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CEA Question

sfan428's picture
Posts: 32
Joined: Jun 2010

Hello all, quick question that I hope you can help with. I had surgery on 9/8 and the surgeon at that time said he was fairly certain they were able to remove everything. Only one of the 16 lymphnodes they removed came back positive. Anyway, I began my first of 6 rounds of FOLFOX on 10/25, at which time they took my first CEA level post surgery. That one came back at .7, down from almost 20 before surgery. However, this last CEA that was taken on 11/8 came back at .9. My oncologist says that this is nothing to worry about, but how can one not worry a bit. I just wanted to reach out to all of you and confirm that this is indeed normal. Am I all worried over nothing? I appreciate all your help.

God bless,

pepebcn's picture
Posts: 6352
Joined: Aug 2010

I see you put a . before and we use to put the 0 in Europe so it's driving me a little confused!

sfan428's picture
Posts: 32
Joined: Jun 2010

Sorry about that ... yeah it jumped from 0.7 to 0.9. Still a good number but certainly has me concerned. Obviously would have been happier had stayed at 0.7.

pepebcn's picture
Posts: 6352
Joined: Aug 2010

Your CEA is one of the best l ever hear not worry about just great! Cea use to jump up and down every day! even One point or two just in a month! So your Cea is perfect!. 0.2 is just a joke! Congrats again!

Lovekitties's picture
Posts: 3372
Joined: Jan 2010

Dear Shane,

As we have heard CEA may or may not be a good indicator.

I would say that a 0.2 difference is an allowance for error rather than concern.

Don't worry just yet with only a 0.2 increase. If it eases your mind any, ask the doc to take it again.


Marie who loves kitties

CherylHutch's picture
Posts: 1399
Joined: Apr 2007

Hey Shane,

A difference of .02 is nothing to worry about. You could have sneezed just before and that is what caused the jump ... ok, so sneezing has nothing to do with it, but .02 is barely readable. It is so minute that it's quite possible the technician who read the first one read it as a .07 when in fact it was a .09. Anything under <4.0 is considered stable and normal.... so you are way normal :)

My "norm" when nothing is happening will fluctuate from 1.0 - 2.5. Of course when I see a 2.5, I start getting worried and my oncologist is totally fine with that. Back in June, mine had jumped to 8.0... so that was something to be "concerned" about, but not to panic over. CEA has been relatively a good indicator for me, but as my oncologist says... CEA readings are not all that reliable, no matter how much of an indicator they can be. When it did jump like that, I had a CT scan and sure enough, the small tumours in my lungs had started growing, plus a tumour in my kidney. So back on chemo I went (Xeloda). After 3 months, the CT scan showed that the lung tumours and the one in the kidney had shrunk by 30%. Yayayaya! My CEA had gone down to 5.0 (Yayaya... a trend downards). This past bloodwork 2 weeks ago, my CEA was at 6.9. Grrrrrr! Even my oncologist said that didn't make sense since by CT scan was so favourable. So she said not to panic or worry... we will stay on the chemo and the next CT scan is early December. If the tumours have shrunk again, then all is good and the CEA is just being affected by the usual fluctuations and treatment.

So, a .02 is not even worth looking at... you are doing good :)


Kenny H.'s picture
Kenny H.
Posts: 503
Joined: Aug 2010

Thanks for info on this. I went for treatment #2 today & also saw ONC. said mine was at a 2.5 but did not seemed concerned (or explain much to me)on it

Lori-S's picture
Posts: 1286
Joined: Sep 2010

First it is important to have a baseline number for your cea. I had mine done before any treatment and surgery and then after surgery and have had it done regularly since. The normal for a non smoker is 0-3 and 0-5 for a smoker. All sorts of things can elevate your CEA such as colds, flu, infections, inflamations. My doctor has told me that it is not so much the number but, the trend in your numbers that count. I am so anal that I keep a spreadsheet of my CEA. Mine has continued to climb since after surgery. My oncs response to this is that my CEA is a good indicator for me and because of that he would expect my CEA to climb before any changes showed on my scans, basically that the scans would catch up to my CEA. Here is how my CEA has gone with the first number pre-surgical and the 2nd post-surgical:

05/14/10       9.7
05/22/10       2.3
08/11/10       4.6
09/15/10       5.6
10/13/10       6.8
10/22/10       8.3
11/04/10       8.9

PS: Shane welcome to the FOLFOX Club. I had my first on 10/25 too. I'm having a very tough time with the oxy .. ouch ... hope you are doing well. I wouldn't worry about such a slight change in your CEA as it is still within normal and so slight that it can be accounted for by any of the above listed things or even just by being done at a different lab.

