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Dr. Andrew Rynne

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What causes elevated CEA level after colon surgery?

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Dr. Anshul Varshney

Internal Medicine Specialist

Practicing since :2009

Answered : 3072 Questions

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Posted on Mon, 4 Aug 2014 in General Health
Question: Hello, my dad had suegery march to remove a colon tumor. He was dukes c1. He has been on xeloda only 3 weeks as he was
Not happy initially to take chemo but agreed now .however we have noticed a cea rise. May was 3 which is fine, XXXXXXX was 4 and now july 6. We are concerned . He is a smoker but even still it should not rise.

Is this cancer cells stili in body etc?
doctor
Answered by Dr. Anshul Varshney 10 hours later
Brief Answer:
Get a PET scan

Detailed Answer:
Dear Friend.
Welcome again. I understand your concern.
See it is not essential that after colon surgery the cancerous cells get removed completely. There might be small cancer cells persisting in the lymph nodes.
An advisable and wise decision in his situation is to get a PET scan done.
This would help in detecting the tumpur cells and to see the extent of spread.
You can go to a cancer hospital in your city and discuss my opinion with your doctor. I am sure he would agree to this and would post him for PET scan.
If you have any further query please ask me.
Stay Healthy.
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
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Follow up: Dr. Anshul Varshney 6 hours later
Could there be mets with this kind of rise? Like tumors in liver lungs?
doctor
Answered by Dr. Anshul Varshney 4 hours later
Brief Answer:
Detail follows

Detailed Answer:
Dear XXXXXXX
With such kind of rise possibility is there but confirmation can be done only by PET scan. In matter of cancerous situations it is not at all advisable to comment things with uncertainty. It Is always better to be sure. So get a PET scan to be sure.
If you have any further query feel free to ask me.
Good Luck
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
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Follow up: Dr. Anshul Varshney 2 hours later
Do cea levels have to be very high for mets?
doctor
Answered by Dr. Anshul Varshney 10 hours later
Brief Answer:
Detail Follows.

Detailed Answer:
Dear XXXXXXX
Actually CEA is as a tumor marker for gastrointestinal tract malignancies.
When the CEA level is abnormally high before surgery or other treatment, it is expected to fall to normal following successful surgery to remove all of the cancer. but rising levels indicates progression or recurrence of the cancer.
Also, levels >20 ng/ml before therapy may be associated with cancer which has already spread (metastatic disease).
These are words from standard guidelines and this is what is followed in clinical practice, so this can not be said that there are no chances of metastasis. Chances are there, so get a PET scan done.
If you have any further query please ask me.
Stay Healthy
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
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