CEA and CA19-9 levels

TerpStar

Hi, my dad was diagnosed with colon cancer and he’s been undergoing chemo for the past 6 months. He started with a CEA of 29 and a CA19-9 of 97. CEA went from 29, to 10.5 and then started increase to 10.1, then 10.3 and now it’s at 12.9. CA19-9 kept going down and went from 97 to 37, then 38, and now it’s 33 and normal. I guess I’m not sure why the CEA went back up and the CA19-9 is now normal. Is it common for CEA to fluctuate? Or for CA19-9 to be normal but CEA to be high?

Trubrit

CEA can fluctuate. It can be affected by several things, including inflammation. Some have even said that stress can affect it, but don't quote me on that.

It is such a roller coaster of emotions. Try your best to take a deep breath, and know that too much worry isn't going to change what is, but it can affect your own health.

Yeah, hardly works, but I had to say it.

Wishing your dad the best.

Tru

TerpStar

https://csn.cancer.org/discussion/comment/1697085#Comment_1697085

Thank you for the response, Tru. I’ll do my best to keep a positive face. Thanks for the kind words!!

Trubrit

How is your dad doing?

I am surprised that others have not been on the forum to answer, as there are members here, much more knowledgeable than myself. Hopefully, this will bump your post up, and others can share their thoughts and feelings.

Tru

TerpStar

He’s doing okay, his CEA is rising. He was on a combination of IV chemo and pills but the doctor has decided to take him off the IV chemo and place him only on pills for now. I’m trying to get a better understanding on why the doctor decided that if the CEA is rising but just holding faith that he’s making the right decisions on my dad’s treatment.

I hope I can hear from the other members as well. It’ll be nice to feel like I’m not the only person in the world who feels like this of a loved one.

Thanks again!

beaumontdave

Welcome, my CEA always rose with my two recurrences, and was a useful indicator, for many it's not. You didn't mention what his specific initial diagnosis was, or where, but if they are trying to shrink a mass, the numbers certainly would fluctuate. Get a second opinion if you don't have full confidence in the doctor you have. Luck and strength to your pop...................Dave

TerpStar

https://csn.cancer.org/discussion/comment/1697780#Comment_1697780

Thank you for the message, Dave. He was diagnosed with colon cancer in 2019 and found a mass in his colon that they removed through surgery. After that he was doing great. In October of 2021, we found out that the cancer came back and it was metastatic stage 4 and it spread to this ribs and he has a lump in his lung and liver. Now he has completed 8 cycles of IV treatment with combination of chemo pills. During the treatment, his CEA and CA19-9 was decreasing. Now it’s slowly going back up and last month the CEA shot up to a 20.1 from a 12.1. We completed a CT scan and it showed the lumps have decreased by little but still present. The doctor mentioned that they will put him on maintenance therapy and stop the IV treatment for now but to me it didn’t make sense if his CEA is going up and the lumps did not completely decrease. Based on your experience, you mentioned that if they are trying to shrink a mass, the CEA will fluctuate. It could be just that but we are meeting with the doctor next week for labs and to see what the plan is moving forward.

STI_1911

https://csn.cancer.org/discussion/comment/1697780#Comment_1697780

Hi Dave, i am new to this forum. I had colon cancer surgery last year in September, followed by a six month Chemo. Chemo sarted with the regular CAPOX scheme but was switched to Capecitabin mono therapy after the secodn infusion of Oxaliplatin wich left me with paralysed hands and face. I had a T3 N1b staging with no metastasis at that time, the tumor could be removed completely, 2 Lymphnodes affected out of 23 that were taken. Now my CEA value is rising, slowly but rising. It was at 10.2 before surgery and 2.0 right after. Now after almost 9 month it slowly rised to 4.0.

When you say your CEA always rose with your recurrences, how fast did it rise?

Thanks

beaumontdave

https://csn.cancer.org/discussion/comment/1698032#Comment_1698032

Hi, my CEA levels after the initial colectomy were steady risers, like 6ish after chemo, then up to 47 or so within 2 years, the point at which they 'scooped' 3 mets out of my liver. It did a slower rise again, over a similar amount of time to 16 by the time they pull one more met from a spot in the liver near where a previous met was. After that, it's been 2.4-2.8 for the almost 8 years since, though it finally hit 3 this last blood panel [which perked my concern level even now, but we'll see what the next one shows]. In your case 2 to 4 in a nine month period strikes me as fairly slow, with 4 still being a normal/okay number on the scales I've dealt with. Still it's enough to make one anxious, every time it pops up in your mind. I hope it stays even or drops on your next test, and mine for that matter. Years of watching and waiting, knowing it can be accurate, yet also knowing it can 'oscillate' for benign reasons, makes it a particularly annoying thing to deal with. After the second liver resection however, it was my one source of hope. They did needle lung effusion removals, needle biopsied a spot in my lung, scanned 5 CT's at shorter intervals, followed each by a PET scan, worrying me with their searching, and the one thing that held steady was the CEA, so I suppose I can't fault the thing too much. I wish you luck with it....................................Dave

STI_1911

Dave, thanks a lot for your answer. Some say it can bounce up and down as much as 30%, other say 0.5 in absolute value. But in my case it only went up. You are right, still below the threshold but enough to make me anxious. And it's not only poping up in my mind, it's somehow blocking my mind completely, keeping me from doing my job etc. Stupid enough, insurances here are very reluctant to pay for a PET scan if there is no good reason. And i hate taking decisions based on what insurances pay for.

Cheers

Guido