Opinions needed PLEASE!....CEA rising...scans clear...chemo or not?

idlehunters said:

Hey Kathleen!...
Great to hear Dicks colonoscopy came out good. Thats encouraging news. The last 2 PET/CT's I have had they scanned head to toe. I have never had that done previosly. It was always chin toid thigh. It felt good to see what was going on in my brain. I always wonder about that area...of course I have wondered about that area my whole life..LOL!!! You take care! Tell **** I said "Hey"

Jennie

more resolution
Our radiologist said ears to thigh has higher CT resolution for 99.9+% of where CRC mets show up.

John23 said:

Hey, remember this?

I posted this way back in September 16, 2010 - 10:55pm



----------------------------------------

To: Jennie -


Whew.

Re:
"my peeps on the Cancer Board say that their docs tell them that
dying tumors...dying cancer cells..can cause a rise in CEA.
He told me that is absolutely NOT true. He siad when cancer cells
are dying they have less or no CEA in them at all... They are DEAD.
can't measure the antigen in something dead. "

Oh? Ok.:

"Chemotherapy and radiation therapy can cause a temporary rise in
CEA due to the death of tumor cells and release of CEA into the
blood stream. Benign disease does not usually cause an increase
above 10 ng/ml."
From: http://www.medicinenet.com/carcinoembryonic_antigen/article.htm

---------------

"The data presented in this study support both lines of
thought concerning CEA production; however, these results
strongly uphold the theory of CEA release by dying cells."
From: http://etd.lib.ttu.edu/

-------------

"recent observations of CEA upregulation in CRC cell lines by cellular stressors such as
hypoxia9 or exposure to cytotoxic drugs such as 5-fluorouracil.10,11 Moreover, it is plausible
that apoptotic release of CEA from dying cells could trigger transient increases"
From: http://cigjournals.metapress.com/index/8278xq0v077w2166.pdf

-------------

"One possible explanation for the rise in marker levels among
patients with regressing tumor is that the dying cells may
release large amounts of marker into the blood."
From: http://www.faqs.org/abstracts/Health/Tumor-marker

------------

"Colorectal cancer patients whose CEA blood tests rise at the
beginning of chemotherapy and then fall (CEA flare) do better
than patients with a consistently rising CEA. CEA flares don’t
necessarily predict worsening cancer.

Compared to patients with consistently rising carcinoembryonic
antigen (CEA), patients who had a CEA flare had more tumor
shrinkage, longer time before their cancer got worse, and longer
survival time."
From: http://fightcolorectalcancer.org/research_news/2009/

------------

"If we had followed this ASCO guideline of measurement of CEA
level every second month, one of the surge patients would have
been incorrectly interpreted as having experienced treatment
failure, and therapy would have stopped. The patient would have
been incorrectly removed from the treatment, giving her a time to
progression of 11.2 months and 27.3-month survival. To avoid
inappropriate therapy changes based on clinical misinterpretation
of a CEA surge as an impending disease progression, we suggest
that future ASCO guidelines should mention the possibility of CEA
surge. Furthermore, we suggest that no therapy changes should be
based on CEA levels alone at all during the first 6 months of therapy.

An initial rise in CEA level during effective chemotherapy in
colorectal cancer patients may not always indicate progression of
disease but may be a transient CEA surge in patients responding
to chemotherapy. In monitoring tumor responses and in future
guidelines for the use of tumor markers, the possibility of a
surge phenomenon should be taken into account. This will
especially be important if a new, more effective treatment with
high response rates or rapid tumor destruction is introduced. "
From: http://jco.ascopubs.org/content/21/23/4466.full

-------------

Those last paragraphs (note bolded text) say more than enough regarding
CEA and mistakes that can be made with treatment scheduling.

And Re:

"He told me that is absolutely NOT true. He siad when cancer cells
are dying they have less or no CEA in them at all... They are DEAD.
can't measure the antigen in something dead. "

Maybe you oughta' shop around for a new Onco..... You deserve
better care than an idle assumption.

(I wanted to re-phrase that last statement....... My extreme anger at
physicians that are too busy making money to do research, was showing).

John

---------------------------------


There. How was that?

It's like Deja'Vu all over again.

We always manage to worry about everything after a diagnosis
of cancer; I don't think it ever stops. (not for me, anyway)

Think good things!

John

CEA advice
I finished chemotherapy about 6 weeks ago. My Cea level in sept, after my surgery was 3, recently, about 3 weeks ago my level was something like 7.8. I have no idea what was in between. My oncologist did a pet scan which showed nothing but he wants me to have a colonoscopy, scheduled for next week.
I havent gone to any of the links you provided but after finishing treatment and the CEA rises, it is an indication to look for cancer, am I right?