlated to your vitamin D level, but you never know. If you are deficient in vitamin D, that is something you would definitely want to discuss with your doctor.

Take care and keep us posted,

Paige

Hi,
Yes I see that none of my doctors are concerned with my cea rise, it is just unusual for me since I was stable since 2021. I take vitamin d and a lot of other supplements but I would like to have vitamin levels checked, I like to know.

[Green Tea]

False elevations of carcinoembryonic antigen levels are common in patients under surveillance for colorectal cancer recurrence (2014)
https://acsjournals.onlinelibrary.wiley.com/doi/full/10.3322/caac.21247

[Beckster]

I had the same procedure as you in 2016 at the age of 57.. Perfect bloodwork with no symptoms. It was found during a routine colonoscopy. I had 2 high risk factors...LVI and Grade 3 tumor. I started with Capox, but because I was allergic to Oxy, so I finished with 6 months of capecitabine. You can see by my signature that my CEA fluctuated over the years. For some reason, it was higher in the spring and summer and lower in the fall and winter. My oncologist said that he not only looks at CEA, but other things in my bloodwork. He was never concerned. A lot of things can cause this fluctuation.

[I_will_fight]

10Christa, I am going through a similar experience to your own.

My CEA had been fluctuating between 1.2 and 1.4 for four years as well. In the last blood control it was raised to 1.6.

This is just 0.3 increase over the previous reading six months earlier but it also amounts to 23% increase which I find unsettling.

I also had a liver echography done which found some attenuation suggesting "incipient liver steatosis" (aka the beginning of fatty liver disease)

I had put on a bit of weight and stopped exercising in the last few months so i guess this might explain the liver thing, which in turn I hope it explains the CEA increase.

Hopefully this is reversible and I am taking steps to lose weight and I have resumed exercising.

It appears that general liver stress raises CEA. This study, for example, shows that non-alcoholic liver steatosis correlated with CEA elevation in healthy subjects.

https://pubmed.ncbi.nlm.nih.gov/23392905/

10Christa hopefully the next blood test will show that your CEA trend was not meaningful.

Good luck!

[I_will_fight]

Q1 CEA < 1.12 μ g/L, FASTING GLUCOSE 5.16 (4.94 – 5.44) ,   LDL-cholesterol 2.65 ± 0.84 ,NAFLD, n (%) 18 (36) ,Regular exercise, n (%) 25 (51.0)
Q2 CEA 1.12 – 1.66 μ g/L, FASTING GLUCOSE 5.11 (4.83 – 5.83) ,   LDL-cholesterol 2.77 ± 0.76 ,NAFLD n (%), 26 (52) ,Regular exercise, n (%) 23 (46.9)
Q3 CEA 1.66 – 2.50 μ g/L, FASTING GLUCOSE 5.47 (5.11 – 5.99),  LDL-cholesterol 2.77 ± 0.76,NAFLD, n (%) 27 (54) ,Regular exercise, n (%) 20 (40.8 )
Q4  CEA ≥  2.50 μ g/L, FASTING GLUCOSE 5.63 (5.12 – 7.05) sign < 0.01,LDL-cholesterol 3.05 ± 0.65 0.01 sign 0.01,NAFLD n (%), 34 (68) sign0.02 ,Regular exercise,n (%)20 (40.8 ) NS


This is from the above study, I cant upload tables or images for some reason so I listed manually.

As you can see they divided the subjects in four groups based on CEA level, the group with higher CEA was more likely to have prediabetes/insuline resistance, poorer lipid profile and Non alcholic fatty liver disease (NAFLD), all these correlations were statistically significative (this is the p-value in the last row, for those mathematically inclined)

These patients were also less likely to exercise regularly, although this did not reach statistical significance.

So I think this suggests that CEA rises with poorer liver health. This could be causation or correlation.