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What does CEA mean?

Posts: 83
Joined: Apr 2003

It's been 6 months since my last Chemo treatment and I had a blood test in April to monitor my liver. Is that what CEA is? My oncologist never explained anything in detail. What should CEA levels be? Thanks again for the info. To Sponge Bob---if you read this message, I guess my technical problem fixed itself. Arlene

nanuk's picture
Posts: 1363
Joined: Dec 2003

this is a question asked frequently on this and other forums, and I don't feel qualified to answer your question; I do know that it is one test that can indicate tumor activity, but not in all patients.. I used the phrase "CEA tests" in the Search feature on this site, and received 188 hits..you might want to browse those posts for some CEA information. I'm sure you will also get
an abundance of answers from our more educated semi-colons.. Bud

rep801's picture
Posts: 26
Joined: Apr 2003

Arlene - Tough question, and even tougher when your oncologist doesn't explain things.

CEA is one of a number of tumor markers and stands for CarcinoEmbryonic Antigen. The basic concept behind tumor markers is that by measuring them you can add a piece to the puzzle in the monitoring of specific cancers. Probably the most well known tumor marker testing is the PSA test in men for Prostate cancer. Different markers are associated with different types of cancer, so if you did a search on just tumor markers you would see all sorts of cryptic letters and numbers (CEA, CA19-9, CA125......)

There has been considerable discussion in various medical journals about the use of CEA and it's role in predicting future tumor growth/decrease. I think the best site to gather some basic information from a number of medical journal resources is www.thedoctorsdoctor.com. Use the search function and type in CEA. You will get a number of abstracts that discuss the the entire scope of research on CEA.

What should a CEA level be? - I get tumor markers every month, and the lab that does my tests (could vary if yours uses a different test, or QC thresholds are set at different levels) indicates the 100% of non-smokers and 100% of smokers expected CEA values are 0-10.0. At the 98% level those numbers drop to 0-2.5.

Now for the art(interpretation) behind the science. As I indicated I have tumor markers run every month, and have had for 3 years. My CEA has come down from a high of 25 to it's current 14.1, and once had a low of 9.8. Clearly my results are outside the expected range in terms of best case and 100%, but they show a continous downward trend.

As I have worked through these things with my surgical oncologist and oncologist we have determined that the trend line is more important than any given individual result. I have had a couple of physicians tell me that a +/- 20% bounce in individual tests is within the variablility of the test. My surgical oncologist (I see a particular specialist every 3 months due to a very rare form of appendicidal/colon cancer) takes 3 factors into account in determining my condition - CT scans, Physical exam and patient functioning, and finally Tumor Marker results. He has never discussed the actual weighting of those 3 factors, but tumor marker results seem to carry the lightest weight. Not to say that they are not important, but because of variability in the test and the potential for something as simple as a cold to impact the results, individual results have never caused him to react. Again the trendline of the results seem to have more importance for him. As a statistician I have to agree.

None of what I have said should be used to cut across the relationship with your own physician. Take it as advice from some one who has been dealing with these things for over 3 years. Do your research with the power of the internet as Nanuk suggests, and then use your learnings to initiate/drive the conversation on your next appointment with your oncologist.

Good Luck


Posts: 836
Joined: Apr 2004

CEA stands for carcinoembryonic antigen and it is a type of protein released by many bowel and rectal cancers. It therefore rises in level in teh blood when these cancers are tehre and goes down as they are treated. You can then use them to montior any recurrence.
The downsides are that the test is not very specific in that a lot of other things can make your CEA go up such as other tumours. Also some bowel cancers don't release the protein so if your CEA didn't go up initially at diagnosis it is unlikely to go up if teh tumour returns. ALso in some cases there needs to be alot of tumour bulk to make the CEA go upsubstantially which may leave it too late for treatment.
Therefore not all docs recommend monitoring it although tehre is little harm in having it done every 3-6 months as long as you interpret the results in the light of its limitations. You liver function test is a separate test they do which is likely to be for monitoring any recurrence of the tumour in your liver (one of teh favourite places for bowel cancer to spread to).
There is a website with more info on CEA at www.ehendrick.org/healthy/000258.htm
Hope this is helpful,

spongebob's picture
Posts: 2600
Joined: Apr 2003

WOW! That's one of the great things about the CSN - seems like the semi-colons know as much as the experts sometimes. I would just add a couple of comments to agent's (Bob's) response:

1. CEA tests are among the most suspect of all diagnostics due to the wide swing in results. I spoke with a Dr. friend of mine recently who told me how he drew two CEAs from the same patient on the same day and sent each to a different lab - and got back two different results.

2. Some people (myself included) don't ping on a CEA test (my numbers have always been around 1.0)

3. So many people get very worked-up when their CEA is "elevated" - like Bob said, it's not so much the actual number as it is the number taken in combnation with all other facors.

Glad your techno problem got fixed. Stay well!

- SpongeBob

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