Sign-in to Ask A Doctor - 24x7
OR
Sign in with Google
What Do These CEA Levels Post Chemotherapy Indicate?
Question: My dad started folfiri . Has had 3 sessions so far. He had bowel
Surgery in march and was dukes 1. Thereafter xeloda was started.
Stopped at 4 cycles as cea was rising and scan needed to be done .
Pet scan showed a 16 mm liver met and 1 aortocaval met .
Folfiri was started in October every / weeks .
Had three sessions so far.
Cea was as follows-
May 3 XXXXXXX 4
July 6
August 9.8
However in sept it dropped to 8 ( when he was having no chemo )
But December cea was 9. So gone up 1 point . Does this mean chemo
Not working as cea should reduce right?
Surgery in march and was dukes 1. Thereafter xeloda was started.
Stopped at 4 cycles as cea was rising and scan needed to be done .
Pet scan showed a 16 mm liver met and 1 aortocaval met .
Folfiri was started in October every / weeks .
Had three sessions so far.
Cea was as follows-
May 3 XXXXXXX 4
July 6
August 9.8
However in sept it dropped to 8 ( when he was having no chemo )
But December cea was 9. So gone up 1 point . Does this mean chemo
Not working as cea should reduce right?
Brief Answer:
Another PET/CT scan is necessary to determine chemo response.
Detailed Answer:
Hello!
Thank you for the query.
CEA should go down in case of positive chemo reaction. But you can not say that the chemo is not working basing only on CEA levels. The best way to see chemo reaction is to compare previous PET or CT scan with current scan. If the mets would get smaller, chemo works fine.
Please also note that nowadays, single liver mets should be removed by a surgeon. I suggest you to consult his surgeon and consider this met removal.
Hope this will help. Feel free to ask further questions.
Regards.
Another PET/CT scan is necessary to determine chemo response.
Detailed Answer:
Hello!
Thank you for the query.
CEA should go down in case of positive chemo reaction. But you can not say that the chemo is not working basing only on CEA levels. The best way to see chemo reaction is to compare previous PET or CT scan with current scan. If the mets would get smaller, chemo works fine.
Please also note that nowadays, single liver mets should be removed by a surgeon. I suggest you to consult his surgeon and consider this met removal.
Hope this will help. Feel free to ask further questions.
Regards.
Above answer was peer-reviewed by :
Dr. Prasad
But when xeloda was stopped his dropped to 8. Is that strange ? And now 9 on chemo .
Is folfori known to work?
Also he
Has a liver met plus a node so would thy still remove the liver met?
Is folfori known to work?
Also he
Has a liver met plus a node so would thy still remove the liver met?
Brief Answer:
Difference between CEA 8 and 9 is reallt not much.
Detailed Answer:
The difference between CEA level 8 and 9 is really not much. So its really hard to say why it has lowered after xeloda stop.
Yes FolFori is known to work. That is why it is used in the treatment.
It is possible that the node has disappeared due to chemo treatment. In such case, liver met can be removed. Its really worth to try.
Regards.
Difference between CEA 8 and 9 is reallt not much.
Detailed Answer:
The difference between CEA level 8 and 9 is really not much. So its really hard to say why it has lowered after xeloda stop.
Yes FolFori is known to work. That is why it is used in the treatment.
It is possible that the node has disappeared due to chemo treatment. In such case, liver met can be removed. Its really worth to try.
Regards.
Above answer was peer-reviewed by :
Dr. Prasad
I know if node gone and just 1 liver met that would be great .
But I'm worried cea not come down. What u say survival is like approx with a single met and 1 node ( providing there's no further spread ?)
But I'm worried cea not come down. What u say survival is like approx with a single met and 1 node ( providing there's no further spread ?)
Brief Answer:
You never know what exactly CEA level indicates.
Detailed Answer:
You never know what exactly CEA level means. It may be 9 due to liver met only. Maybe the lymph node does not affect CEA level. You never know.
Being hones with you, his chances for 5-year survival are 30%. So there is still hope. You needs to fight and you need to support him. This is just a statistical number. Remember that every person is different. Every cancer is different.
Regards.
You never know what exactly CEA level indicates.
Detailed Answer:
You never know what exactly CEA level means. It may be 9 due to liver met only. Maybe the lymph node does not affect CEA level. You never know.
Being hones with you, his chances for 5-year survival are 30%. So there is still hope. You needs to fight and you need to support him. This is just a statistical number. Remember that every person is different. Every cancer is different.
Regards.
Above answer was peer-reviewed by :
Dr. Yogesh D
Yea so true. Is it better cea is 9 rather like 60-70?
His blood works r all normal like liver function etc . How can it b normal with a liver met?
His blood works r all normal like liver function etc . How can it b normal with a liver met?
Brief Answer:
Small met does not affect liver function at all.
Detailed Answer:
Of course. CEA level 9 is not really high. In case of generalized cancer (mets all over) it can reach 60-70 or even hundreds.
Nature gave us liver much larger than it is necessary. It means that we do not need whole liver to live. Only 1/3 of healthy liver is enough to live. That is why liver transplant is possible and that is why tiny liver met does not affect liver.
Liver tests like ALT, AST detect the enzymes from the liver cells. This enzymes get released to the bloodstream if a lot of liver cells get destroyed in short time (by an alcohol for example). Now liver met does not grow fast. They grow very slowly. Try to imagine that it destroys (or better replaces) few cells a week. This is really not much. And for sure not enough to be detected with regular liver tests.
Regards.
Small met does not affect liver function at all.
Detailed Answer:
Of course. CEA level 9 is not really high. In case of generalized cancer (mets all over) it can reach 60-70 or even hundreds.
