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CEA NUMBERS

bruins1971's picture
bruins1971
Posts: 227
Joined: Nov 2010

Just wondering for those of you in treatment how often does your Onc test your blood for CEA? Mine has not tested it since late September saying that he fully expects that the cancer is gone at this point. After removing the tumors from the colon in March and the liver in August along with the petscan back in April showing the cancer only in the liver he now feels that I am cancer free and God willing he is correct. He is a really great ONC who runs the clinic I am at for GI cancers. He came from MD Anderson in Houston which is one of the best cancer centers in America. I will finish up my 12th chemo in early January and then have a CT scan to see what's up. If they see anything abnormal he will then order a petscan. I can hardly believe that I am so close be being done. This day seemed like it was sooooo far away back in Feb was I was DX staring at colon and liver surgery with 12 rounds of chemo. I could not have made it without the support of my family, friends and of course my faith in God. I hope everyone is having a great day but again I was just wondering about the CEA number thing.

Bobby in Dallas

karguy's picture
karguy
Posts: 1024
Joined: Apr 2009

My doctor checks my cea once or twice a year,and I have a cat scan once a year,but this year I had 2 because I had an intestinal infection.Good luck.

TxKayaker's picture
TxKayaker
Posts: 177
Joined: Jun 2009

I on a every 6 month schedule in fact my next scan and blood tests are scheduled for the 17th of Dec.
Mike in Carrollton

bruins1971's picture
bruins1971
Posts: 227
Joined: Nov 2010

Hey Mike I work in Addison so I know Carrolton very well nice to see another DFW person on this site. What stage are you?

TxKayaker's picture
TxKayaker
Posts: 177
Joined: Jun 2009

Stage III -- Been NED since surgery April 5 , 2009. Actually I work in the Oil & Gas Industry during the week I'm in Odessa commute back to DFW with our friends @ SWA on weekends been at this almost 3 years now.
Lake Lewisville picture in my avatar.
Take Care

annad723's picture
annad723
Posts: 44
Joined: Nov 2010

Hi Bobby,

Since I am still being treated, my onc tests my CEA at least once a month. So happy for you. I am not a candidate for surgery as I have multiple mets to the liver, both lobes. Am on my 4th different drug, still trying to hang on.

But so very very happy for you. A Christmas blessing indeed Bobby. May you feel only joy this Christmas season.

Much love--Anna

bruins1971's picture
bruins1971
Posts: 227
Joined: Nov 2010

Never give up Anna we can always look to the Lord for hope and guidance. I am sure that we all go through the days where we all think we are just holding on yet somehow we always make it through. For me I believe that Jesus is there for me when I get down. I pray things get well for you and I too wish you a very Merry Christmas....

Bobby in Dallas

Lori-S's picture
Lori-S
Posts: 1287
Joined: Sep 2010

Every 2 weeks right now simply because of the way my CT scans and CEA have been looking. And I am currently in my early FOLFOX treatments. The onc is watching for any signs of the chemo working or not and determining if the spots on my bones are responding or not

bruins1971's picture
bruins1971
Posts: 227
Joined: Nov 2010

Prayers and good wishes are headed your way... stay positive..

bobby in dallas

Lori-S's picture
Lori-S
Posts: 1287
Joined: Sep 2010

Bobby ... same to you!

AnneCan
Posts: 3692
Joined: Oct 2009

My CEA is done @ least every 4 weeks + sometimes every two. I am in active treatment (chemo).

geotina's picture
geotina
Posts: 2118
Joined: Oct 2009

George has been in some type of treatment since May, 2009 His CEA level is checked every 4 weeks, a couple of times went to 6/8 weeks. Generally, while in active treatment, CEA is checked routinely. Get your doc to run the blood test for you and you can compare the numbers. When George started this mess his numbers were up near 900 and during Folfox dropped to 17, but has been gradually going up since ending Folfox and have recently shot up so we know the cancer is on the move again and stronger chemo is around the corner.

Take care - Tina

idlehunters's picture
idlehunters
Posts: 1792
Joined: Apr 2009

I get mine done every 4 weeks unless I feel a need to get it done sooner. Craig (Sundanceh) lives in Arlington. Go Cowboys!!!!

Jennie

Annabelle41415's picture
Annabelle41415
Posts: 6304
Joined: Feb 2009

During treatment blood was drawn every week for just the white/red count general stuff, but once a month for CEA. After treatment it was every three months for a year, now it is every six months.

