CEA variation - real change, or not?

peterz54
peterz54 Member Posts: 341
in Colorectal Cancer #1
there are many posts here expressing concern about changes in CEA. Having a lab background early in my career I know that all analytical results have a variation associated with them, and that results which fall within that variation cannot be considered to be different. hence, for examaple, it may be that there is no real difference between a CEA of 3 and a followup CEA of 3.2 or 2.8 some time later.

I have asked the lab manager who processes my wife's CEA results about the variability in their results and expect an answer back soon. But she agreed in principal that one should not conclude there are changes occuring based on small percentage changes in reported results.

here's the key point for CEA followers - Ask your doctor, or have the doctor contact the lab and tell you whether an apparent change is real. There will likely be different variability at a CEA concentration of 2 ng/ml than say 20 ng/ml, or as in my wife's case, 500 ng/ml.

Comments

  • geotina
    geotina Member Posts: 2,111 Member
    #2
    Thanks Peter:
    I agree with you, very small changes in CEA can be nothing or insignificant. In my hubby's case when he went from 20 to 80 to 200, well it told us cancer becoming very active and more aggressive treatment warranted. Happily it is down to 11.4 and we will take that any day (lowest it has been since 3/09).

    Thanks for the info, hopefully it will ease people's minds.

    Tina
  • PhillieG
    PhillieG Member Posts: 4,866 Member
    #3
    Thanks for the info Peter
    I think is part of why my Oncologist is not a fan of her patients trying to interpret their own CEA counts. It's easy for someone who doesn't understand all of the factors involved to see a change in the numbers and think it's more significant than it might be.
    I hope your wife is doing well.
    -phil

    BTW: I see you don't accept private messages Peter...
  • sdp
    sdp Member Posts: 181
    #4
    geotina said:

    Thanks Peter:
    I agree with you, very small changes in CEA can be nothing or insignificant. In my hubby's case when he went from 20 to 80 to 200, well it told us cancer becoming very active and more aggressive treatment warranted. Happily it is down to 11.4 and we will take that any day (lowest it has been since 3/09).

    Thanks for the info, hopefully it will ease people's minds.

    Tina

    CEA tests
    I had CEA , and ca 199 tests done on diagnosis and they were CEA 935 and ca 199 > 1200.

    After 2 months of chemo the tests are CEA 15.2 and ca 199 40.6

    The problem is that the tests were done in two different labs.

    Do the results vary a lot if done in different labs .? My onco says there is a huge variation and I should have got them done at the same lab.

    Now, maybe after two further rounds of chemo I shall get them done at the same lab or at both labs.

    If anyone has any advise on this pl suggest.

    Sdp
  • sdp
    sdp Member Posts: 181
    #5
    geotina said:

    Thanks Peter:
    I agree with you, very small changes in CEA can be nothing or insignificant. In my hubby's case when he went from 20 to 80 to 200, well it told us cancer becoming very active and more aggressive treatment warranted. Happily it is down to 11.4 and we will take that any day (lowest it has been since 3/09).

    Thanks for the info, hopefully it will ease people's minds.

    Tina

    CEA tests
    I had CEA , and ca 199 tests done on diagnosis and they were CEA 935 and ca 199 > 1200.

    After 2 months of chemo the tests are CEA 15.2 and ca 199 40.6

    The problem is that the tests were done in two different labs.

    Do the results vary a lot if done in different labs .? My onco says there is a huge variation and I should have got them done at the same lab.

    Now, maybe after two further rounds of chemo I shall get them done at the same lab or at both labs.

    If anyone has any advise on this pl suggest.

    Sdp
  • sdp
    sdp Member Posts: 181
    #6
    geotina said:

    Thanks Peter:
    I agree with you, very small changes in CEA can be nothing or insignificant. In my hubby's case when he went from 20 to 80 to 200, well it told us cancer becoming very active and more aggressive treatment warranted. Happily it is down to 11.4 and we will take that any day (lowest it has been since 3/09).

    Thanks for the info, hopefully it will ease people's minds.

    Tina

    CEA tests
    I had CEA , and ca 199 tests done on diagnosis and they were CEA 935 and ca 199 > 1200.

    After 2 months of chemo the tests are CEA 15.2 and ca 199 40.6

    The problem is that the tests were done in two different labs.

    Do the results vary a lot if done in different labs .? My onco says there is a huge variation and I should have got them done at the same lab.

    Now, maybe after two further rounds of chemo I shall get them done at the same lab or at both labs.

    If anyone has any advise on this pl suggest.

