CEA explained, please!

kblairj
kblairj Member Posts: 21 Member
edited June 2023 in Colorectal Cancer #1

Can someone please give me a very simplistic explanation of CEA levels. My husband had an emergency colonectomy in January and was diagnosed with Stage IV colon cancer. CEA was 6.7. He started Xelox (1 3-week cycle and not tolerated), and it was 6.6. Then switched to Folfox. After 1 round, CEA was 5.8. Now, just before his 3rd cycle of Folfox, it is 6.6. Note: He is a T1 diabetic with hypothyroidism and I read that this can elevate CEA. Just wondering if we should be concerned that the chemo may not be working.

Also, I see CEA levels listed on the board that are in the hundreds. Are they stating them differently or can it really go that high?

Thanks for any insight! Keep fighting the good fight, all!

Comments

  • Capox Dude
    Capox Dude Member Posts: 122 Member
    #2
    https://medlineplus.gov/lab-tests/cea-test/

    take a look at this

  • kblairj
    kblairj Member Posts: 21 Member
    #3
    https://csn.cancer.org/discussion/comment/1705463#Comment_1705463

    Thank you for your reply. I have read that, but I still don't have answers to my two burning questions:

    1) Does mild fluctuation of CEA indicate anything of concern?

    2) How high can CEA go? I see some posters referring to CEA levels in the hundreds---or are those just stated differently?


    Thanks for any insight!

  • agekrelve
    agekrelve Member Posts: 4 Member
    #4

    I don't believe at the fluctuating levels you are observing for CEA is atypical or of concern given the early stage of treatment your husband is at currently. If it goes from 6 to 10 to 15 all of sudden then it would be more of a concern in my opinion. The other thing I read too is that when cells are dying they also release CEA store intracellularly so it may also be an indication the treatment is working.

    There is inherent variability in the assay that is utilized to report the result as well. I would check to see if the assay used for CEA is consistent as I have had three different methods used in the last 1.5 years that gave slightly different results within 0.5-1.0 of each other over the course of treatment and monitoring. Lastly, CEA is a good marker for some with colorectal cancer but not all.

    Yes, CEA levels can go that high.

    That is my two sense.

  • SandiaBuddy
    SandiaBuddy Member Posts: 1,381 Member
    #5

    All of the prior comments seem very valid, but I would add that over time, it seems like CEA is a good indicator for some and a meaningless indicator for others (for me it was meaningless). Unscientifically, it seems to me it is about a 50/50 split. That may not be much comfort in your husband's situation, but at least it might indicate there is a 50% chance the CEA reading is not something to worry about.

  • Capox Dude
    Capox Dude Member Posts: 122 Member
    #6

    What I am about to say, applies only to me personally, and my own physiology. Two years after chemo ended my CEA slowly rose from 1.4 to 17. It turns out that inflamed lungs and phlegm plugs in your respiratory system can produce high CEA for some people. I had lab work done last Thursday and my CEA is now 1.9. Which is all to say, everyone who says there is NO direct correlation between CEA and cancer reoccurrence in every case are correct.

    Having said that, CEA levels in the hundreds are possible, although associated with malignancy. I guess what I’m trying to say is that there is normal, abnormal (but not really a diagnostic)…..and so abnormal that it is almost a diagnostic certainty of a problem. For those relevant diagnostic break points in any type of cancer, for any CEA level, and for any individual patient, I would consult my oncologist and not the opinions of people on this board. Certainly, no offense intended by that statement. Your question is a good one.

  • WinstonBishop
    WinstonBishop Member Posts: 2 *
    #7

    Just to address high CEA levels, I had a CEA of 8400 when I was diagnosed with stage IV. Had a primary tumor in my sigmoid about 5.5cm, and ~60% coverage in my liver.


    CEA has always been a strong indicator for me, and it usually increases pretty fast if I have something new growing inside of me, but it is not a reliable marker for everyone.

  • WinstonBishop
    WinstonBishop Member Posts: 2 *
    #8
    https://csn.cancer.org/discussion/comment/1705495#Comment_1705495

    I am 8 months post-liver resection and NED, and I just had my labs drawn yesterday. My CEA have been in the low 1's since surgery, but they came back at 3.5 this morning. I'm obviously frantically trying to find any info to indicate why this could not be cancer. I have never heard that inflammation in the lungs could cause it to rise. Does that mean that if I've been vaping (both oil and flower) pot more consistently in the last 6 months, that this could be causing a potential CEA rise? Or even a virus or something you may be dealing with? Typically, if I have a recurrance, my CEA with jump with little ambiguity, which is why I'm trying to make sense of a 1.7 jump in a month (or a 2.3 point jump over the last 3 months) vs a 25 point spike. Also, I get that 3.5 is still technically "low" (Kaiser says below 5 is normal) but I have been between <1 and 1.4 since my surgery, so it's definitely trending in a direction I do not like to see.


    I know you are not my Dr (I've already panic messaged them lol), I'm just casting a wide net looking for anecdotes and bits of info people may have picked up while I await their responses.

  • kblairj
    kblairj Member Posts: 21 Member
    #9
    https://csn.cancer.org/discussion/comment/1706102#Comment_1706102

    Thanks for your reply. From what we can tell this far, it is not a reliable marker for my husband. He is also T1 diabetic and has some inflammatory RA which can both affect CEA levels. His has been hovering between 5-6 ever since he was diagnosed, regardless of imaging results and both before and after surgery. Our Dr. at MSKCC said he wasn’t concerned so I will chose to also not be too concerned 😊

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