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Medical Forum / Diseases and Disorders / Cancer / April 2005elevated CEA value, looking for advice
Hi there, I would like to ask you if you can give me some information regarding my cea value.I am not a smoker,though I smoked lightly for 3 years but I quit 16 months ago. However I do have a small lung problem, i.e. spastic bronchitis. I have no other problems or symptoms whatsoever, but my doctor decided I have the cea test along with a general blood count test, "just in case", when I visited him because I thought I had a lump on my shoulder(he thought it could be a lemphaden), but it turned out it was nothing serious, and the ultrasound veirified that. Anyway, the CEA came at 4.94 (upper limit of 5 for non smokers, 10 for smokers). I got really scared and depressed, to me it seemed (and it still seems) that sooner or later I will encounter problems since the value is very close to exceeding the threshold of 5. So I decided to have the test again 13 days later exactly, and It came slightly lower, at 4.33. Of course, I'm still very worried. However, my doctor says I should not worry, and the next CEA value when I take the test again about two months later, will be lower. Is there anyone who can make anything out of these numbers? Any comments welcome, thanks in advance for your valuable insight > Hi there, > > I would like to ask you if you can give me some information regarding > my cea value.I am not a smoker,though I smoked lightly for 3 years but > I quit 16 months ago. Good job. I guess you want to live to see your great grand children. Stopping smoking is a great thing to help you see them. Smoking is the stupidest thing I can think of, short of running in front of a bus, jumping off a high bridge without a parachute or lying down on the track in front of a speeding train. > However I do have a small lung problem, i.e. > spastic bronchitis. I have no other problems or symptoms whatsoever, [quoted text clipped - 6 lines] > it still seems) that sooner or later I will encounter problems since > the value is very close to exceeding the threshold of 5. The CEA is use to monitor people who have had cancer, not as a screening test for cancer. I would think that your level is fine, because I would expect the upper limit of normal to be somewhere between that of nonsmokers and smokers. But what do I know. I don't know your whole history nor have I examined you. However, if you only smoked for 3 years, your risk of cancer is quite low, nearly that of someone who never smoked before, although still a bit higher. > So I decided > to have the test again 13 days later exactly, and It came slightly [quoted text clipped - 3 lines] > > Is there anyone who can make anything out of these numbers? Nope, there isn't. The reality of the matter is that the CEA is not a good screening test for people who don't have a history of cancer. A value of less than 5 is normal. Your value is normal. And, I would expect that the upper limit of normal for someone who had smoked until 16 months ago is somewhere between 5 and 10, like maybe 6 or 7. You're fine. Don't worry. Just don't start smoking again. Jeff > Any comments welcome, thanks in advance for your valuable insight > Hi there, > [quoted text clipped - 18 lines] > > Any comments welcome, thanks in advance for your valuable insight CEA is a terrible screening test. The values you report mean nothing if you have no bowel symptoms. It's a good example of why NOT to take tests unless there is a good reason Thank you both (Jeff, Steph) for answering my question. I was told today that even a cold could affect the cea test, I heard of a case with a cea of 50 because of a severe cold. I mean, could it be that my spastic bronchitis could give me also such a big cea number in the future? Also, are you saying that at this point whether one has a CEA value of .06 or 4.94 he should (not)worry the same? My doctor suggested I have the CEA test again 3 months later. Why so long? I forgot to mention there is no cancer in my family tree. (Hope I'm not being psychotic, but you probably understand...) Jeane: I think you are being extremely fixated on a meaningless statistic here. You don't seem to be listening to what others are saying (RE: uses of CEA) MB > Thank you both (Jeff, Steph) for answering my question. > [quoted text clipped - 11 lines] > > (Hope I'm not being psychotic, but you probably understand...) > Thank you both (Jeff, Steph) for answering my question. > [quoted text clipped - 11 lines] > > (Hope I'm not being psychotic, but you probably understand...) Being on the edge of the normal range for most blood tests is not uncommon, and not really -abnormal-. It certainly has NOTHING to do with cancer. You could have advanced cancer and still have normal CEA. CEA is only evidence of cancer if it is -very- high and steadily rising over a long period. Yes, some lung conditions can increase CEA. I'm not sure about your specific condition. The recommended use of the CEA test is to monitor response to treatment of known cancers, where the level is already high, and as possible evidence of metastases after a cancer has been removed. In both cases it is the -rate of change- of level that is mainly of interest. If the level is anywhere near the normal range then the result is meaningless for this purpose anyway.  