CEA - What's the Efficacy for Monitoring Colon Cancer

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  • tanstaafl
    tanstaafl Member Posts: 1,313 Member
    mostest?

    We've watched CEA, CA19-9 and CA 72-4 as series with the broadest combined coverage.  Two out of three is particularly meaningful.  Before and after surgery may give a good indication of sensitivity and range, but nothing guaranteed since each cancer nodule can have its own evolution.   For us, CEA and CA19-9 have been sensitive to tumor growth and have the most data.  CA19-9 is noisey, disturbed by inflammation, and other "benign diseases". We track ESR for some normalization of CA19-9 from inflammation, all totaled basically an expensive pain in the ---, but any percentages and bits can improve one's odds.  

    An initial dragnet of biomarkers, before first surgery, might allow odd but important fish that occasionally turn up, like CA-129.  

    When the chips were down CA19-9 seemed to provide critical information in terms of confirming CEA rise (for my wife, it can vary for each patient), and showing pronounced response to a change of chemotherapy before CEA did.   

    MCV may be a useful tool for 5FU based treatments but is not a confirmed standard test either.  Basically MCV starts low before 5FU based treatment including Xeloda. The higher and longer the rise, the more likely a favorable outcome.  When MCV drops back down, that particular chemo formula is likely no longer working.  Some papers assign threshholds of response, with 103 and above being most favorable. For my wife, MCV seems to be favorably responsive with some immunotherapy adjuncts.      

    LDH is something we watch for met activity and chemo response, too. Along with SGOT, SGPT, ALP, GGTP.

    ESR itself is a measure of inflammation, and helps measure how we are doing on controlling that.

    We watch RBC and WBC to guage tolerable chemo severity, primarily for a tolerable amount of leucovorin.   

    Basically, the more involved you are and resolved to take knowledgable concrete steps, the more you can do with expanded monitoring.   

     

     

  • taraHK
    taraHK Member Posts: 1,952 Member
    Interesting question

    It's an interesting question. It seems that CEA is a reliable marker for some of us, and not for others.

    I was one of those for whom CEA was not a reliable marker -- not elevated when I was diagnosed with Stage III rectal cancer, and not elevated when I had lung metastases (3 separate times). But my oncologist kept taking it -- and, after skipping merrily along in NED-land for a few months -- suddenly my CEA was elevated -- for the first time ever. Sure enough, had some tests and I had bone mets. My oncologist reckons my cancer mutated (in fact, probably has several times) - but who knows. 

    I guess if cost is not an issue, I'd say keep getting CEA tested. It may not be a very reliable marker for CRC, but it's one of the few we have if not the only. 

    Tara

  • luvinlife2
    luvinlife2 Member Posts: 172 Member
    Hi Rick :)

    My CEA has actually been a very good indicator of how my cancer is behaving.  I have been in active treatment for over 4 years and have my CEA tested every 3 weeks.  Interestingly enough, my ALP numbers also fall and rise in accordance with my CEA so my onc relies on this test and we follow up with a CT scan if the numbers trend upwards.

  • AnnLouise
    AnnLouise Member Posts: 276 Member
    A good indication for me......

    My CEA number has always been a good indication in the progression or regression of my cancer. Always happy to see the numbers go down and the minute the number goes up my doctor orders a scan and there is progression somewhere. My number is the highest it has been for a long time and I am starting radiation next week for a lung tumor. So my number should go down....it is 24 now and was 1 last summer after my liver resection. Anyway to answer your question, my onc thinks it is a good indicator for me. Your numbers sound good to me.....~ Ann

  • PatchAdams
    PatchAdams Member Posts: 271
    Maxiecat said:

    Update...CEA is on the

    Update...CEA is on the rise... Went for X-rays today on my back...been having a lot of pain in my lower back.   I heard from the nurse that the dr is concerned and wants to see me soon

    Please update us!

    So concerned about you!