Kim

pepebcn's picture
pepebcn
Posts: 6352
Joined: Aug 2010

Hugs!

scouty's picture
scouty
Posts: 1976
Joined: Apr 2004

Maybe it is just me but I think your oncologist is being arrogant and assuming way too much. What if the chemo regime you are on isn't working, how long do you want to wait to find out?

I have never heard of any stage IV semi-colon in treatment that has gone 6 months without a scan of any kind or testing CEA in 3 months like you have done. Quite honestly I am stunned and it upsets me that he is playing with your life like he is.

I don't want to alarm you but I personally would be demanding scans and a full blood work-up ASAP. If you were at MD Anderson or any other comprehensive cancer center your CEA would be checked every time you got a chemo treatment right along with your other blood work and you would be getting scans every 6-8 weeks. Something doesn't sound right but again it could just be me and my belief that you drive your treatment plan or you might get run over.

In my soon to be 7 years on this site I have seen way too many fellow semi-colons passively accept what their docs tell them to just to find out it wasn't the right way to go and then it's too late to change the ultimate outcome.

Lisa P.

Lori-S's picture
Lori-S
Posts: 1287
Joined: Sep 2010

I would kind of agree with you just because of what my CEA has been showing both before and during chemo. Last visit I was told that if my CEA doesn't start showing a decrease soon we will assume that the FOLFOX isn't working for me. I'm happy to be having regular CEA draws while in chemo. My onc said that because my CEA is a good indicator for me (after getting a baseline before and after surgery and monitoring it since along with scans) that my CEA will show activity before anything will show on my CT scans. He said that the CEA will help him stay ahead of the cancer. We don't want to be playing catch up if we can help it.

herdizziness's picture
herdizziness
Posts: 3642
Joined: Apr 2010

Like Lisa, I'm a bit shocked as well. Since your chemo doesn't stop until January, I am very, very surprised he isn't testing and checking CEA every time the day or so before chemo. I can't imagine why he isn't doing this??? Your CEA could be up, your cancer could be there, and you have no idea. I don't think I could stand being in the dark that long.
Winter Marie

Lori-S's picture
Lori-S
Posts: 1287
Joined: Sep 2010

I'm with you. I'm hoping that of course Bobby's onc is right. I'm sure we all are but, I'd be in a panic not knowing what my CEA is in my circumstance. The CEA isn't that expensive. Before I got this current onc, I had mine draw myself at a local lab. My climbing CEA is what pushed me towards finding an onc I was comfortable with and starting chemo. As you might remember one onc and the sugeon were saying I was only a IIc and didn't have to have chemo if I didn't want to. If I had gone by that Lord knows where I would be right now! I'd be a stage 4 seven months out with no treatement.

scouty's picture
scouty
Posts: 1976
Joined: Apr 2004

and cost $47 at my cancer center (much less after insurance does their negotiating thing) BUT most smaller clinics don't spend the money to pay for the testing equipment in their office like they do for the basic WBC, RBC, and some of the other basic blood counts. That means they would have to send it someplace else to be tested and may try to avoid that "extra pain" even though they have the venue to send it to. Maybe CEA wasn't an indicator for him but that doesn't mean it isn't now nor does it explain the 8 months without ANY SCANS!!!!

Quite honestly what worries me the most is the fact that I know of a privately owned chain of GI cancer centers in Texas that seem to be much more interested in making money then they are helping patients. One of my dearest friends from here went to one and her oncologist decided to treat her aggressive stage III colon cancer with a chemo regime not on the "company recommended list" and while it was completely successful (and still is 7 years later) and her insurance company ended up approving and paying for the treatment, he got fired for it.

Scary stuff and all the more reason we have to be our own advocate or have someone else that is.

LivinginNH's picture
LivinginNH
Posts: 1458
Joined: Apr 2010

Ok, ok, I simply can't stand to hold my tongue any longer. Rick's CEA numbers before HIPEC were <0.9 - yes, less than ZERO - but the Pet/Ct found tumors in the peritoneal cavity that the CT alone simple couldn't pick up! As I've mentioned to you, he had liver surgery in March, 8 rounds of chemo as a "mop up", then, WHAM! - HIPEC surgery in early November. PLEASE change doctors or at least get a second opinion - you NEED a PET/CT!!! Dang, I'm sorry for my rant, but I just don't want you getting hit with a left hook at this point. Please remember, the CEA numbers just don't tell the whole picture! Truly, I'm very worried for you...

