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New to this, Curious about CEA levels

Posts: 1
Joined: Oct 2018

My father finally rlented and went to the Dr. after having bowel movements for about a year with blood. The blood work came back and while the red blood cell count, platelets, and white cell counts were elevated, it wasn't much. His PSA came back fine BUT his CEA level came back at 4,000. 

I can't find anything on a result that high. His colonoscopy is scheduled for November 12th but if anyone has ANY information or experience with a level this high please let me know.

NewHere's picture
Posts: 1343
Joined: Feb 2015

Welcome to the board, sorry you are here.  But it is a good place.

CEA may or may not be an indicator of an issue.  For some people it is a good indicater, while for others not as much.  Some threads discussing CEA  (note that some are older.  If you scan the front page there are a few active CEA ones going now.)




The definative answer will be when your Dad has his colonoscopy to see what is going on.  There are a few scales used for CEA, so I am used to my scale of 1,2,3,4, etc.  I think others have had high CEAs on scales that are expressed like what you are mentioning.  I am guessing someone may jump in on that. 

Posts: 163
Joined: Apr 2017

mine was 1,600.  It can go pretty high. 

Annabelle41415's picture
Posts: 6733
Joined: Feb 2009

Welcome to the board and sorry you have to be here but it sounds like you are a wonderful child looking for answers for their father.  CEA isn't always reliable. Elevation doesn't always mean cancer either as many factors can go into it elevating.  It's a good thing that he is going in for his colonoscopy soon.  They will find out where the blood is coming from and it could be a very good explanation of something that is not cancer.  Wishing him well and come back here if you have any further questions.


Posts: 41
Joined: Apr 2017

You should verify the reported figure is "4000 ng/dl".   It is possible, and I've heard of higher numbers just once, but it's uncommon.

On the blood work, calculate the neutrophil to lymphocyte ratio (either from percent or absolute figures) and this should be <3. Higher values increase te odds of a poor outcome.

CEA can be produced by benign conditions, like smoking, hepatitis, alcoholic liver, COPD, bile duct or bowel blockage, ... -, and also by numerous cancers.   Still it's most indicative of CRC at high levels.   Some cancerous CRC tumors produce no CEA in the blood stream, but this is not related to the person, but to the tumors genetic expression, and to it infusing CEA into the bloodstream.

Sorry to be blunt, but a CEA > 40ng/dl is almost certain to indicate CRC.  CEA above 200ng/dl favors metastatic (stage4) CRC. There can alway be other causes for an elevated CEA, and even lab errors occur, but you need to be prepared for the worst possible news, and I've never been one to believe that 'happy talk' was worthwhile. I would wager that your father is facing stage4 CRC.

The sequence of events is likelly to be / a colonoscopy taking a biopsy of a large suspicious polyp,  / a pathology report finding high-grade dysplasia & moderate-poor differentiation in the biopsy, / a chest+adbominal constrast CT, / a meeting with a surgical oncologist about the CT, status, clinical staging and treatment plan.   CRC metastases can spread to any number of places, but liver, lungs and peritoneum are the most likely.   If its metastatic, then you'd prefer to hear that the number and size of metasteses is limited, and that they are all surgically addressable.  For rectal CRC radiation & ostomies (permanent or temporary) are more common.

I obviously don't know your father, nor much about you, except that you care.  Most people are in a state of shock when they hear they have cancer, and it really takes months to get past that.   So there is an excellent chance he won't be thinking clearly.  I suggest that you, or someone else who hs a little emotional distance, go to that surgical oncologist meeting with him, and be prepared to ask hard questions.

I sincerely hope that you come back next month and post abot how wrong I was, how a benign bowel blockage and a bad test caused the worry, but I think it's important to prepare mentally for something worse.


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