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CEA and inflammation

nunez67
Posts: 2
Joined: Sep 2017

I'm not a colon cancer patient--I'm a breast cancer patient. Diagnosed in 2007, local recurrence in 2015.

The reason I'm here is to ask about benign reasons for abnormal CEA. I know that inflammation from smoking and IBS and that sort of thing can cause abnormal readings. But what about post-operative inflammation? My new onc isn't giving me a straight answer.

I had major surgery (mastectomy with reconstruction) in 2015 and a more minor revision surgery in 2016. I still have inflammation from these surgeries, which can be seen on current MRI and CT.

My CEA is abnormal (6.5, 7.2 and 5.9 over the past month) after many years of always being under 3, even with active breast cancer. My other tumor marker, which is more breast cancer specific, is currently normal. I switched oncologists right after the 2015 surgery, and that onc didn't pull tumor markers, so I am missing CEA data from 2015 until now with the new onc.

Colonoscopy revealed a 3mm tubular adenoma. Onc tried to blame CEA on that. Gastro said no, it wouldn't affect CEA and my colon was otherwise fine. Bone scan was clear. CT shows a possible problem with my endometrium, for which I am having a biopsy done soon.

I realize there could be occult mets. My breast cancer subtype is also very difficult to see on CT, and if my endometrial biospy is negative, I am considering sending my scans to Memorial Sloan Kettering in NY, where they have a radiologist who specializes in my subtype.

But I keep wondering if the abnormal CEA is simply due to the residual inflammation from the past two surgeries. Any thoughts and input on that are appreciated. Thanks in advance.

ron50's picture
ron50
Posts: 1729
Joined: Nov 2001

    My cea was never a good idicator of cancer for me . At diagnosis it was only 2.8  , 4 is considered baseline. Since cancer (I am out to 20years) my cea has been in the <.5 range . Only once did it spike to 1.6 and that was when I was dxed with a peptic ulcer . So the answer is yes inflammation can cause a rise in cea. This past April I had 4 tubular adenomas removd during a ascope. The largest was 11 mm. It did not increase my cea. There was some mild displaysia in the polyps but no cancer. Cheers Ron.

tanstaafl's picture
tanstaafl
Posts: 1302
Joined: Oct 2010

Yes inflammation can substantially increase CEA scores for CRC.  We try to track the level of inflammation with ESR and hsCRP, along with a lot of bloodwork.

Our surgeons used celecoxib aka Celebrex for post-op  inflammation and pain because it's documented fairly well. We used intravenous vitamin C and heavy duty supplements post operatively to prevent a lot of potential problems including imflammation and experienced good results with both surgery and 5FU.

coloCan
Posts: 1956
Joined: Oct 2009

About a year and a half or so ago my CEA spiked to its highest,shocking both me and my onc but then i remembered a few days earlier a skin doc told me the discomfort i was having was due to shingles. I found little in research bearing on shingles and CEA other than that shingles involves inflammation and inflammation can raise CEA level.  Medication for the shingles was taken and a month or so later CEA returned to its usual range. Assuming inflammation from surgery is inflamation-on a much more severe level than a skin problem.....i wouldn't rule it out for your CEA increase,tho i'm no expert on this

nunez67
Posts: 2
Joined: Sep 2017

Thank you all for the responses. I am really starting to think that my post-op inflammation is the culprit, especially since it's severe enough that the radiologists comment on it when they read my scans even though I'm years out from surgery.

I so wish my 2015-16 onc had pulled TMs so I'd have an immediate post-op baseline, but he didn't pull any blood at all (protocol for his facility since I wasn't on chemo at the time). I think if my endometrial biopsy is negative and my CEA doesn't rise and just hovers in the 6-7 range, I will chalk it up to the inflammation.

Thanks again for the input!

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