I finally received the results of my CEA results from my lab/blood work and CT scan from July 15. (For the record, I was NED.) (Also for the record, all my lab/blood work came out within the ranges.) CEA stands for carcinoembryonic antigen. The CEA test measures the amount of CEA in the blood, and sometimes in other body fluids. CEA is a type of tumor marker. Tumor markers are substances made by cancer cells or by normal cells in response to cancer in the body. A CEA test can't tell you what kind of cancer you have, or even whether you have cancer. So the test is not used for cancer screening or diagnosis. But if you've already been diagnosed with cancer, a CEA test can help monitor the effectiveness of your treatment and/or help find out if the disease has spread to other parts of your body (CEA information from MedicinePlus). In my case, I've had 16 CEA tests since May 2013. Put another way, I've had 16 CT scans since I was first diagnosed with cancer in 2013 to July 2019. That's a lot of CT scans but it gives you an idea of what a high-risk, high-surveillance patient goes through. Initially, I was Stage I; with recurrence in May 2016, I became Stage IV. I still have 2 1/2 years remaining for CT scans or, according to the math, five more CT scans remaining for my five-year high-surveillance program. Initially, I was on the five-year program but in the third year recurrence happened and I had to start all over again with CT scans every three months for two years and then scans twice a year for three years. The normal range for CEA is 0-2.5 ug/L. CEA usually doesn’t enter the equation until one has been through surgery and is in treatment (chemo/radiation) or prior to treatment. High levels of CEA could or may indicate the presence of cancer or recurrence. Normal levels following treatment indicate that the cancer was likely all removed. But back to my CEA tests. My first CEA test on May 1, 2013 was 1.1 ug/L. Given the fact that I had a tumor the size of a lime in my ascending colon, the low CEA reading is remarkable. In short, it appears that my CEA wasn’t a determinate factor in evaluating the presence of cancer. In the four CEA tests that followed over a two year period, my CEA was 1.0, 1.6, 1.2, 1.4 respectively. Then there was a slight spike at the time that my recurrence was diagnosed. In late May 2016, the level was 2.1. Right before my recurrence surgery in November 2016, the level was 2.4. I had my first post-surgery CT scan in January 2017. The CEA level was 1.5. There was a slight spike in April 2017 - 1.8. Then, in the following 2 years the levels were 1.5, 1.4, 1.3, 1.2, and 1.4. In January, the CEA spiked to 2.0. In July 2019 (my most current CT scan/CEA test), the CEA level was 1.1. I think what is interesting is that at the time of my recurrence and the two spikes in my CEA in association with it, the levels were still in the normal range. Was it because the small size of the lesion on the left lobe of my liver? The 2.4 reading before my recurrence surgery was high but still within the threshold of the normal range. Perhaps, in some cases, the CEA doesn’t have to spike over the threshold to indicate the possibility of cancer. Usually, when I read my CEA results, I’m looking for higher numbers - 3.0 or beyond. CEA is a hot topic in the cancer support groups that I’m a part of. I’ve seen people with 5.0 to 8.0 CEA levels. High numbers like that is a cause for alarm. But, again, perhaps the numbers don’t have to be that high for some survivors. With that said, the spike to 2.0 in January 2019 is a bit worrisome. It jumped from 1.4 to 2.0. Why the spike? Certainly, my current level of 1.1 provides some solace. But in the back of my mind is always the thought that cancer cells are floating somewhere in my blood stream patiently waiting to take foothold somewhere. And, perhaps, that quirky, recent spike may be telling me something. Hopefully, it isn't.
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Robert Desjarlait
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