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Suggest treatment for elevated CEA levels in a person with colon cancer

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Posted on Fri, 29 May 2015
Question: My sister was operated for colon cancer in 2008. Subsequently she underwent operation for metastasis liver in 2011. Again she had operation for mass in abdomen in 2014. After that she was given chemotherapy for 6 cycles in 2014. Her CEA level came down to 2.2 subsequently increased to 3.6 within another 6 months in XXXXXXX 15 and is now 7.5. USG scan appears normal. Pl suggest the course of treatment.
doctor
Answered by Dr. Monish De (1 hour later)
Brief Answer:
CT scan of whole abdomen

Detailed Answer:
Hi

Normal level of CEA is less than 5 micrograms per liter (mcg/L)

Although USG scan is normal as your sisters CEA has now increased to 7.5 i would advise you to do a CT scan of whole abdomen

If the scan shows the colon cancer has progressed then second line chemotherapy has to be planned but if the disease is radiologically stable then wait and watch policy with bood test for CEA after 3 months is recommended

Regards

DR DE
Above answer was peer-reviewed by : Dr. Vaishalee Punj
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Follow up: Dr. Monish De (1 hour later)
My Sister is physically active and feels no abnormality. However she has problem with bowel movement.She was given only chemotherapy and radiation therapy was not given.What could be the reason for increase in CEA level? Will Chemotherapy
result in increase in CEA levels?
CT scan is enough or PET scan is required?
Awaiting your amswer please.
doctor
Answered by Dr. Monish De (7 minutes later)
Brief Answer:
No role of radiotherapy

Detailed Answer:
Hi

There is no role of radiotherapy in colon cancer

If the first line chemotherapy does not work and the disease progreses the CEA can rise

As your sister is physically active CT scan is enough

Regards

DR DE
Above answer was peer-reviewed by : Dr. Vaishalee Punj
doctor
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Follow up: Dr. Monish De (24 minutes later)
Even after 6 cycles of chemotherapy (MFOLFOX4)is there any possibiility of recurrence or spreading?
Is there any connection between problem in bowel movement and increase in CEA level? Mammography is normal. Is it enough to have CT scan for abdomen only or for whole body?Also USG scan showed mild splenomegaly without focal lesions. What is its effect?
Kindly provide your valuable answers and suggestions.
Regards.
doctor
Answered by Dr. Monish De (26 minutes later)
Brief Answer:
PET scan suggested

Detailed Answer:
Hi

Chances of recurrence after 6 cycles of chemotherapy is 35%

Problem in bowel movement may be related to recurrence as your sisters CEA is on the rise

USG is not showing any metastasis but it is not an accurate method to judge spread of colon cancer

I woud advise you to do a PET scan as it can detect recurrence and metastasis more accurately than CT scan

If you have no more clarifications then please rate the answer and close the thread

Regards

DR DE
Above answer was peer-reviewed by : Dr. Vinay Bhardwaj
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Dr. Monish De

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Practicing since :2004

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Suggest treatment for elevated CEA levels in a person with colon cancer

Brief Answer: CT scan of whole abdomen Detailed Answer: Hi Normal level of CEA is less than 5 micrograms per liter (mcg/L) Although USG scan is normal as your sisters CEA has now increased to 7.5 i would advise you to do a CT scan of whole abdomen If the scan shows the colon cancer has progressed then second line chemotherapy has to be planned but if the disease is radiologically stable then wait and watch policy with bood test for CEA after 3 months is recommended Regards DR DE