Nature gave us liver much larger than it is necessary. It means that we do not need whole liver to live. Only 1/3 of healthy liver is enough to live. That is why liver transplant is possible and that is why tiny liver met does not affect liver.
Liver tests like ALT, AST detect the enzymes from the liver cells. This enzymes get released to the bloodstream if a lot of liver cells get destroyed in short time (by an alcohol for example). Now liver met does not grow fast. They grow very slowly. Try to imagine that it destroys (or better replaces) few cells a week. This is really not much. And for sure not enough to be detected with regular liver tests.
Regards.
Above answer was peer-reviewed by :
Dr. Vaishalee Punj
I see. Can the chemo get rid of the node u think ? Cuz then he in a better position hey? Also
With chemo can
More mets still appear?
The prob is they are only now giving irinotecan, not 5 fu with it as he has chest discomfirt . But hes tolerating irinotecan
Well so far . Can this effect the effectiveness of it?
With chemo can
More mets still appear?
The prob is they are only now giving irinotecan, not 5 fu with it as he has chest discomfirt . But hes tolerating irinotecan
Well so far . Can this effect the effectiveness of it?
Brief Answer:
Chemotherapy can cause affected node disappearance.
Detailed Answer:
Yes, chemo can get rid of metastatic node. This would be very good reaction for chemo.
Yes, more mets can appear. As mentioned above, mets grow really slowly. It takes years before they will show up.
Giving Irinotecan as a single therapy can be as effective as with 5-FU. But it usually means that the dosage of Irinotecan must be higher. This can give more side effects of this medicine.
Chemotherapy can cause affected node disappearance.
Detailed Answer:
Yes, chemo can get rid of metastatic node. This would be very good reaction for chemo.
Yes, more mets can appear. As mentioned above, mets grow really slowly. It takes years before they will show up.
Giving Irinotecan as a single therapy can be as effective as with 5-FU. But it usually means that the dosage of Irinotecan must be higher. This can give more side effects of this medicine.
Above answer was peer-reviewed by :
Dr. Vaishalee Punj
So far he tolerating well . Whats the smallest size that can be seen on a pet scan?
But what im confussed about is that all scan before operation were clear, the scan after op in april was even clear but sept pet scan showed the liver met and node. So cpuld ghis problem happened after surgery in that cells escaped ?
Im
Confussed .
But what im confussed about is that all scan before operation were clear, the scan after op in april was even clear but sept pet scan showed the liver met and node. So cpuld ghis problem happened after surgery in that cells escaped ?
Im
Confussed .
Brief Answer:
PET can detect 10 mm large tumors.
Detailed Answer:
Usually PET can detect tumors not smaller than 10mm.
The point is that when cancer gives mets, it sends single cells all over the body. Most of this cells are destroyed by immune system. Only some of them can survive and settle in an organ like liver or lung. Such single cells needs lots of time to multiply. It takes years. During this years it can be undetectable. This cells could be in the liver before the surgery. You never know that.
Regards.
PET can detect 10 mm large tumors.
Detailed Answer:
Usually PET can detect tumors not smaller than 10mm.
The point is that when cancer gives mets, it sends single cells all over the body. Most of this cells are destroyed by immune system. Only some of them can survive and settle in an organ like liver or lung. Such single cells needs lots of time to multiply. It takes years. During this years it can be undetectable. This cells could be in the liver before the surgery. You never know that.
Regards.
Above answer was peer-reviewed by :
Dr. Vaishalee Punj
I see . Should we get a second opinion then as they ate saying that due to the node they cant remove liver met?
Brief Answer:
Please wait till the chemo will be over.
Detailed Answer:
I suggest you to wait till the chemo will be over. Than get another scan and consult it with surgeon. Maybe the node will be gone.
Please wait till the chemo will be over.
Detailed Answer:
I suggest you to wait till the chemo will be over. Than get another scan and consult it with surgeon. Maybe the node will be gone.
Above answer was peer-reviewed by :
Dr. Vaishalee Punj
The node was 10 mm. Is this large ? Plus the liver met suv XXXXXXX was 5.2 , is that high?
Brief Answer:
10 mm is not a large node.
Detailed Answer:
10 mm is not a large tumor.
SUV 5.2 clearly indicates that this is metastatic tumor.
10 mm is not a large node.
Detailed Answer:
10 mm is not a large tumor.
SUV 5.2 clearly indicates that this is metastatic tumor.
Above answer was peer-reviewed by :
Dr. Vinay Bhardwaj
If it goes with chemo/ surgery and no more mets is survival
Good?
Good?
Brief Answer:
His survival is 30%
Detailed Answer:
Survival at his stage is 30%. He will be in this 30% if there will be positive chemo reaction and liver met will be removed. If not, he will be in 70% who will not survive.
His survival is 30%
Detailed Answer:
Survival at his stage is 30%. He will be in this 30% if there will be positive chemo reaction and liver met will be removed. If not, he will be in 70% who will not survive.
Above answer was peer-reviewed by :
Dr. Vinay Bhardwaj
Sorry 1 thing, so could the cells have escaped after surgery for these 2 to develop as all previous scans were fine?
Brief Answer:
This cells have escaped before the surgery.
Detailed Answer:
No, I do not think this cells have escaped after surgery. Most likely they has escaped before the surgery. This cells left as a tiny mets which were invisible in any scans.
This cells have escaped before the surgery.
Detailed Answer:
No, I do not think this cells have escaped after surgery. Most likely they has escaped before the surgery. This cells left as a tiny mets which were invisible in any scans.
Note: For further queries related to kidney problems Click here.
Above answer was peer-reviewed by :
Dr. Vinay Bhardwaj
Answered by
Get personalised answers from verified doctor in minutes across 80+ specialties
