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Is increase in CEA level a matter of concern?

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Internal Medicine Specialist
Practicing since : 1981
Answered : 824 Questions
Is a cea rise fron 3 to 6 in three months worrying in a person who had bowel cancer surgery?
Posted Sun, 17 Aug 2014 in Colon Cancer
Answered by Dr. Karen Steinberg 53 minutes later
Brief Answer:
Doubling of CEA levels suggests cancer return

Detailed Answer:
Hi, thank you for using Healthcare Magic. Yes, I am sorry to say, a doubling of CEA levels from 3 to 6 is worrisome. The CEA level is followed in persons who had bowel cancer to monitor for return or spread of the cancer. The doctor will likely do more testing (including imaging studies) to see where more cancer might be located. Chemotherapy may be necessary.

Hope this answers your query. If you have further questions, I would be happy to answer them.
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Follow-up: Is increase in CEA level a matter of concern? 6 hours later
Thank you.

So a scan should def be done? We are v anniyed that my fathers oncologist, is focusing on the number ( he keeps saying numb is not high). But i dont understand why he is ignoring that each month a rise is taking place.
Answered by Dr. Karen Steinberg 12 hours later
Brief Answer:
May be too early for a scan

Detailed Answer:
I did some further research on CEA monitoring in colon cancer. I am presuming that his initial level was high and returned to normal after the surgery, and then started rising again.

CEA is used for monitoring response to therapy and for a recurrence. If it was not high to begin with, then it cannot be accurately used for monitoring. The particular tumor your father has would not be producing the CEA, and the levels are related to something else (smoking, liver problem, etc). CEA is not used for diagnosis.

The increase is indeed worrisome if the presumptions are correct. However, the levels are not very high. What this means is that there is not enough tumor present to be picked up on a scan. The increases could still be due to something else, so a scan will not be helpful right now. The oncologist is likely waiting to see if the CEA goes to a level where the tumor can be detected on a scan.

Metastases would be showing a very high level (upwards of 20), so this is less likely to be the case.

Please talk to the oncologist and ask him your questions. Tell him your concerns. You can ask about the details we have discussed here. Ask him at what level he thinks further testing should be done and why. Open communication with the oncologist would be helpful for all of you in dealing with this frightening condition.

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Follow-up: Is increase in CEA level a matter of concern? 12 minutes later
He is a smoker yes but prior to surgery his cea was never measured so
We dont know what it was . Its just that bit by bit ir keeps going up. He was a dukes c1. He is on xeloda for 6 months
Answered by Dr. Karen Steinberg 47 minutes later
Brief Answer:
CEA in this case not accurate for monitoring

Detailed Answer:
If the CEA had not been measured prior to the surgery, then we don't know what the level was and can't say that your father's particular tumor is producing it. Measuring it now is using it for diagnosis, not monitoring. CEA is not accurate for diagnosing colon cancer. The small changes you are seeing now can be due to a variety of conditions unrelated to the cancer .

Dukes C1 means lymph nodes were involved. Once lymph nodes are affected, the tumor can start metastasizing. The Xeloda is being used to treat that. The prognosis for this stage is poor. The CEA changes do not provide any additional information at this time to alter therapy.

Talk to your oncologist about your concerns. He knows best why he is following this course and you have a right to have it explained so you understand.
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