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Question - Need Help

Posts: 100
Joined: Mar 2004


*diagnosed 2002 - Stage IV
*2002 - two surgies to remove met in liver plus tumor in colon
*recurrence in 2004 - surgery to remove mets in liver
*recurrence in 2005 - surgery to remove mets in liver
*recurrence in 2006 - cea at all time high of 55 and went to 189 before starting treatment (avastin)
*avastin not working - started vextibux (sp.) in June 2007 - cea down to 14 after 3 months of treatment
Latest CT Scan - no change in the liver except one met is larger - doc says this may be a dying met (many mets) + mets in lung are shrinking

So confused. For the past 5 years, my dad's cea level has matched what is in his body. When he had a cea of 2.5, he had a very small met that could barely be seen on a pet/ct scan. When he had a cea of 17, he had one met that was surgically removed in 2005. I think that we need a pet scan. Is it possible that some of the mets that remained stable from the scan in June to now are dead but still on a ct scan? Has anyone had this experience. It is odd that the mets in the lung are shrinking considerably but nothing in the liver. Any thoughts? Very frustrated and need some hope.

spongebob's picture
Posts: 2598
Joined: Apr 2003

j -

By the sounds of things your dad is doing pretty good...

To answer your questions:

Is it possible that some of the mets that remained stable from the scan in June to now are dead but still on a ct scan?

ABSOLUTELY. "dead" tumors/growths/etc. are often noted on CT scans. You're correct to inquire about a PET. The PET scan is the best way to determine if there is cellular activity and verify if the area visualized by the CT is "dead" or not.

As for CEA following symptoms/status of disease... it's a good marker but it's not a 100% indicator. Many of us here had "normal" CEA when were fully involved with active disease. Sometimes it goes up and sometimes it doesn't - do like you're doing and use the CEA number in conjunction with otyher diagnostic tests.

Keeping your family in my prayers.

- SpongeBob

vinny3's picture
Posts: 933
Joined: Jun 2006

It's certainly possible that the area where the mets are won't clear as rapidly as those in the lungs due to the type of tissue in each of those organs. The lung mets are mainly surrounded by air wheras the liver mets have dense tissue around them. A PET scan should show whether or not these are likely to be active. Ask the oncologist about that.

SB is right. The CEA is just one part of the picture and not the most accurate part.


apache4's picture
Posts: 272
Joined: Jul 2007

The other two replies were right on. I had so many liver mets that I wasn't a candidate for surgery. After chemo,CT scans showed them being stable, but my greatest news was the PET scan showed them all DEAD except for one small one. That was a huge surprise. A PET scan is the way to go.

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