Cynthia

Lori-S's picture
Lori-S
Posts: 1287
Joined: Sep 2010

You are right. It's not JUST the CEA number. It's all the tests. Have to get the big picture.

scouty's picture
scouty
Posts: 1976
Joined: Apr 2004

I am really upset and won't sleep good tonight being so angry at his doctor! The only silver lining I see is that Bobby and his family will have a heck of a lawsuit if the doc's guess is wrong!

herdizziness's picture
herdizziness
Posts: 3642
Joined: Apr 2010

I'm in agreement with all us gals!!!!
Winter Marie

bruins1971's picture
bruins1971
Posts: 227
Joined: Nov 2010

My CEA number was 26 at it's highest point right before chemo started. After liver surgery in August it dropped to 1.8 but I promise yall this much I will have it tested on Tuesday the day of my next chemo. As for scans I've had dome since the pet scan but they were while I was in the hospital for the liver surgery. So I guess they were not just looking for cancer but really looking at the fluids that were being drained. I had a CT in September looking at the fluids and abdominal area. I know I'm getting one on late January next about a month after my last chemo. I was told you need to wait 4 weeks after the last chemo or they CT can show false results due to the chemo. I appreciate all the concern and again I'll ask for my CEA test Tuesday.

herdizziness's picture
herdizziness
Posts: 3642
Joined: Apr 2010

I will feel a bit better after that. Please let us know the results.
Winter Marie

Lori-S's picture
Lori-S
Posts: 1287
Joined: Sep 2010

It isn't so much how high the number is .... as all tumors express different amounts ... it's how the trend in the CEA is going. My high before surgery with a very agressive tumor was only 9.7. Of course I'm much higher now ... darn it. And like said it is combined with the other tests/scans to get the whole picture. It's just a piece of the puzzle. But, I'd definitely ask to have it drawn.

scouty's picture
scouty
Posts: 1976
Joined: Apr 2004

So CEA is a good indicator for you, all the more reason to have it tested more often and good for you for getting it done Tuesday.

I have never heard of having to wait 4 weeks for a CT scan due to chemo, surgery yes but not just chemo. That does not make sense to me knowing how a CT scan actually works. Luckily you are getting one in January and make sure they give you one that looks at the chest, abdominal, and pelvic areas and that they do the CT IV contrast along with the contrast you drink.

I'm sorry my fellow AT&T employee friend but I am still concerned for you and the quality of care you are receiving.

FYI, the highest my CEA ever was was 35 and I had 5 known tumors (1 in my rectum, 3 in the liver and 1 in my lung) so the "lower" number doesn't mean anything other than aggressive versus slow growing tumors. Unless you are a smoker, you want it to stay 3 or under.

scouty's picture
scouty
Posts: 1976
Joined: Apr 2004

How does it feel to have a few of the "girls" after you? Kerry, the not so old coot is probably jealous!

herdizziness's picture
herdizziness
Posts: 3642
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ROFLMAO

tootsie1's picture
tootsie1
Posts: 5056
Joined: Feb 2008

Hey, Bobby.

I was diagnosed at Stage 1 (sigmoid colon) and just passed the 3 year mark in Nov. My oncologist tests my CEA every 3 months. I honestly don't remember what he told me about how long that will last. I assume until 5 years?

*hugs*
Gail

bruins1971's picture
bruins1971
Posts: 227
Joined: Nov 2010

So does my low CEA number to start with say my cancer I'd not aggressive? I'm so new at this I really don't know what each test means. All I know is that when the blood test are done the results fall into the normal range but I'm not sure what tests they run as they are all abbreviations. I know white and red blood counts but I'm not sure about the others.

Lori-S's picture
Lori-S
Posts: 1287
Joined: Sep 2010

a low CEA before surgery or treatment just means that your tumor/cancer does not express as much CEA as someone who has a high number. Every tumor and cancer is different and can be even with the same person. A new tumor may express higher or lower numbers than a previous. Usually if you are down below 3 for a nonsmoker then it is assumed that you are within the normal range and doing well, unless you have a history of lower than the normal numbers and tumors showing with them. That's why it's not just the CEA that tells the whole story. It's really just like each of our cancers, they can be so different in regard to how they act. Cancer doesn't play by the rules.

