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Rising CEA Level

FiftySeven
Posts: 2
Joined: Aug 2004

My father has been diagnosed with colon cancer. Following surgery his CEA level was at 23. Over the past 6 months of chemotherapy his CEA level has went down until it reached about 3-4. This last test it had went up to over 30. Does anyone have experience with this? Is this of major concern? I've heard the numbers fluctuate but does it fluctuate that much?

Any help/insight is appreciated.

rep801's picture
rep801
Posts: 26
Joined: Apr 2003

Wish I could give you a really clear answer, but CEA alone is not indicative of anything. I just got my latest tumor markers, and for the CEA test results the following disclaimer comes everytime:

"Serum CEA levels, regardless of value, should not be interpreted as absolute evidence of the presence or absence of disease. CEA is not intended for use as a cancer screening test"

What does all that mean? - You have to take the CEA in the context of other indicators. I know in my case that my surgical oncologist puts the same if not more weight against 1)Physical Exam, 2)General overall patient feeling/change in symptoms and 3)CT results. Obviously this means you need to have your father consult with his oncologist.

Finally, regarding fluctuation. Yep they can move that much. Up front a 10-20% change is within normal variability of an individual test.

Additionally a question that needs to be asked is if the lab has changed their test. Differences in assay (test) methods can not be used interchangebly. If the lab has changed their assay, they should be providing new baselines of old results against the new method so that they can be properly interpreted. If the oncologist/hospital has changed the lab they use the relating of results becomes even more complex.

I have been having monthly tumor marker testing for 4.5+ years now and have seen individual months vary by 50%+. Every month of CEA and other marker results are charted, and my surgical oncologist and I don't really get excited unless a 6 month series of results continually is above the overall trend line. (How is that for a bunch of statistician speak? - Sorry, only way I know how to explain it.)

So I guess I am saying don't panic just on the result of a 30+ number, but your father needs to be having conversation with his oncologist.

Bob

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