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CEA Levels

findthebesthelp
Posts: 3
Joined: Nov 2017

Hi all, 

Concerned about the latest CEA rising trend in quarterly blood test results.  Here is a little history:

- Colon Cancer diagnosed in summer of 2014

- Surgery (Total Colectomy) late summer 2014

- 6 months of Chemo Oxy and 5FU following surgery, ending early the following year

- Started quarterly blood tests to monitor CEA levels and bi-annual CT scans

- It's been 2.25 years worth of blood tests and CT scans so far and the CT scans have returned with No Evidence of Disease

- Concerned about last 5 quarters (1.25 years) of rising CEA, with some considerable jumps from quarter to quarter of the scale of 1 to 1.1 points.

- During the past year or so, have experienced tooth loss and bone loss near the mouth.  Have 2-3 teeth that broke off leaving the roots that need to be pulled, and 1 back tooth recently shaking and needing pulled.  Dentist said there's about 50% bone loss in the mouth and most teeth are shakey.  Dentist also said there is an infection in the mouth and will be giving anti-biotics (penicilin) to treat it.  So there may be inflammation involved.

- Have heard that inflammation can be a cause of CEA rising, but not sure if applicable to inflammation in the mouth.  Exposure to cigarette smoke and other things can also cause a rise in CEA apparently.  As a non-smoker, only inflammation would make sense.  Haven't been exposed to second hand smoke on a regular basis so that couldn't explain the consistent rise and whole point jumps, right?  As for inflammation, due to infection in the mouth, how likely would that be to cause a consistent rise in CEA over 4 quarterly CEA tests, and whole point jumps?  Wouldn't it be more like a fluctuation up and down as your body fights the infection, with some days succeeding better than other days?  And wouldn't the CEA value tick up more gradually by .1, .2, .3, and not by a whole point?

 

Post Surgery (there may be some quarterly blood test CEA results missing from before 10/31/15 that I need to track down):

10/31/15 - 1.9

1/26/16 - 1.6

4/30/16 - 1.9

7/28/16 - 1.9

10/29/16 - 1.7

1/28/17 - 2.1

4/29/17 - 3.0

7/29/17 - 3.1

11/1/17 - 4.2

 

As you can see, starting at least from1/28/17, there has been an upgrade trend.  It was the first time CEA broke 2.0 barrier, then the next quarter it jumped to 3.0, then next quarter 3.1, then most recently earlier this week it jumped to 4.2, a 1.1 increase.

Can infections in the mouth or elsewhere cause such a sustained, consistent rise in CEA... it's not even ticking up by .1 or .2, it's making about 1 full point jumps.  

The oncologist at our hospital says they consider anything below 5.0 as "normal".  She said if it were to hit like 10, she'd order a scan sooner than scheduled.  Other people indicate their oncologists/hospitals consider anything 3 and below to be "normal".

The oncologist also said we've reached the 3 year mark, but I need to go back and check records to see if that is 3 years of full CEA results and CT scans or 3 years since chemo ended.  I would think a proper 3 year mark would be 3 years of test results, and not measured by the date when chemo ended, right?  As you can see above, the records of results I have amount to 2.25 years of results.  I'll have to see if I had results for 3 quarters before the above or not.

The consistency of CEA rise (no downtick, only upticks) and the jumps in CEA value by approx 1 whole point are concerning.

Can anyone with knowledge or experience help shed some light on my questions above?

Thanks in advance! 

Coachjim
Posts: 16
Joined: Dec 2016

My CEA has jumped to 4.3 3 times in the last few years when I was sick.  Soft tissue infection is one of the causes of a benign elevation in CEA.  I would have a retest after the tooth is pulled and the infection cleared up.  I've lost 3 molars so far (thank you chemo).  I don't have bone loss, tho. 

findthebesthelp
Posts: 3
Joined: Nov 2017

Thanks for your reply.  From the quarterly CEA results I posted, the fluctuations were up and down, and the swings were in tenths of a point, so I find the last 5 quarters of only rising CEA numbers concerning.. no up and down there.. in addition, some of the swings have been a sizable 0.9 to 1.1 increases, rather than 0.1, 0.2, 0.5 or such.

From what I can gather from other peoples posted CEA histories, they mostly seem to be small increases and decreases over time.. 1.7, 1.9, 2.1, 1.8, etc.  So I'm trying to understand how CEA works, and what's considered normal fluctuation and what is a tell tale sign of something more..

Also, when I think about the inflammation that could be due to the infection(s) in my mouth due to gum disease, tooth loss, etc., I wonder if the expected fluctuations in CEA would be up, down, up, down and more of a gradual increase and decrease as the body fights the infection.  I'm not sure I can explain 5 quarters of only increases (some of the increases being relatively larger than the others) with the inflammation.  Another data point is that about 2 years ago I got cellulitis in my left foot (thinking a kid pushing a grocery cart into my foot and causing some scratching and/or skin breakage of the skin on my foot caused it) and there was inflammation that I took antibiotics to take care of.. I don't recall elevated CEA levels during that incident.  So I'm wondering if inflammation/infection would always cause a rise in CEA level or if there are only infection/inflammation cases in which CEA becomes elevated.  

 

 

 

 

tanstaafl's picture
tanstaafl
Posts: 1292
Joined: Oct 2010

Yes treatments and inflammation can cause substantial distortions in CEA and other blood tests, so it can be challenging to separate the influence. 

One former member here had wild swings in his markers from the inflammation after an RFA procedure, and various infections, like his port.  IIRC, his CEA swing was about  a factor of three for perhaps a factor of 10 in his hsCRP.   He also used several labs two from his home area and overseas then so tracking the units was painful e.g. a factor of 100...

We approach this with several prongs:

Anti-inflammatories that have both inflammation reducing and anti-cancer properties - e.g. celebrex, low dose aspirin, boswellia, curcumin

IV vitamin C, both in maintenance and particularly the day before blood draw

up-to-date dental work (outside US). I know retirees that travel across the US to modern Mexican dental clinics and save 80-90%.

supplements that support bone and joint formation, and selected supplements in general

more frequent lab tests, more of them for cancer (CA199, AFP), liver (GGT, LDH) and inflammation (e.g. ESR, hsCRP), and self education.  Basically, additional maintenance pays dividends.

 

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