The most important blood counts will be your

WBC - White Blood Cells & Lymphocytes - these will tell you how easily you are prone to infections, colds, pneumonia etc.

RBC - Red Blood Cells - will tell you if there might be internal bleeding, low blood volume, anemia.

PLT - Platelets - this will tell you if your platelets are low and if you are prone to bleeding and lack of blood clotting.

They will also do a Chem Panel to check your chemistry for such things as low Calcium, liver function .... etc

PS: anyone please chime in as I'm not that far out of this round of chemo and I sometimes miss things with my chemo fog.

scouty's picture
scouty
Posts: 1976
Joined: Apr 2004

I would add ANC (absolute neutral count) which is one of your white blood cell counts. That number truly reflect your bodies ability to fight infection and yes cancer is considered an "infection". That is the main number I concentrated on in 2004/2005 and kept it as high as I could. I thought it was a true indicator of how weak or strong my immunce system was.

Bobby, now that you are close to stopping chemo you really need to get on the internet and do your own research so you can ask your doc better questions. You can google any of those abbreviations and learn what they mean and decide if they are important or not.

That way you'll be able to pay if forward down the road! After all that is what this site is all about or at least that is the way I was "taught".

herdizziness's picture
herdizziness
Posts: 3642
Joined: Apr 2010

Your CEA count done each time before you have chemo, may or may not be a good indicator as to your cancer cells and spreading. However, since you don't have your CEA count for every time, you cannot tell if your CEA is a good indicator for cancer or not.
Add to that, your lack of scans, and you don't have any good indicators as to how your cancer is.
If this was my case, I would be one nervous individual, pacing the floors every night.
My counts and scans allow me to know where I stand in my cancer world.
One thing I have learned from this board, is you need to keep account of what your cancer is doing to you. Never rely on your onc's alone, trust him all you want, but make sure the available tests prove what he/she says.
Winter Marie

pete43lost_at_sea's picture
pete43lost_at_sea
Posts: 3908
Joined: Nov 2010

I am getting a second opinion from an another onc on monday as my xmas present
merry xmas everyone
Pete

Lori-S's picture
Lori-S
Posts: 1287
Joined: Sep 2010

to you too Pete our mate down under - Christmas in summer!

herdizziness's picture
herdizziness
Posts: 3642
Joined: Apr 2010

I don't think we've introduced ourselves. I'm Winter Marie aka big mouth.
I'm so glad you are giving yourself an early Christmas present. I open mine on the 20th.
WE do what we do for ourselves and for each other, if you do not look after yourself, you can't look after another. I'm glad you're here looking after us as we will do for you.
Winter Marie

lisa42's picture
lisa42
Posts: 3661
Joined: Jul 2008

Hi Bobby,

My onc normally would test my CEA once a month, except that I'm on 3 week cycles with my chemo right now, so we test it every 3 wks, right before having chemo at the start of each new 3 week cycle (2 weeks of chemo in a row, 1 week off).
I know some oncs emphasize it more than others. It has been very accurate for me & it's been up, down, and up again lately, so he wants to watch it carefully, believing that it goes up or down in response to the cancer activity level and response to the chemo.

Lisa

bruins1971's picture
bruins1971
Posts: 227
Joined: Nov 2010

It's funny how so many people have the CEA tested at different times. Some weekly, some by weekly some monthly and yet still others every couple of months. CEA is certainly different for everyone I guess. Dang this cancer is a tough one to get on top of and just when you think you're on top of it I am sure it changes it's ugly head. Like I said earlier I will certainly have the CEA testes next week so I know what the number is. Part of me does not want to know but it seems like I need to know if it's creeping up, God willing it's still sitting right at 1.8 or lower. I am also going to ask about all the CT scans I have had in the past few months around surgery if they looked for cancer or if it was simply looking at the fluids left from the surgery....

xmomtofourx
Posts: 44
Joined: Sep 2010

Bobby, good luck I hope your numbers stay low and you can finally see the end of this. Secondly, I'm just curious about all this myself. If you have the surgery and your cancer seems to be gone should you still be getting your CEA tested and any scans done? My surgery was in June, my last CEA testing was in Aug and my Oncologist says I don't need anymore more done at all and has completly released me...I worry if this is right and if I should be having more done than just a yearly colonoscopy.
(sorry Bobby, didn't mean to highjack your thread).

