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Does An Increasing Level Of CEA Suggest Ineffectivity Of Chemotherapy
Question: Hi help needed please
My dad has has first session of chemotherapy , oxyplatin few weeks ago and cea was 65 before the chemo and now 3 weeks later it's 78!
Very worried this means the chemo not working right ?
My dad has has first session of chemotherapy , oxyplatin few weeks ago and cea was 65 before the chemo and now 3 weeks later it's 78!
Very worried this means the chemo not working right ?
Brief Answer:
not necesarily
Detailed Answer:
Hi and welcome.
This is not significant elevation of cea and it isn't necessarily meaning that there is no chemotherapy effect. Tumor progression would cause much higher craw levels even up to 1000. But cea isnt relevant indicator of tumor growth and other tests such as pet scan should be done to determine disease stage. Wish you good health. Regards
not necesarily
Detailed Answer:
Hi and welcome.
This is not significant elevation of cea and it isn't necessarily meaning that there is no chemotherapy effect. Tumor progression would cause much higher craw levels even up to 1000. But cea isnt relevant indicator of tumor growth and other tests such as pet scan should be done to determine disease stage. Wish you good health. Regards
Above answer was peer-reviewed by :
Dr. Pradeep Vitta
Hi thanks
My dad was a stage 3 in November 2013 and now stage 4.
He has liver let's and peritoneal nodules .
Irinotecan failed so he given oxyplatin as raltitrexed .would it be worth adding avastin .
Even before his cea was rising and irinotecan
And a scan showed it didn't work .
The cea should be decreasing right ?
Please see attached , is this very wide spread disease ?
My dad was a stage 3 in November 2013 and now stage 4.
He has liver let's and peritoneal nodules .
Irinotecan failed so he given oxyplatin as raltitrexed .would it be worth adding avastin .
Even before his cea was rising and irinotecan
And a scan showed it didn't work .
The cea should be decreasing right ?
Please see attached , is this very wide spread disease ?
Brief Answer:
Unfortunately yes
Detailed Answer:
Hi.
I am afraid that this is very advanced stage of the disease, especially since there are peritoneal deposits and multiple liver metastases. This is definitely inoperable and any chemotherapy protocol is useless in 90% of cases,while only in minority it may have some effect that prolong life for several months,but chances for long term survival are negligible I am afraid,although is is hard to predict exact prognosis.
In this situation, stopping chemo should be considered as well if he has bad side effect of it.
The CEA level at this point doesnt have some purpose. Tumor progression is clear and CEA lowering isnt expected, you can try with some other chemotherapeutic protocol if he can stand it and hope for slowing down tumor progression. I hope something will work for him and that you will find strength to go through all this.
Wish it works for him.
Unfortunately yes
Detailed Answer:
Hi.
I am afraid that this is very advanced stage of the disease, especially since there are peritoneal deposits and multiple liver metastases. This is definitely inoperable and any chemotherapy protocol is useless in 90% of cases,while only in minority it may have some effect that prolong life for several months,but chances for long term survival are negligible I am afraid,although is is hard to predict exact prognosis.
In this situation, stopping chemo should be considered as well if he has bad side effect of it.
The CEA level at this point doesnt have some purpose. Tumor progression is clear and CEA lowering isnt expected, you can try with some other chemotherapeutic protocol if he can stand it and hope for slowing down tumor progression. I hope something will work for him and that you will find strength to go through all this.
Wish it works for him.
Above answer was peer-reviewed by :
Dr. Pradeep Vitta
Brief Answer:
not really
Detailed Answer:
These metastases are significant and liver has good functional reserve so even 20% of healthy liver can have adequate metabolic function. However, tumor progression in such cases is usually fast and liver will be completely infiltrated sooner or later.
Bigger problem are peritoneal deposits so called carcinosis. Such lesions ,if dont respond to chemoth, grow rapidly and cause intestinal obstruction, cahexia etc.
So, this can be called preterminal stage and progression can still be slowed down.
not really
Detailed Answer:
These metastases are significant and liver has good functional reserve so even 20% of healthy liver can have adequate metabolic function. However, tumor progression in such cases is usually fast and liver will be completely infiltrated sooner or later.
Bigger problem are peritoneal deposits so called carcinosis. Such lesions ,if dont respond to chemoth, grow rapidly and cause intestinal obstruction, cahexia etc.
So, this can be called preterminal stage and progression can still be slowed down.
Above answer was peer-reviewed by :
Dr. Prasad
So they key here is chemo
To work right ?
That's y I'm worrying - this is the history so far:
Only 1 liver met in august 2014 so irinotecan started October 2014. Cea rising on it .
Nov cea 10
Dec cea 12
Stopped and disease progression
However from dec- march cea XXXXXXX to 65 without no treatment .
Oxyplatin started 31 march- first round
Cea at 27 march was 65
Cea on 16 April is 78
So im thinking if chemo was working then cea would reduce right . Even on irinotecan cea was rising but few points per month .
Should avastin b added ?
To work right ?
That's y I'm worrying - this is the history so far:
Only 1 liver met in august 2014 so irinotecan started October 2014. Cea rising on it .
Nov cea 10
Dec cea 12
Stopped and disease progression
However from dec- march cea XXXXXXX to 65 without no treatment .
Oxyplatin started 31 march- first round
Cea at 27 march was 65
Cea on 16 April is 78
So im thinking if chemo was working then cea would reduce right . Even on irinotecan cea was rising but few points per month .
Should avastin b added ?
Brief Answer:
Hi
Detailed Answer:
It may be combined with avastin or Cetuximab,but if there was no response on irinotecan and oxyplatin,then some improvement is not likely. But if there is possibility to start some of these 2 drugs, and if he wont have side effects then it is worth of try.
Regards.
Hi
Detailed Answer:
It may be combined with avastin or Cetuximab,but if there was no response on irinotecan and oxyplatin,then some improvement is not likely. But if there is possibility to start some of these 2 drugs, and if he wont have side effects then it is worth of try.
Regards.
Above answer was peer-reviewed by :
Dr. Pradeep Vitta
What about this cea rise from 65 to 78? Only had first round of oxy and cea went from 65 before chemo to 78 3 weeks after chemo ?
Also he's struggling with food since chemo and losing weight
Also he's struggling with food since chemo and losing weight
Brief Answer:
still not significant elevation
Detailed Answer:
this is still not some significant elevation, but if there is continuous grow of cea after 2nd and 3rd rounds of chemo then it means that it doesnt work an dit should be switched or another one should added. Weight loss may be caused by chemo or by tumor progression. If there is rapid weight loss then you should consider parenteral nutrition. Also, if after 3rd round chemo is proved to be uneffective and chemo side effects persist, then chemo should be stopped since there is no benefit from such treatment
still not significant elevation
Detailed Answer:
this is still not some significant elevation, but if there is continuous grow of cea after 2nd and 3rd rounds of chemo then it means that it doesnt work an dit should be switched or another one should added. Weight loss may be caused by chemo or by tumor progression. If there is rapid weight loss then you should consider parenteral nutrition. Also, if after 3rd round chemo is proved to be uneffective and chemo side effects persist, then chemo should be stopped since there is no benefit from such treatment
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Above answer was peer-reviewed by :
Dr. Yogesh D
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