JoyceSteele's picture
Posts: 146
Joined: Nov 2010

Hi everyone, my CEA was 645 when diagnosed and before just finishing FolFox w/Avastin it was at 8.5 and stayed there for 4 mos. My Dr. was very pleased. Then about 6 wks ago it started to climb, to 12.4, and 3 weeks ago is/was at 14.5. My oncologist still says it is nothing to be concerned about, he is very happy in the context of things (going from 645) and that he is not changing anything. I see him next week. I was a basket case for days and then realized I know and trust my oncologist and he would have sent me right away for a CAT scan if he was concerned. He said it will and can go up and down. I write notes when he or my nurse call so I can go back and focus on his positive words, it is comforting. Thinking of you Shane, will say prayers for you.


Posts: 372
Joined: Aug 2006

I would be worried!!!How are you going to fit NED on your cake and then that naked dance? Please get the wife to do that:) CEA's are reliable for about 50% of population to start with but yours sounds like it works for you which is good. A 0.2 increase is nothing. Mine was 14.6 prior to surgery and 2.3 post surgery. I am also one who CEA works well for but Pet scans don't (very low grade tumors don't show up well inside colons). My ONC was very happy and expected the big drop. I had three node involvment next to the tumor Stage 3c. PET scan will likely show nothing again but will have one anyway. ONC was so happy he doesn't see the need for another CEA until I finish folfox. The surgeon found no additional areas to be concerned in his search either and my surgeon is one of the best so I am hopeful to NED myself. Congrats now and in the future when confirmed. Lou

Annabelle41415's picture
Posts: 6711
Joined: Feb 2009

.9 is nothing. While you are on chemo your CEA usually goes up so I'm thinking you are good to go. Don't worry about a couple points. They are more concerned when it goes up to 15 or 20. You are still at .9 not even to a 1 yet. Take a good long breath and exhale - yup you are fine :)


Kenny H.'s picture
Kenny H.
Posts: 503
Joined: Aug 2010

Thanks Lori, Anna & everyone. Have a better understanding on it now, explained well.
Learning so much about this disease as I go along (no expert)and gather so much info from you all. Guess I need to ask my Onc more questions but I go brain-dead when hes reading info off and examining me (plus he seems to be in a hurry, lots of patients)
Then going down the elevater its hits me "what did he say" wonder what that meant!

tootsie1's picture
Posts: 5065
Joined: Feb 2008

I wouldn't think it would be anything to worry about. Anyway, if you're like me, you'll have it done again in a few months. So then you can see if there's an upward trend developing or not.


sfan428's picture
Posts: 32
Joined: Jun 2010

Thanks everyone, I know I could count on you to set me it straight. I guess after getting the 0.7 on Monday and then getting the 0.9 on Tuesday from this weeks draw I just went into panic mode.

Cheryl-good luck on your next reading, hope all goes well and I will be thinking about you.

Lori-yeah the FOLFOX club is certainly a treat. the tingling in the fingers every morning is kinda getting old. And as I understand, we are the lucky ones who get to experience the joy of the oxy in the winter as well. I will have gloves and mittens hanging from the frong door, the refrigerator and probably a pair in the car and at work just in case. It is no fun at all. Wish you the best with it and hope it gets easier for you.


Buzzard's picture
Posts: 3073
Joined: Aug 2008

I think between 0-3 for a non smoker and 4-6 for a smoker is relatively fine. It when it doubles or triples that concern should be taken and maybe re test for accuracy or a CT for anything sneaking up on us...I sincerely think you are fine as frog hair....Love to all of you, Buzz

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