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Tumor markers (CEA and CEA 19-9) have gone too far. What to do?

misert
Posts: 4
Joined: Sep 2017

 

My mother received 4 cycles of Avastin + Xeloda.

After the second cycle, before the start of the third cycle, CEA was 528, CEA19-9 was over 2016.

The last, fourth cycle was received on July 27, 2017, and we stopped there.

Today, the mother did a laboratory analaise, tumor markers increased.

CEA - 1112

CEA 19-9 same, more than 2016

 

Otherwise, my mother has colorectal cancer and metastases on the liver. He operated colon and liver in 2014, but in the meantime, the metastases went to the lungs and on the bones. On the liver, the new secondary deposit jumped to 6.5cm

From 2014 to February 2017, she has consistently received chemotherapy, Folfox, Folfiri, Folfox, Mitomycin, but did not give results.

Avastin did not include her immediately at the beginning.

In June 2017, in a private clinic began getting Avastin and Xeloda, we wanted to try it, maybe it could help her.

Should we continue with Avastin + Xeloda chemotherapy?

Is there anything more effective than this chemotherapy?

We wanted to operate the liver tumor again, but doctors do not want it, because the tumor spread throughout the body.

Can doctors still operate a tumor on the liver and prolong her life?

Annabelle41415's picture
Annabelle41415
Posts: 6723
Joined: Feb 2009

Sorry for your mother's diagnosis and treatments.  Also sorry I'm not able to help.  I'm hoping that someone can chime in to help you with your questions and concerns.  Hope she can get the treatment needed to get her through this.

Kim

darcher's picture
darcher
Posts: 305
Joined: Jun 2017

I've read that in some cases an increase in CEA is an indicator the chemois working.  CEA checks a certain cancer protien and often when cancer cells are dying they release it into the blood raising the number.  I've also read that the CEA isn't that good an indicator of anything.  Like in my case.  My CEA was 1.3 yet I still have cancer. Go figure. I'd do what the doctors say.  They have the knowledge and experience to deal with this. 

tanstaafl's picture
tanstaafl
Posts: 1303
Joined: Oct 2010

I'd seriously look for other markers.  They are less cancer or CRC specific, but once you've been diagnosed with CRC, a different set of analyses  should be applied with more thorough blood work. Of course they're not "standard medicine", and most people miss out.   I can't tell you how many times we would have gotten nailed with less bloodwork.  

tanstaafl's picture
tanstaafl
Posts: 1303
Joined: Oct 2010

Those are some serious biomarker levels.  At that level, CT scans are likely fairly sensitive to individual areas' growth and/or shrinkage and/or new mets.  I'm a little surprised that only Xeloda-Avastin alone are the oncologist's regimen, they're usually more aggressive with Folfiri-Avastin.  Many of the people with CEA/CA199 that high are BRAF mutants rather than KRAS mutants.

To compare the serial markers at much lower levels, we consider inflammation (ESR, CRP) and blood  sugar levels.  What we do to combat the rise of marker levels, is to target off-label drugs like cimetidine, baby aspirin, and celebrex, and to seriously increase supplements associated with immunological, inflammatory and cancer benefits.  Avastin has warnings with cimetidine but some people go ahead.   We never used Avastin and instead were able to control those markers with metronomic (daily) chemo, mild drugs and heavy duty, selected supplements including IV vitamin C, and to flip inoperable to an important operation.  

It looks to me, for your mom to achieve any likelihood of NED, you have to improve the chemo stack and probably achieve major operations beyond normal skill levels and "limits of operatbility".  We found this was possible in our situation by extra technical performance with extended immunochemo.  Normally the next step is just (again/more?) Folfiri-Avastin.  Recent PD-1 treatments have had some outstanding success on less common MSI-H metastatic colorectal cases, so I would check that out.

The question in highly advanced cancer is the ability to fund and technically coordinate  multiple lines of analysis and attack despite financial/medical hurdles and footdragging, to yield effective multimodal results.  We overcame some hurdles by DIY.

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