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CEA steady rise, treatment options - moving to stage 4?

Posts: 25
Joined: Aug 2011

My mom's CEA has been rising since she ended the treatment in Dec'11.

Dec'11 - 2.55

Mar'12 - 2.67

Jun'12 - 3.05

Sept'12 - 3.32

Dec'12 - 3.65

Mar'13 -4.68



(Also before surgery - 23.9, after surgery - 4.55, after chemo/rad in dec'11 - 2.55)


We did a PET CT in dec'12 which showed "Metabollically active focus along right internal iliac vessels with small nodular soft tissue with SUV-6.5"

and we repeated the scan in Mar'13 which said "Stable metabolically active focus is seen along right internal iliac vessels with small nodular soft tissue with SUV - 5.2"

it has not increased in size but was present stable.


The doc said these are the options now:

1. Check with surgeon to see if we can remove it completely and start treatment if its +ve, making it stage 4.

2. Check if needle biopsy can be done but its close to blood vessels

3. Assuming its the metastasis, directly start with the chemo treatment, FOLFIRI (assumption bcz scan has a spot though not measurable and cea steadily rises and NOT confirmation since the spot in scan did not grow)

4. Else wait and watch for some more time and repeat scan.


Planning to get a second opinion on this but not sure what to do at this state.

If we go with option 4, is it very risky?

Has anybody here started treatment assuming its disease, if not 100% sure?


We havent done a colonoscopy yet after the treatments, would it/any other test, help to find cause for CEA rise?


Any inputs here would be really helpful..




Son of mom,

May'11 - surgery to remove the tumour in rectum

Found stage 3c. ( 10/26 nodes +ve)

June - Dec' 11 folfox chemo + radiation

Dec'11 - pet ct - clear

thxmiker's picture
Posts: 1282
Joined: Oct 2010

I would get a second if not third oppinion.  


There are many alternative treatments that can be added to one's life to increase the odds in the battle against cancer.   Med Diet, adding mushrooms, cruciferous vegtables, supplements, exercise, no more fatty foods, no more chemical boxed food, less if not zero red meat, no nitrates, etc...  None of these can hurt your health and can only help your health. Why not battle cancer as healthy as one can be?


Sending good thoughts for you to fid a positive treatment for you!

Best Always, mike

Posts: 39
Joined: Feb 2013

before ruling out ....why go blindly with option 4 when you are not too sure...


Sundanceh's picture
Posts: 4408
Joined: Jun 2009

I would point out that if you were not diagnosed as a Stage IV, that you do not graduate to being a stage 4 - even if you experience recurrence.

If you were dx'd a stage 4....then you're a 4....

If you were dx'd as a IIb or a IIIc....and then experienced a recurrence, it would be classified as a metastatic and not a primaryt stage 4 dx.

It would read like this:



Just wanted to clarify - there is much confusion on the staging of cancers, but this is how it is differentiated. 


Posts: 271
Joined: Nov 2011

My onc says once a met appears, the patient is restaged to Stage IV. 

Sundanceh's picture
Posts: 4408
Joined: Jun 2009

My first onc has said it went to stage 4....I went with that for a long time.

My 2nd onc said it was considered metastatic...

And there was a guy up named Blake, who referenced some medical material (wish I could remember) can't remember the links been a few years) and we discussed this for awhile through some pms....and he informed me of howone of the big cancer agencies classified.  And that was how he explained it to me.

The importance in the staging from what I remember was in what protocol was administered....it made a lot of sense to me.

I can live with it either way...bottom line is I spread regardless of what the class was. 

Maybe I can find some info on this one of these days.....

Anyway, as always, it's amazing how all the doctors see, identify and classify everything seems to be different from door to door.   

Interesting to hear what your doc said too....

Have a nice w/end:)  Hope all is going well for you!

Sundanceh's picture
Posts: 4408
Joined: Jun 2009

I need to be finishing up my work project, but after I replied to the post, it got me thinking where I had seen some of this info.

I found a link to NCI that discusses the staging.......


The link I just listed is the NCI link for metastatic cancer.....the second line from the top says...

  • Metastatic cancer has the same name and same type of cancer cells as the original cancer.

And that's why Blake had told me that they added the mCRC on to the original dx......I was a IIB.....so technically now, I'm a Stage IIb mCRC

I'll be checking in with my onc at the end of this month....so I'm going to ask him about this as well......I'd like to know if this is right or not.

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