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Dr. Andrew Rynne

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What does CEA level at 6 indicate?

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Dr. Robert Galamaga

Oncologist

Practicing since :2002

Answered : 2616 Questions

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Posted on Sat, 9 Aug 2014 in General Health
Question: Hi my dad had colon cancer surgery in march- he was a dukes c1.

However his cea in may was 3, but 4 in XXXXXXX and went to 6 in july.

He is on xeloda since three weeks ago as initially he was refusing chemo . He is a smoker but even still that cause a rise month by month. What do we do n does this mean mets??
doctor
Answered by Dr. Robert Galamaga 24 hours later
Brief Answer:
Thanks for the query

Detailed Answer:
Hello again,

Xeloda tends to be very well tolerated as far as chemo goes. Hopefully he can complete a full recommended course.

I understand your concern about the CEA. at a level of 6 this does not confirm metastatic disease but we do see a trend here which is somewhat concerning. His doctor may consider requesting some type of imaging evaluation in the next few weeks or months to see if there is any evidence of disease elsewhere in the body.

Continue to see the oncologist for followup visits and follow recommendations regarding continued treatment.

Thanks again for sharing your health care concern.

Dr. Galamaga
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
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Follow up: Dr. Robert Galamaga 14 minutes later
He initially did not want chemo . Started xeloda 3 weeks ago n seems to be tolerating it well. .

But could xeloda not b working due to cea rise?

If not mets, then what else could b happening? Could there be cells left behind from surgery?
doctor
Answered by Dr. Robert Galamaga 2 days later
Brief Answer:
Followup

Detailed Answer:
Thanks for the additional question.

It is always possible that a very microscopic amount of cancer might be left behind after surgery which is generally why we advocate for chemotherapy to help decrease the risk of recurrent disease and improve the likelihood of long-term remission.

I think what is very important regarding tumor markers is establishing a trend. If the trend is slowly increasing this is more concerning that there might be some microscopic cells left behind. It does not necessarily mean that chemotherapy is not working. It takes some time for chemotherapy to take a full effect which I am sure the oncologist has reviewed with you.

I do not necessarily think there is any immediate need to change the course of therapy. I would sit down and talk to the oncologist about how he feels about additional diagnostic studies including laboratory tests or scans.

It sounds like he is getting excellent treatment. Please feel free to touch base with us any time again.

Dr. G
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
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Follow up: Dr. Robert Galamaga 37 minutes later
The fact that the cea has risen from may till now from 3 to 6, does this then indicate a steady rise?
doctor
Answered by Dr. Robert Galamaga 3 days later
Brief Answer:
Followup

Detailed Answer:
thanks for the follow up.

I certainly understand your concern with the increase in the level of the protein. I usually request at least three time points to compare and try to establish a trend. I think another level in the next few weeks would be helpful. If it continues to rise then the doctor might request some additional type of workout.

Thank you again as always for sharing your healthcare concern with us.

Dr. G
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
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