SignatureTim Jackson -Who needs to pay Microsoft? Free Open Source Software- www.mozilla.org FIREFOX Web Browser, THUNDERBIRD Email/News www.openoffice.org Office Suite > Thank you both (Jeff, Steph) for answering my question. > [quoted text clipped - 11 lines] > > (Hope I'm not being psychotic, but you probably understand...) It's a very blunt tool, and in you it is being used for a very poor indication, as it is a useless screening tool. > > Hi there, > > [quoted text clipped - 23 lines] > > It's a good example of why NOT to take tests unless there is a good reason i'm sorry to see that these numbers mean so much to you. from what i have learned in my last nearly 2 years as a stage 4 bc survivor, cea means little unless you are charting it over an extende period of time. i am myslef (stupid me) still a smoker, although quite a bit less than i used to be, and my cea bounces all over the place. example- when first diagnosed - things were the worst they could be in terms of numbers - i had cea of 14 and ca 27-29 of nearly 300. cea - it's been jumping around between 3 and 10 and ca 27-29 has dropped to 20 since treatment began. but i have been able to justify (explain) the cea blips with colds, flu and just plain stress (personally i think it's more of a stress/immune system response indicator than any concrete indicator of cancer growth). we follow the ca 15.3 - a bc tumor marker - as well as cea and pay close attention to just plain common sense. it has worked fairly well so far. bottom line, one number means little if not placed within a context. hope all's well. -christina Cheers to all of you (especially to to falice and Susie, it feels great to have a chat with real winners.) See, the way I see it is that I'm so close to the upper limit that I could be a suspect for cancer more than anybody else. However, the way most of you see it is that this is really a meaningless number unless one has a problem. But this is part of my concern as well. Should I have a CEA above 5, It will be too late for me to do anything (it is hardly elevated at the initial stages). I am convinced now that perhaps I should relax my mind, but there is always this thought that "in any case, I'm a primary suspect for cancer" because a value of 1 or 3 is much better than a value of 4,33 or 4,94. See, I did not see it as many of you that have the knowledge (Steph, Jeff) see it, i.e. as either a negative or a positive test, but as a value whose level also means something, and I think the message you guys arte giving me is that the level does not really matter as long as the test is negative and there are no bowel or other problems whatsoever. Come to think of it, If every person on earth took the test and diagnose cancer, things would be much better for them, but I guess this is not the case. However, i must admitt I hate my doctor for having me go through this. > See, the way I see it is that I'm so close to the upper limit that I > could be a suspect for cancer more than anybody else. However, the way [quoted text clipped - 14 lines] > the case. However, i must admitt I hate my doctor for having me go > through this. I think you've got a loose screw somewhere.. Nobody's making you go through anything that you aren't letting them do to you. If you're in the US, you're the customer; tell the doctor that if he orders the test again, that you will advise your insurance not to pay for it, and do it (if he goes against your instructions). http://www.medicinenet.com/carcinoembryonic_antigen/article.htm Both benign and malignant (harmless and cancerous) conditions can increase the CEA level. The most frequent cancer which causes an increased CEA is cancer of the colon and rectum. Others include cancers of the pancreas, stomach, breast, lung, and certain types of thyroid and ovarian cancer. Benign conditions which can elevate CEA include smoking, infections, inflammatory bowel disease, pancreatitis, cirrhosis of the liver, and some benign tumors in the same organs in which an elevated CEA indicates cancer. Chemotherapy and radiation therapy can cause a temporary rise in CEA due to the death of tumor cells and release of CEA into the blood stream. Benign disease does not usually cause an increase above 10 ng/ml. What are the limitations of CEA testing? CEA is not an effective screening test for hidden (occult) cancer since early tumors do not cause significant blood elevations. Also, many tumors never cause an abnormal blood level, even in advanced disease. <end quoted text> So where does that leave you? Nowhere...quit obsessing and forget the test and get on with life. Report troublesome symptoms or signs to your doctor, but otherwise forget the CEA test until/unless you are diagnosed with colorectal cancer. J (...) Quote from article: > CEA is not an effective screening test for hidden (occult) cancer since > early tumors do not cause significant blood elevations. Also, many tumors [quoted text clipped - 5 lines] > doctor, but otherwise forget the CEA test until/unless you are diagnosed > with colorectal cancer. It maybe useful for following other cancers, too, *after* diagnosis. I suspect that there was another patient in this doctor's practice who had cancer that was being followed by CEA. So this doctor went ahead and ordered it, without knowing what he was doing. I have seen a few doctors follow up on things that didn't need follow-up, because they had problems with a particular case. You're correct. The doctor's patients would be better off if they got on with life and reported things when they occurred. Of course, the doctor should do the proper preventive measures like vaccines and screening things proven to work, like checking blood pressure, stool for blood and mammograms. Jeff > J > "J" <banish@invalid.anon> wrote in message > (...) [quoted