Small study showed high accuracy but hurdles remain, two experts said
by youngmom on Wed Mar 04, 2009 12:00 AM
I posted a few days ago that I was doing well after major surgery for stage 4 colon cancer an that all my lab tests were normal. After seeing my oncologist today to get back on treatment, I was told that my CEA level, which was checked in the hospital back in January after the surgery, went up from 3.6 to 10. Doctor seemed concerned. But, my CEA when I was first diagnosed almost a year ago was 1600. So my gut tells me that 10 is still pretty remarkable. Also, the cancer center I go to has its own lab. I know that the scale the hospital lab uses is lower than the one used at the cancer center. A normal CEA at the cancer center lab is under 7 and normal at the hospital is under 3. So I am very to close to the normal range on both.
My question is how reliable is a CEA level in determining a recurrance? I have read a lot of reports that say monitoring the CEA level, after surgery, is in most cases pretty much worthless in determining if a recurrance has happened. But, my doctor is always checking it (every two weeks) and is always concerned if it goes up even by a few points. His concern, actually sometimes it's downright negativity, really bums me out. And since I don't have another level checked for two weeks and sometimes don't get the results for another two weeks after the test, I stay stressed for a long time, waiting the results of the next one.
I am young and in great health otherwise, I am seeing a naturopath who has me on natural supplements recommended by one of the founders of the Cancer Treatment Centers of America, I exercise regularly, I am taking aspirin every day as recommended by my surgeon, I am going to treatment and have very little side effects, I go to church every Sunday, I have all the faith in the world most of the time, but this CEA level stuff is really confusing and hard to deal with. I think I'm stressing and working myself up over something very trivial, especially compared to what I've just been through. Or am I? Also, is it expected to have a detectable CEA level even after an assumed successful surgery (my surgeon is very confident he got it all and my oncologist is amazed I made it through surgery)?
I know it's a lot of questions. Looking for positive answers if possible. Still hanging on to faith, but I know God wants us all to seek out advice and support from each other too. That's why he put us all here. To help each other. Any answers or advice is much appreciated.
by mrready on Wed Mar 04, 2009 12:00 AM
There are no absolutes for CEA levels. For some people they are a good marker of whether or not the cancer has recurred. For others they aren't.
My CEA after my colectomy was 2.1. After adjuvant chemo it had spiked to 11. The first thing my oncologist did was wait two weeks and test it again. It was 9.6. He did a CT scan of my abdomen and chest and both were clear. A physical exam noted a lump above my collarbone which turned out to be a metastases of my supraclavicular lymph node. My oncologist said that he was very sorry and that I had 12 to 24 months left. I did Folfiri and Avastin last summer followed by radiation to my left shoulder. When I saw my oncologist in December my CEA had dropped to 1.6 and he could find no evidence of disease. I just had my 3 month CEA test last week and it is down to 1.4. So now I no longer have a prognosis. My oncologist thinks that the cancer will recur again, but for now I feel good. I work full-time, exercise daily, and enjoy life.
Here are a couple things to remember about CEA: Women's numbers are generally higher than men's. Inflammation and infection can cause CEA numbers to rise even though no cancer is present. I personally have found when I eat a good diet (no red meat, no sweets, no cold cuts) and I exercise, my CEA level actually drops without medical treatment.
by ADKer on Fri Mar 06, 2009 12:00 AM
I don't know the answer to your question about the implications of your CEA. However, you have done very well in treatment and I urge you to focus on that. Worrying will not change things one way or the other. The thing to focus on is whether or not there is any metastasis and what can be done to get rid of it if there is. I am Stage IV also, so I know how hard it is to not worry. Just try to stay proactive and focus on whether additional treatment, or a change in treatment, is required and what that might be if the answer is yes.
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