CEA level

i feel everyday is a new struggle appointment tomorrow for dad

need prayers 

would anyone tell me how long did it take them to recover from Open colon resection and  when did they recover anemia 

my dad is 2months and 10 days post operation 

it was a open colon resection

steveja said:

CEA test are VERY accurate,

FWIW

CA19-9 has even less support than CEA.  You might want to examine the neutrophil:lymphocyte ratio (the numbers are on a basic CBC blood test).   High ratios suggest a problem and poorer outcomes.

 

 

CEA is the best marker overall for stages 1-4, at initial diagnosis with a single reading.  However some CRC cancer patients with a nice low CEA have high CA199 values that can be important.

CEA is the best marker overall for a series of blood tests at detecting recurrence, however some patients with low, flat CEA levels have high, responsive CA199.

CA199 is best used with skill and timing. CA19-9 is a marker affected by several conditions (inflammation, biliary diseases, other cancers, diabetes, thyroid problems,  treatments like RT, RFA or heavy cyclical chemo)  or changes in conditions, that overlap the common CA199 range for CRC, 19 - 37.  Nevertheless, careful use of CA199 can provide valuable information for advanced CRC patients (stages 3 and 4), and patients with KRAS and BRAF mutant cancer (even stage 2s). Especially with supporting panels like hsCRP, ESR, HgbA1C, thyroid for interference data.

Used in combination with high CEA, high CA199 predicts metstatic cancer and shorter OS if not successfully exterminated.  High CEA and high CA199 together is an especially important finding.  E.g. One member struggled with low CEA, high CA199 cancer for many years; when his CEA became active too, his conventional treatments were no longer effective and he was quickly gone. 

High pre-op CA199 increases the likehood of targeted cimetidine successfully stopping cancer recurrence in those patients  who would recur after 5FU based treatment.  Ultralow CA199  (under 2 units) predicts cimetidine is of no value to these CRC patients.   The Japanese data suggest that tissue staining with both CA199 and CSLEX1 (a particular CD15s antibody) is the best companion marker treatment today for those stage 2 and 3 patients who will recur and die without cimetidine in the post op period.  All too cheap and big medicine isn't interested in cheap.  This targeting even appeared to work well for us, dealing with stage 4b.

In our case, CA199, rising rapidly, was also the first responsive marker to an improved chemo treatment.  The greedy little metastatic mutants producing CA199 sucked up the chemo and died faster than the slower CEA bearing cells sitting there like inert lumps, relatively speaking.   CA199 bearing cells are more likely to imply uncontrolled, -able metastasis if not targeted effectively. 

Marker expressions change with time, as cancer cells struggle to survive too. Several off label tests, like the NLR that you mention, provide pieces of information.  It is worth tracking many treatment related panels, to us.

Most doctors are totally out of the loop on CA199 related CRC skills. However, as an added marker for high risk patients, especially the very first use, preferably before any heavy duty treatments, very high value pieces of information can be obtained.

Annabelle41415 said:

CEA

As stated above my CEA level was always normal and my radiologist and oncologist told me this was the marker to look for so it wasn't a good indicator for me.  I'm wondering why they never suggested the other marker test knowing that the CEA marker was a waste of a test.  Hmmm, do doctors just not know this or are they to blind to even think about giving you another marker test because they are too much boxed in to a set standard.  Makes me angry that they have a test that could be more accurate.  Thanks for the info.

Kim

First they are stuck in a box by training.  They are taught nothing basic about it in US med schools and have nothing to develop from.  At least, I'm old enough to remember the discovery years of CA199 in the scientific news, and it was discovered from CRC.  I pointedly asked all oncologists (including Ivy, MDA alums) about extra CRC markers and got no useful information in 2010-2011.  Our internal medicine MD was actually slightly better at the principles of marker use and hunting. Life Extension Fdn had some useful info.

Second, is that CA199 is largely munged as a marker during std US treatments and much of the (half+)year that follows.  Heavy cyclical chemo rapidly degrades CA199 accuracy by cell damage and inflammatory rises each cycle . Ditto initial radiation tx for rectal cancer in the US (some countries avoid[ed] RT with better surgery and chemo techniques, at least for several decades).  Sometimes, even after a surgery, an infection will degrade accuracy.  So, during US oncologists' tenure, CA199 problems typically develop rapidly - as an iatrogenic result !  "dr's fault"

Third are economic and legal problems.  Insurers got a statute passed that enables them to easily save costs by dismissing "nonstandard medical practices" as prosecutable fraud rather than having to discuss the merits.  This is totally corrupt and bad science, but has been the situation for a while.  There are other legal intrusions to force some "standard" upon drs and patients too.

So why bother?  Because the life it saves could (have) be(en) yours. In many situations and cases it is the only useful marker, as a monitoring marker for KRAS/BRAF mutants, as a one time, prognostic companion marker for cimetidine, or  especially for many of the patients that have ultralow (poor) CEA.  It's information value is additive to CEA, not "competitive".

When is it useful?  Periods before treatment, and long after, are likely good.  Not all treatments disrupt CA199 - e.g. natural immune tx, continuous immunochemo, surgery.  Some treatments are likely to improve its stability - like anti-inflammatories, certain diets, and IV vitamin C.   The year on chemo following my wife's second surgery, her CA199 data were tighter than most std patients' CEA data, off chemo.

So what has CA199 done for us?  1. it early predicted the likely treatment utility of cimetidine, probably important for many stage 2-4a KRAS/BRAF mutants patients that would later suffer recurrences; 2.  it showed us chemo dosage response when CEA could not and most patients would have "lost" the chemo and helped make a succesful surgery, 4. as time goes by, CEA is a less valuable, less useful marker for my wife, still on long term chemo.  Well worth the money for our most expensive, cash paid marker, as much as I despise the 3.8x CEA price that we pay.