text clipped - 12 lines] > > It maybe useful for following other cancers, too, *after* diagnosis. Yes, thanks Jeff. Some of them were mentioned in the part that you snipped. I think the highest I've seen mentioned on newsgroup was Lowkey's at 21,660 The very wordy Lowkey... http://groups-beta.google.com/group/alt.support.cancer/msg/e0f13e733c2f9cec Wish I'd known about the coke back then. He was having so much trouble with nausea. Is it you who posts that cancer patients are prone to clots or bleeds? Many of us thought that Lowkey might actually succeed. As I recall his tumours had shrunk significantly on Erbitux (cetuximab) and his CEA levels had significantly dropped, but then he died of a brain hemorrhage. It still plagues me, because a lady on another newsgroup who has a giant aneuysm was told that straining or coughing too much can cause the aneurysm to burst and he sure was straining. There were a lot of "nausea/gagging without vomiting" posts. He'd had chronic headaches all his life and was blaming the nausea on the medicines. http://www.cedars-sinai.edu/5651.html They missed the boat, concentrating on the cancer and/or chemos (I now see). Sorry for the vent. We can't go back and change things, but there's an argument to not always assume. > I suspect that there was another patient in this doctor's practice who had > cancer that was being followed by CEA. So this doctor went ahead and ordered > it, without knowing what he was doing. I have seen a few doctors follow up > on things that didn't need follow-up, because they had problems with a > particular case. You're correct. The doctor's patients would be better off > if they got on with life and reported things when they occurred. Do you mean litigation? Or "went on automation" (as far as bloodwork, just ordering up the same tests for each patient, whether called for or not)? > Of course, the doctor should do the proper preventive measures like > vaccines and screening things proven to work, like checking blood pressure, > stool for blood and mammograms. Thank you, yes. I forgot to mention those. By the way, Jeff, since you're crossposting, I'm supposed to ask (for alt.support.cancer) those who claim to be doctors their qualifications. (that's mainly to prevent /distinguish those who claim or name themselves "docs" who are not. Also on various cancer newsgroups, sometimes I ID certain doctors/newsgroups to go ask questions of; mainly on sci.med.diseases.cancer or sci.med. Are you willing to share? J >> "J" <banish@invalid.anon> wrote in message >> (...) [quoted text clipped - 27 lines] > > Is it you who posts that cancer patients are prone to clots or bleeds? I have never posted that. But it is true. > Many of us thought that Lowkey might actually succeed. As I recall his > tumours > had shrunk significantly on Erbitux (cetuximab) and his CEA levels had > significantly dropped, but then he died of a brain hemorrhage. Chemotherapy can also cause problems with clotting or bleeds. > It still plagues me, because a lady on another newsgroup who has a giant > aneuysm [quoted text clipped - 24 lines] > > Do you mean litigation? No. I meant that the doctor may have had a patient who had a lung cancer with a high CEA. After that, the doctor started screening for lung cancer with CEA for every patient who is at risk, so as to not miss another lung cancer case. Sadly, though, this stratagy will only lead to more costs and confusion for the patient. (Of course, there could have been ligatio involved, either for this doc or one the doc knows.) Unfortunately, people respond emotionally, not very logically. I once saw a pediatrian test every patient with strep throat for a serious complication of strep throat. It was not a good idea because most cases of that complication clear up on their own, and even if you catch that complication early, there is benefit to early diagnosis, so there is no benefit for screening. > Or "went on automation" (as far as bloodwork, just > ordering up the same tests for each patient, whether called for or not)? CEA is not part of any commonly ordered tests, except for oncologists. >> Of course, the doctor should do the proper preventive measures like >> vaccines and screening things proven to work, like checking blood [quoted text clipped - 14 lines] > you > willing to share? I am an MD, but I went into research rather can patient care. Jeff > J > "J" <banish@invalid.anon> wrote in message > [...] [quoted text clipped - 54 lines] > > Jeff Thank you, Jeff. Sorry I'm late replying. J > Hi there, > [quoted text clipped - 18 lines] > > Any comments welcome, thanks in advance for your valuable insight Dear Jean My cea has hovered around 7 since my diagnosis of ovarian cancer 4 years ago and my oncologist is real pleased with that. I'm doing extremely well ,had chemo for a year, and no eveidence of recurrence. I don't even know what my level was at the time of diagnosis but I asked my pcp what it was at that time a few visits ago and he said it was 5 times what it should have been. I've read that anything below 30 is real good. I still don't know what my original numbers were. I guess I'm not concerned, I just like that my oncologist isn't. > My cea has hovered around 7 since my diagnosis of ovarian cancer 4 years ago > and my oncologist is real pleased with that. [quoted text clipped - 6 lines] > I still don't know what my original numbers were. I guess I'm not concerned, > I just like that my oncologist isn't. Thanks for your post, Susie and welcome to alt.support.cancer, J |
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