CEA and FGD

MKW213

I was diagnosed in March with high-grade 3b anal cancer.  First PET scan showed FDG of 18, which I was told today was very high. Got the results of my second PET scan today and FDG is 4--"probably" still irritation from radiation therapy or could be more cells lurking around. Two lymph nodes on the original scan were gone on the second scan, and nothing else showed on the second scan. Now have to see colorectal guy again to see if he wants to biopsy--there is no palpable tumor whatsoever per radiation oncologist and colorectal.  Anybody else have FDG experience like this?

Also, noticed that my original CEA level was 7.2 and is now only down to 7. It should be, I believe 2.5 or less. Didn't notice this until I got home, so am working myself up into a "poor spell." Shouldn't the CEA have gone down? Does this mean there is cancer elsewhere in my body that didn't show up on PET scan?

Am so tired of doctors and tests. But love the support I get here when I ask for it! Thanks in advance

 

mp327

MKW213

I'm not sure when your treatment was completed, but it doesn't surprise me that there was still some activity showing on your recent PET scan.  The same thing happened to me.  First PET showed 7 something and PET done about 6 weeks after treatment finished showed 4 something.  It was determined to be inflammation.  I am now post-treatment over 6 years, so apparently it WAS inflammation.  PET scans are very sensitive and can light up for things other than cancer, such as inflammation or residual radiation that is left over from treatment--even brown fat (look that one up!).  If you were diagnosed in March, then I'm guessing you finished treatment perhaps in June sometime?  If it's only been 3 months, then it seems premature to me for a biopsy to be done.  I would really question that, as healing can be compromised because the tissue that has been radiated can be very fragile.

As for the CEA, it's not a useful marker for anal cancer.  It is used most often to detect cancer of the colon.  Because colon cancer and anal cancer are not the same type of cancer, the CEA would not be an indicator for a recurrence.  Unless you had symptoms pointing to the possibility of colon cancer, I would not be too concerned about this.  However, I'm not a doctor, so please discuss this with him/her.

As for tiring of tests and appts., the best advice I can give you is get used to it.  I still see my colorectal doctor every 6 months and my oncologist at least once a year--6 years out. 

MKW213

mp327 said:

MKW213

I'm not sure when your treatment was completed, but it doesn't surprise me that there was still some activity showing on your recent PET scan.  The same thing happened to me.  First PET showed 7 something and PET done about 6 weeks after treatment finished showed 4 something.  It was determined to be inflammation.  I am now post-treatment over 6 years, so apparently it WAS inflammation.  PET scans are very sensitive and can light up for things other than cancer, such as inflammation or residual radiation that is left over from treatment--even brown fat (look that one up!).  If you were diagnosed in March, then I'm guessing you finished treatment perhaps in June sometime?  If it's only been 3 months, then it seems premature to me for a biopsy to be done.  I would really question that, as healing can be compromised because the tissue that has been radiated can be very fragile.

As for the CEA, it's not a useful marker for anal cancer.  It is used most often to detect cancer of the colon.  Because colon cancer and anal cancer are not the same type of cancer, the CEA would not be an indicator for a recurrence.  Unless you had symptoms pointing to the possibility of colon cancer, I would not be too concerned about this.  However, I'm not a doctor, so please discuss this with him/her.

As for tiring of tests and appts., the best advice I can give you is get used to it.  I still see my colorectal doctor every 6 months and my oncologist at least once a year--6 years out. 

mp327

Thanks so much for you input. I finished radiation on May 23. I saw a PA today, not the regular oncologist. She never mentioned the CEA, just saw it in my lab work after I got home. But know I get different answers from specialists in their own domain than I do from docs in other specialties, so will patiently wait to see my colorectal doc. I'm a medical transcriptionist and over the 40 years I have done this have learned about enough to scare the bejeepers out of myself. Know I am my own worst enemy!!

Had a partial colonoscopy that showed nothing in the first 3 feet.  Had to stop because of severe pain--woke me right out of conscious sedation. So thanks for that info, too.

I'm trying to get used to the tests. I also need a total hip replacement and a hernia repair, so it just never seems to end. The best advice I have been given is to use the "low beams" and not look so far into the future. Easier said than done, but I'm trying.

Thanks so much for your support and information.

 

mp327

MKW213 said:

mp327

Thanks so much for you input. I finished radiation on May 23. I saw a PA today, not the regular oncologist. She never mentioned the CEA, just saw it in my lab work after I got home. But know I get different answers from specialists in their own domain than I do from docs in other specialties, so will patiently wait to see my colorectal doc. I'm a medical transcriptionist and over the 40 years I have done this have learned about enough to scare the bejeepers out of myself. Know I am my own worst enemy!!

Had a partial colonoscopy that showed nothing in the first 3 feet.  Had to stop because of severe pain--woke me right out of conscious sedation. So thanks for that info, too.

I'm trying to get used to the tests. I also need a total hip replacement and a hernia repair, so it just never seems to end. The best advice I have been given is to use the "low beams" and not look so far into the future. Easier said than done, but I'm trying.

Thanks so much for your support and information.

 

MKW213

I had to smile when I read your statement about having been a medical transcriptionist, as I was also a medical transcriptionist for several years.  I'm not a hypochondriac, but oftentimes I would type up some notes on a patient and think--hey, that happens to be all the time!  It would leave me wondering if I had something wrong with me as well!  However, on to the next patient, next problem, and I would forget all about it!  I transcribed for a internist for awhile, then switched to physical therapy, which was much more interesting, IMO! 

My medical oncologist has run several CEA's on me over the years, however, not recently.  I think it's just a measure of caution, making sure that everything looks good and all systems are "go."  I would still ask about it on your next visit.  I'm sorry you are dealing with other issues--certainly those two surgeries are nothing to look forward to.  But I agree, try not to look too far ahead and take it one day at a time.  Best wishes to you!