    Sdp
  • coloCan
    coloCan Member Posts: 1,944 Member
    #7
    sdp said:

    CEA tests
    I had CEA , and ca 199 tests done on diagnosis and they were CEA 935 and ca 199 > 1200.

    After 2 months of chemo the tests are CEA 15.2 and ca 199 40.6

    The problem is that the tests were done in two different labs.

    Do the results vary a lot if done in different labs .? My onco says there is a huge variation and I should have got them done at the same lab.

    Now, maybe after two further rounds of chemo I shall get them done at the same lab or at both labs.

    If anyone has any advise on this pl suggest.

    Sdp

    Yes,different labs will come up with different CEA values.....
    I'm afraid to go too long without at least CEA test so in between onc visits,i have lung doc run CEA. Each uses a different lab (lung doc recently switched labs so my last CEA from his office gives me my new baseline from his lab),CEA varies abit but the trend is what's important....I know my # will be different so i only compare onc's tesrs with onc's and lung doc with long doc tests.....Even tho number differs, trends are identical......
  • sdp
    sdp Member Posts: 181
    #8
    coloCan said:

    Yes,different labs will come up with different CEA values.....
    I'm afraid to go too long without at least CEA test so in between onc visits,i have lung doc run CEA. Each uses a different lab (lung doc recently switched labs so my last CEA from his office gives me my new baseline from his lab),CEA varies abit but the trend is what's important....I know my # will be different so i only compare onc's tesrs with onc's and lung doc with long doc tests.....Even tho number differs, trends are identical......

    What are the numbers in your CEA
    Hi

    Can u pl,enlighten what the diff numbers are in ur onc and the other test,

    Since , I have done two tests one from each lab I can't even tell the trend

    So if u can tell me both the numbers I will have a better idea
  • coloCan
    coloCan Member Posts: 1,944 Member
    #9
    sdp said:

    What are the numbers in your CEA
    Hi

    Can u pl,enlighten what the diff numbers are in ur onc and the other test,

    Since , I have done two tests one from each lab I can't even tell the trend

    So if u can tell me both the numbers I will have a better idea

    As a stage threer, it seems that once your treatment concludes,
    your appointments with oncologist,radiologist,surgeon,etc get further and further apart and the time between scans increases as well (3,6,12 months). I can understand minimzing radiation exposure but as i see no harm in a CEA test,some time ago i had asked my lung doc (i have COPD)if he can run a CEA on me so i don't go too long without a CEA done and this way i have a general idea of where things may be. If a took a CEA from onc right now and one at my lung doc an hour later, the result will differ so i only compare onc results with onc tests and lung results with lung tests.....I compared the first CEA my lung doc did with the one done by onc nearest in time and the one from onc was .2 higher (in future, that would NOT be constant but onc CEA always a bit higher than lung doc) Til lung doc changed labs,CEA from both labs rose abit on two consecutive tests, then both stayed the same, then both dropped a bit and now I'm awaiting results from lung doc's new lab and see onc this thursday for new CEA test........Its probably better to use one lab (unless you have a warped way of thinking-akin to mine)

    I don't compare the results i get on any bloodwork done by lung doc's office with that done at cancer center because results will differ for reasons explained by onc and research nurse and made sense at that time but now that explanation has been lost somewhere in my chemo-addled brain.....steve

    PS: being overweight and/or tobacco affects CEA
  • pete43lost_at_sea
    pete43lost_at_sea Member Posts: 3,900 Member
    #10
    sdp said:

    CEA tests
    I had CEA , and ca 199 tests done on diagnosis and they were CEA 935 and ca 199 > 1200.

    After 2 months of chemo the tests are CEA 15.2 and ca 199 40.6

    The problem is that the tests were done in two different labs.

    Do the results vary a lot if done in different labs .? My onco says there is a huge variation and I should have got them done at the same lab.

    Now, maybe after two further rounds of chemo I shall get them done at the same lab or at both labs.

    If anyone has any advise on this pl suggest.

    Sdp

    spd, i had very different results from different labs
    one lab measured 17 plus or minus 1 over a month.

    one test was sent to a different lab inadvertently, only with 3 days diffenence and the result was 66.

    we have no explanation. i stick to the lab that gives the lowest scores of course.

    hugs,
    pete
  • here4lfe
    here4lfe Member Posts: 306 Member
    #11
    In my experience
    My wife's CEA has been like a digital thermometer, up is bad, and everytime her numbers went up, by however little, they found cancer. Not a false reading yet.

    Best

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