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Suggest Treatment For Increased CEA Count When Having Colon Tumor

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Posted on Thu, 29 Jan 2015
Question: Cea rising on irinotecan which was started in oct for a liver met and aortocaval node.

Primary colon tumor removed in march and xeloda was started .


August cea was 9.8
Oct 8
Dec 9 XXXXXXX 10
doctor
Answered by Dr. Monish De (50 minutes later)
Brief Answer:
CT scan of whole abdomen

Detailed Answer:
Hi

Since the CEA is rising with irinotecan i would advise you to do a CT scan of whole abdomen.

If the metastatic colon tumour is stable radiologically meaning there is no increase in diameter of metastatic liver and aorto caval node lesions then irinotecan can be continued but if there is increase in the diameters of the lesions in the scan then irinotecan needs to be stopped and third line chemotherapy needs to be started.

Regards

DR DE
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
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Follow up: Dr. Monish De (35 minutes later)
Should the cea rise like this ?it seems to be 1 point per month ?
doctor
Answered by Dr. Monish De (5 minutes later)
Brief Answer:
radiological asessment necessary

Detailed Answer:
Hi

As the CEA is rising even if it is 1 point it may indicate the disease is spreading and that is why radiological picture is necessary to plan the next course of action needed to be taken.

Regards

Dr DE
Above answer was peer-reviewed by : Dr. Vaishalee Punj
doctor
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Follow up: Dr. Monish De (18 minutes later)
How effective is irinitecan ?
doctor
Answered by Dr. Monish De (5 minutes later)
Brief Answer:
FOLFIRI is more effective than irinotecan

Detailed Answer:
Hi

Irinotecan is effective and in 40% patient they prevent the disease from spreading.

FOLFIRI is more effective than irinotecan and they control the disease from spreading by 50% but has greater side effects.

Regards

DR DE
Above answer was peer-reviewed by : Dr. Vaishalee Punj
doctor
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Follow up: Dr. Monish De (38 minutes later)
Ok. If chemo not worlkjng , can these be ablated instead?

Are a 16 mm liver met n 1 node very worrisome? And what if chemo does not work
doctor
Answered by Dr. Monish De (20 minutes later)
Brief Answer:
Ablation can be tried

Detailed Answer:
Hi

16 mm liver metastasis and 1 node is not very worrisom.

If chemo is not working ablation can be tried.

But a fresh scan is needed to asess the size of the lesions.

Regards

DR DE
Note: For further queries related to kidney problems Click here.

Above answer was peer-reviewed by : Dr. Vinay Bhardwaj
doctor
Answered by
Dr.
Dr. Monish De

Oncologist

Practicing since :2004

Answered : 2229 Questions

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Suggest Treatment For Increased CEA Count When Having Colon Tumor

Brief Answer: CT scan of whole abdomen Detailed Answer: Hi Since the CEA is rising with irinotecan i would advise you to do a CT scan of whole abdomen. If the metastatic colon tumour is stable radiologically meaning there is no increase in diameter of metastatic liver and aorto caval node lesions then irinotecan can be continued but if there is increase in the diameters of the lesions in the scan then irinotecan needs to be stopped and third line chemotherapy needs to be started. Regards DR DE