CEA and other markers

taraHK

There was a thread about CEA marker some time ago. I am one of those whose CEA level was not elevated even at diagnosis. Although I do still have CEA test done periodically, I am pretty skeptical about its value for me. My oncologist is doing another marker test for me, called "CA 19.9". He told me that, among individuals who have a recurrence AND whose CEA is not elevated, about 50% have an elevated CA 19.9. He says it is "not in the textbooks" (yet). I should probably state that I am not a doctor, I haven't read up on this myself, and I'm not trying to push this test -- but just wanted to share this information with you -- in case anyone is intersted in exploring.
Tara

Unknown

Hi Tara:

I've heard about this test and I ran it by Bert's oncologist when his CEA was and continues to be elvated (now at 4.4...was all the way up to 9.0 while on chemo) yet nothing ever showed up on any scans and he doesn't smoke. Bert's onc said that since a CEA test was never done on Bert before his surgery, and his current CEA IS elevated, that CA 19 test wouldn't aid in solving our delimma of if Bert's elevated CEA was a sign of recurrence or not. The only time Bert's CEA was ever "normal" was right after surgery....0.9. Thereafter, it inched and inched upwards to 9.0 over a period of one year. He went off chemo and it dropped to 4.4.

Monika

FRANTIC

I was diagnosed with colon cancer in Aug.2003. At that time the physicians were in a state of shock as they never expected Cancer of the colon. They thought it was an Internal hemmoroid. Therefore a CEA was never done.After complications from surgery I ended up in the hospital in which I work in. I had my surgery done in N.Y.city. My oncologist and primary care Drs.are from Long Island. At the time I was in the hospital on Long Island for pulmonary embolisms I met the oncolgist who then ordered a baseline Cea level which was 0.5. This was 3 months after surgery.
Since that baseline marker a Cea level has been done monthly where it shows a consistent 0.5.
I had my radiation done at a Unviersity hospital on the Island, where upon starting the radiation therapy this Dr.ordered a CA19.9 test. I never heard of it until he ordered the test. He asked me if my oncologist did this test and I said no. The oncoligist recommended this radiation oncoligist as he is the chief of radiation oncology. The CA19.9 was 17 of which it was normal. I went back to my oncoligist and asked him why didn't he order the CA19.9 and he said he does not use that test as it it not conclusive and of no help to him. I told him since the radiation oncoligist ordered it, I wanted that test done as well. When I finished the radiation in March 2003,I have consistently told the oncologist to order that test regardless of what he believes. He is very nice and he said If it puts your mind at ease we will do that test. I have to tell him to order it. The normal range is 0-37. It went from a 17 to 33 in July of 2004.
In Oct.it was in the 50's yet the CEA was still below 0. And the petscan was negative. The repeated CA19.9 was still in the 50's. Very worried about this test I spoke with the radiation oncoligist who suggested to wait 3 months to re-do the test. I had it repeated in Nov.30,2004 where it went down to 14. Very strange of the big elevation and then the extreme drop. No answers ofcourse from any of the Drs.
With all the other issues going on with me, I now have Red blood cell aplasia I have forgot to remind the DR. to order that CA19.9 test.
But from what I read it is a marker they use.
Hope this information helps.
Your friend Fran

Lisa Rose

Hi All,

My CEA never elevated either. It remains around 0.7, once it went up to 1.0 while I was doing chemo. My oncologist told me anything under 4 was normal and in a recurrence it could still rise, so we still do it... We also use the blood marker CA 19-9. My blood remains between 14-18 and anything under 35 is considered normal....

Lisa

jana11

Hey Tara,
just to let you know; my CEA has NEVER been elevated. It is always <0.5.
I don't know much about CA 19.9 - but I will try to find out. I am meeting with my surg. onc tomorrow, after getting yet another colonoscopy - eating clears as I write. YUCK.
I did ask the onc about the CEA - he told me it remains important because sometimes it will elevate with a recurrance. Mind you, I had a recurrance and it didn't go up.
I will get back to you about the CA 19.9 - I am very curious now. If it isn't "in the textbooks", it will be in the journal articles. I get all my care at MD Anderson and hope they would have at least heard of it.
Have a good day. jana

jana11

jana11 said:

Hey Tara,
just to let you know; my CEA has NEVER been elevated. It is always <0.5.
I don't know much about CA 19.9 - but I will try to find out. I am meeting with my surg. onc tomorrow, after getting yet another colonoscopy - eating clears as I write. YUCK.
I did ask the onc about the CEA - he told me it remains important because sometimes it will elevate with a recurrance. Mind you, I had a recurrance and it didn't go up.
I will get back to you about the CA 19.9 - I am very curious now. If it isn't "in the textbooks", it will be in the journal articles. I get all my care at MD Anderson and hope they would have at least heard of it.
Have a good day. jana</p>

Me again. OK, I had to look it up myself. CEA is elevated in colorectal cancer about 2/3 the time. CA 19.9 is elevated about 1/3 the time. CA 19.9 is more for pancreatic cancer. They are both tumor markers, and are not anything definate, but may elevate indicating further testing should be performed.
I will still talk to the docs at MDAnderson, but I wanted to let you know what I found with a small search.
jana

Lisa Rose

Carbohydrate Antigen (CA) 19-9

This test is used to monitor gastrointestinal, pancreatic, liver and colorectal malignancies. This test may also be positive in patients with nonneoplastic disease, inflammatory disease of the bowel, cirrhosis and autoimmune conditions.

jana11

I'm back. Well, the MDA doctors told me they don't see any benefit in following CA19.9 in patients with colorectal cancer. They do use it for pancreatic cancer.
This doesn't mean others doctors shouldn't check the levels. Just that the one I talked to doesn't check it for his patients. jana

taraHK

jana11 said:

I'm back. Well, the MDA doctors told me they don't see any benefit in following CA19.9 in patients with colorectal cancer. They do use it for pancreatic cancer.
This doesn't mean others doctors shouldn't check the levels. Just that the one I talked to doesn't check it for his patients. jana

Thanks for reporting back. It is always interesting to learn what different doctors do and recommend, especially at leading cancer centres. I did gather this is a controversial test for colorectal cancer, and there is divided opinion on its use and value.....
Tara