bruins1971's picture
bruins1971
Posts: 227
Joined: Nov 2010

I think that he feels at this point based upon the petscan back in April where it only showed the cancer to be two tumors in the liver that were removed in August that I should be cancer free. Maybe this is why I don't have my CEA number checked as often. When I started my CEA was only 26 this with two tumors in my liver one the size of a baseball and the other was half that size. My last CEA check was in Sept and it was down to normal range at 1.8 God willing it will stay that way. As for the CT scans maybe he is holding off due to how many I have had this year. I promise you I have had at least 15 done due to complications from my colon surgery where I almost died from an infection after I started leaking from the surgery site. It leaked all that junk from inside my colon to my abdominal area and I ended up in the CCU for two weeks. Then I had liver surgery in August and again had CT scans up the wazoo due to drainage issues and them collapsing my lung during surgery. So needless to say I am looking forward to getting this treatment done so I can have a nice break...Hopefully a break of about 50 years or so...

Bobby

CherylHutch's picture
CherylHutch
Posts: 1399
Joined: Apr 2007

Hi Bobby,

I'm a little confused here after reading through all the comments. This last comment of yours, you say that in April, you had two tumors in the liver that were removed in August. I'm assuming that earlier in the year, you had your colon surgery to remove a tumor(s) from the colon and that's when you had complications to the colon surgery. So, am I right in assuming you were diagnosed with colon cancer, had the colon surgery and then found that the cancer had spread to your liver (2 tumours) which you had surgery to the liver in Aug. After the surgery in August, you were on a treatment of chemo... which is going to end this January.

Ok... here's where I'm confused. If your colon cancer has spread to your liver, then you would be considered Colon Cancer Stage IV. Stage IV is incurable, although as many of us have proved here, it can be treatable (unfortunately, some don't survive so theirs does not respond to the treatment, or the cancer ends up being more aggressive and the treatments don't work on it). But for a lot of us, we are "Living With Cancer" vs "Dying From Cancer". The only way one can live with cancer is if they are being monitored and treated. And yes, there can be breaks from treatment. When the cancer responds to treatment and either disappears from medical radar, or one has surgery and all visible cancer tumours are removed. Then, one can breath a little easier because you get a break from treatment. All the technology we have can only detect cancer when it becomes a certain size... so when someone is Stage IV, the cancer has never left their systems... it's just too small to detect. There's no point throwing chemo at it when it's that small because it's too small to respond to chemo... and the last thing you want is for your system to become immune to chemo. Save it for when you need it.

It sounds like your oncologist/surgeons have removed all signs of cancer... and then gave you a regime of chemo to mop up any cancer cells that might think of hanging around and becoming active. That's great. But how do you know there is no active cancer starting up unless you are monitored, which would include regular scans and blood work (especially CEA testing)? As the others have said, CEA is not necessarily a good indicator for all... on the other hand, if it is, then it's a great diagnostic tool. No decisions are made based on CEA alone, but if the trend is your CEA is going up, then it's a good trigger for your oncologist to order more tests and scans. But if he/she says you don't need a CEA test or scan anymore because he/she feels you are cancer free... well, there's something terribly wrong with this picture. If you are cancer free and the oncologist thinks you have been since August, then why does he/she have you on chemo? Someone who is cancer-free or in remission, does not need chemo... and one certainly doesn't want to put chemo in your body unnecessarily because you want it to work when you actually need it.

So yes, I'm glad you are going to get a CEA test next week (and all the other blood workup) but ask your oncologist if he thinks you are cancer free, then why you had to be on the chemo? Also, ask him to clarify... if you are Stage IV, then your cancer has gone systemic, so how can he say someone is every cancer free if they are diagnosed as Stage IV? I'd be really curious as to what his answer is to that question.

Cheryl

Buckwirth's picture
Buckwirth
Posts: 1272
Joined: Jun 2010

Cheryl said I second.

