Oncology Questions? Ask an Oncologist for Answers ASAP
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Hi my dad had a cea blood test may which was 3 then in June the value was 4. It rose by 1 point . Can this mean progression of the disease.
He had dukes c1 Colon cancer surgery in march ,
CEA changes from 3 to 4 is not really a meaningful change
and most likely does not reflect progression of cancer.
for dukes C1 after surgery, he should be getting chemotherapy.
is he getting chemotherapy?
this can cause his CEA levels to change.
also smoking can cause elevation of CEA levels above 5
He initially did nt want chemo but if all agreed . He's been on xleoda - oral tablets for three weeks only now . Surgery was in march .
He is a smoker yes. Should we request a pet scan I is it normal for a 1 point rise to occur in 1 month?
no, he doesn't need a PET scan just because the CEA changed from 3 to 4
He initially refused chemo as worried about the harsh side effects but for sum reason he does not have v bad effects of the tablets Apart from tierdness, pins and needles ?
For progression or reoccurence what level should a cea reading usually be?
CEA levels in the 100s range is worrisome.
that is good he is tolerating the xeloda
xeloda can sometimes cause pins and needles.
he might benefit from neurontin medication.
best of luck to you and him
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Is the oral tablets good for preventinG mets? That's our main worry .
yes, xeloda can help decrease chances of recurrence and metastasis.
xeloda breaks down into 5FU inside of the body.
When would it be wise to do a pet scan ?
Would thebe the tht only test first to detect mets etc ?
a PET scan should be used once or twice a year for patients who have colon cancer to assess their disease status and when the results could change the direction and course of treatment.
it is not the only way to detect metastasis.
CT scans can also detect metastasis.
and if he is on xeloda, a scan should have been done before he started xeloda
and when he stops his xeloda, you could do another scan.
We asked the oncologisy to do a scan and he said not yet .dont know why.
I'm not sure why either.
Also should a cea level rise like that from 3 to 4 in 1 month?
perhaps they want to wait until after the xeloda therapy.
yes, cea can raise from 3-4 in a month without cancer recurrence
As surgery was in march shud we get one done privately
he is 4 months from surgery.
no, he doesn't need a PET scan now
what he needs is a CT scan of the abdomen and pelvis if he has not had that done.
has he had a regular CT scan with IV and oral contrast performed of the chest and abdomen and pelvis?
Ok. Last ct of abdomen was march after his operation as he had fluid from
The surgery . Last chest ct was January .
Would a pet detect small tumors and not a ct?
a PET would not detect small cancers that CT scan with contrast could not detect.
Ok . Do u think we should get a scan done then now?
he is getting xeloda which is oral chemotherapy.
If mets were developin or more lymph nodes getting affected, does the rise in cea start slowly then goes up slowley each month ?
no, CEA of 4 is still normal.
it sounds like you are very worried and anxious about this.
he does not need to get a scan now.
he needs to continue to take his xeloda chemotherapy agent for now.
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If nodes were getting affected again or organs would the cea b higher?
yes, the CEA level would be much much higher.
Yes worried about this small rise
don't be worried about this small rise.
With 10 nodes which were affected he has a high chance mets right ?
but his chemotherapy is to help him decrease his chances of metastatic disease.
Hope he finishes the course as he did not want chemo initially n the family persuaded him. But he started 10 weeks post surgery will that make a difference ?
no, that is fine to start 10 weeks post surgery.
at least he started.
do you have any other questions?
Thx a lot
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Last q . what if the next cea shows a further rise to say 5 or 6?
CEA of 5-6 is not a worrisome level.
We got the third cea result today which is now 6. So may was 3. June 4 and July 6. We are very worried with this constant rise ?
Avdr said this could mean mets ? But ur the oncologisy . But why would it b rising?
But what could b making it rise per month? Could it b cancer agsin in the lymph nodes or liver lungs?
Ok thx. Yes I'm worrying now .cud this mean cancer cells lurking in the body which eventually can cause mets ?
What level would be a concerning level?
Can this rise mean any kind of progression of the disease? May it was only 3?
Ok.so pet scan not necessary yet? What if every month it just increases as so far over three months it has increased ?
Will these levels get back to
Normal range Of under 5? Or what can b done to lower them?
Ok. But it says when I read that normal
For non smokers is less than 2.5 and for smokers 5 and under?
Also, the main worry is if it was 3 in may why didn't it remain the same?
Thx. I read that a persistent rise of cea levels indicates cancer has returned ? As my fathers is jumping up from 3,4 and now 6
Would this not be regarded as a rise?
Im getting very concerned as in may it was only 3 so y a sudden jump
Yes I agree he's got to stop smoking . We have told him so much . Do u think he needs a ct scan ?
Could the rise in cea each month mean that there are still cancer cells in the body though? And that all the cells were not removed during surgery ?
It is always possible to catch all the cells at surgery right ?
The fact that for a dukes c1 they just giving him xeloda alone, is that enough to kill any cancer cells ?
Is that diffetent to xeloda? I thonk he was only offered xeloda or the iv form
Ok. I don't know why they did not offer that .I should calm down then right and not worry about the rise? I
Cuz in may it was only 3, we are panicking why it's gone to 6 now in 2 months
But the worry is that Could this b the start of tumors forming and then as time goes by it will increase more n more?
So this def cannot be mestates right ? Could it b cells left behind during surgery and therefore cea increasing ?
We thoughther on the mend then this now happens .Whole family wirried
Hi, my dad saw the dr Monday and he did not mention the cea increase even .
Fo u think they can look to change the chemo drug if the cea is rising ?
How long does it take for xeloda to work? He been on it three week so far