Buckwirth's picture
Buckwirth
Posts: 1272
Joined: Jun 2010

Double post...

bruins1971's picture
bruins1971
Posts: 227
Joined: Nov 2010

Cheryl let me clarify my situation so as to not have confusion. I was DX with stage 4 colon cancer in late Feb of this year after a colonoscopy found a golf ball sized tumor. A CT performed before colon surgery showed something in the liver so during the colon surgery a liver surgery was in the room and looked at my liver with ultrasound and found 2 tumors in the liver one the size of a baseball the other a little less than half that size. After removing the tumor and about a foot of my colon I then had 5 rounds of chemo to shrink my tumors in the liver. My CEA number before chemo started was at 26 and the number was 1.8 after the liver resection in August. At last check in late September it was still at 1.8 although after reading all these post I have decided that I will make him test the CEA when I go in for Chemo next Tuesday which will be round 11 of 12 for this is my treatment plan as set up before the first surgery.

As for why I am getting chemo now if I no longer have any visible tumors in my body. I guess it's just what you said to go after the cancer cells that are to small to show up on scans. When I asked my doctor when I would be cancer free he stated that he feels I should be cancer free at this point after all the surgeries and treatments but that I am not cured of cancer and would only be seen as cured if I go five years of clean scans then and only then could I say I am cured. Right now I guess you could say I am cancer free to the point that I don't have any tumors. Well I will only know this after I have my scan next month after chemo is done. Has anyone had scans while in the middle of treatment just to see how things looked? He never said I would not need CEA tests or scans in the future he stated the opposite. He said if the scan comes back clear in Jan then I will have another one three months later.

I am like you and many others I don't look at myself as dying from cancer. I look at it as I am living with cancer until I am clean of this cancer. Stage 4 is no longer an automatic death sentence. I have a friend who was DX stage 4 in 2006 and has been clean since 2007 not saying it could not return but he has had three great years of living with cancer. That is something we will all have to do and that is live with cancer at least for until you reach the five year mark of being clean. What seems impossible to man is possible with God and that is how I make it through every day knowing that all it will take is God touching me and the cancer will be gone forever. My faith is strong and will see me through this battle and one way or the other I will win. I will either be cured and live with my family or I will be called home to live in Heaven and although I prefer to stay here with my family for many, many more years I don't have control of that so I just smile and enjoy ever single day given to me.

Bobby

Lori-S's picture
Lori-S
Posts: 1287
Joined: Sep 2010

Remember that we are all at different stages of treatment and that will help decide when the onc wants a CEA. For example say mine hadn't been rising steadily since surgery, then I'm pretty sure that my onc would only draw it once a month instead of before each chemo. We're waiting and hoping that a draw will show a downward trend so we can make the assumption that the FOLFOX is working.

scouty's picture
scouty
Posts: 1976
Joined: Apr 2004

I was stage IV with mets to my liver and left lung and have been NED for 6 years now. So with no cancer cells in my body for that long how can I still have it? My oncologist considers me cured, why don't you?

Lisa P.

PS. Good to see you around and have a great holiday season!

bruins1971's picture
bruins1971
Posts: 227
Joined: Nov 2010

Lisa that is such an awesome thing for you to be NED for that long and yes my friend you are CURED now scream it from the mountain tops and let the world know it can be done.

Bobby

Buckwirth's picture
Buckwirth
Posts: 1272
Joined: Jun 2010

A cure is something that is repeatable. I am happy that you have been NED for as long as you have, but it would probably be more grammatically correct to say you have recovered.

As I type this, there are 40 members online, since there are four stages it is probably fair to say that 10 of those 40 are stage IV. Statistically, one, maybe two of those will be around 5 years from now. If we were talking cure, then the implication is that the two who survived did something right in their treatment, while the 8 who did not failed.

The fact is that all 10 followed similar protocols, but a very small percentage does really well, a percentage does fairly well, and for some the treatment just fails.

Speaking of this as a manageable disease is the most accurate. Even if I survive this, I will never refer to myself as cured, as that is grossly unfair to those who joined me in this journey but never reached the finish.

bruins1971's picture
bruins1971
Posts: 227
Joined: Nov 2010

Good Lord I can only pray that day comes very soon. I'm still in treatment with chemo but only two more rounds left and I guess I'll except the doctor saying I'm NED once the latest scan shows me to be clear. It's so crazy how some people react better than others to the chemo or is it something else out there that effects things? I pray every night for everyone on this board that they find a cure before one more of us passes on. Stage 4 may be viewed as terminal by most but there are people that beat it all together I can only pray that we are amount the many that are still around five, ten even 25 years from now.

Bobby

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