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What Does Drop In CEA Level From 9.8 To 8 Mean?
Question: Can a cea decrease from 9.8 to 8 mean much with a person with colon cancer .
Cancer was removed this year , after 11 weeks xeloda
Started ( Started late as was not sure re chemo ).
Pet scan revealed
A 16 mm liver lesion and one 10 mm aortocaval
Node . Both new findings.
No chemo at present as was stopped at 4 th cycle due to scans taking place .
But confussed y cea has dropped bit when no chemo
At present ,
Due to start chemo for 8 weeks soon .
Cancer was removed this year , after 11 weeks xeloda
Started ( Started late as was not sure re chemo ).
Pet scan revealed
A 16 mm liver lesion and one 10 mm aortocaval
Node . Both new findings.
No chemo at present as was stopped at 4 th cycle due to scans taking place .
But confussed y cea has dropped bit when no chemo
At present ,
Due to start chemo for 8 weeks soon .
Brief Answer:
hi and welcome
Detailed Answer:
No, this decrease don't have any clinical meaning and this is not good marker that shows us cancer relapse or cure. Only very high cea can indicate recurrence but low cea isn't related to chances of complete cure. These nodes are enlarged but not significant and you have good reason to be optimistic about future. Of course if it was dukes b or c then chemotherapy must be continued. Wish you good health
hi and welcome
Detailed Answer:
No, this decrease don't have any clinical meaning and this is not good marker that shows us cancer relapse or cure. Only very high cea can indicate recurrence but low cea isn't related to chances of complete cure. These nodes are enlarged but not significant and you have good reason to be optimistic about future. Of course if it was dukes b or c then chemotherapy must be continued. Wish you good health
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
I think u may not have understood .
Surgery to remove colon tumor done already in march . He was dukes c1.
But a recent pet scan showed 1 aortocaval node of 10 mm to be a met and a 16 mm liver met.
Cea XXXXXXX to 9.8 but then oct reading was 8.
He is due to start chemo soon .
Also can these not be removed / ablated and then chemo ?
Surgery to remove colon tumor done already in march . He was dukes c1.
But a recent pet scan showed 1 aortocaval node of 10 mm to be a met and a 16 mm liver met.
Cea XXXXXXX to 9.8 but then oct reading was 8.
He is due to start chemo soon .
Also can these not be removed / ablated and then chemo ?
Brief Answer:
hi
Detailed Answer:
Sorry,I misunderstood only this part about liver lesion. In this case this is bit more serious. Periaortal Lymph nodes are in most cases inflammatory reactive so it is less common metastatic node change. Also, in case of malignant paraaortal nodes,tumor would already be disseminated to other parts of peritoneum.
Liver metastasis isn't good sign but us is obviously found in early phase and it is resectable and it should be definitely removed first by surgery,ablation or radiofrequent procedures. Chemotherapy should be continued after it.
Such small cea levels don't have clinical significance
hi
Detailed Answer:
Sorry,I misunderstood only this part about liver lesion. In this case this is bit more serious. Periaortal Lymph nodes are in most cases inflammatory reactive so it is less common metastatic node change. Also, in case of malignant paraaortal nodes,tumor would already be disseminated to other parts of peritoneum.
Liver metastasis isn't good sign but us is obviously found in early phase and it is resectable and it should be definitely removed first by surgery,ablation or radiofrequent procedures. Chemotherapy should be continued after it.
Such small cea levels don't have clinical significance
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
We are confussed as they r not resecting it or ablating it cuz of the node . They are doing chemo first to target the microscopic cells .
But chemo may nt work n this is risky right as the met can grow. ?
The met is small n on edge of liver .
So is this aortocaval node not likely to be met? But it lit up on pet scan
But chemo may nt work n this is risky right as the met can grow. ?
The met is small n on edge of liver .
So is this aortocaval node not likely to be met? But it lit up on pet scan
Brief Answer:
hi
Detailed Answer:
From my experience and from literature,pet scan in these clinical situation may have lot of false positive results and many benign lesions light up and sometimes even normal tissue. However,since he had dukes c then enlarged lymh node should always be suspicious of the worst and definitive diagnosis should be found. If you ask me, I would do open surgery,resect liver metastasis and take paraortal lymph node biopsy. After this chemo can be continued
hi
Detailed Answer:
From my experience and from literature,pet scan in these clinical situation may have lot of false positive results and many benign lesions light up and sometimes even normal tissue. However,since he had dukes c then enlarged lymh node should always be suspicious of the worst and definitive diagnosis should be found. If you ask me, I would do open surgery,resect liver metastasis and take paraortal lymph node biopsy. After this chemo can be continued
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
I agree . But y U think they don't want to
Do this ?
The saying we doing other way round - chemo
First for the microscopic cells as even if do surgery more mets may appear .
The size of node is 10 mm. Is that large ?
Do this ?
The saying we doing other way round - chemo
First for the microscopic cells as even if do surgery more mets may appear .
The size of node is 10 mm. Is that large ?
Brief Answer:
hi and welcome
Detailed Answer:
This is small sized node and it is not strange that some doctors consider that it could be managed by chemo only. There is no some significant risk that chemotherapy will lead to increased risk of further metastases. So this is one of possible treatment protocols. After chemo,he will do petscan again and it will reveal is there improvement. Worrying for me us this liver lesion that can't be completely cured by chemo so my opinion is that surgery is required mostly because of this liver lesion.
hi and welcome
Detailed Answer:
This is small sized node and it is not strange that some doctors consider that it could be managed by chemo only. There is no some significant risk that chemotherapy will lead to increased risk of further metastases. So this is one of possible treatment protocols. After chemo,he will do petscan again and it will reveal is there improvement. Worrying for me us this liver lesion that can't be completely cured by chemo so my opinion is that surgery is required mostly because of this liver lesion.
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
They say they r targeting the microscopic cells but surely can remove the met bad then do right ?
Chemo can't get rid of liver met right ?
It's still small
N single and I read that for a solitary lesion surgery can be done .
Chemo can't get rid of liver met right ?
It's still small
N single and I read that for a solitary lesion surgery can be done .
Brief Answer:
hi
Detailed Answer:
Yes,chemotherapy is used to kill microscopic cells ,this is true but if there is resectable liver lesion then it should be surgically removed and it can be done during chemo in case of such small liver lesions. Even bigger and multiple colorectal liver metastases can be surgically treated today if there is no infiltration of big liver vessels. So, try to consult oncologist again a bot this. As I said, there is no need to hurry with anything, their opinion of chemotherapy first is reasonable since it may be good to see will these lesions shrink but if he is fit enough to stand surgery of liver resection and node biopsy then it should be considered too.
hi
Detailed Answer:
Yes,chemotherapy is used to kill microscopic cells ,this is true but if there is resectable liver lesion then it should be surgically removed and it can be done during chemo in case of such small liver lesions. Even bigger and multiple colorectal liver metastases can be surgically treated today if there is no infiltration of big liver vessels. So, try to consult oncologist again a bot this. As I said, there is no need to hurry with anything, their opinion of chemotherapy first is reasonable since it may be good to see will these lesions shrink but if he is fit enough to stand surgery of liver resection and node biopsy then it should be considered too.
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
What survival
Like with this situation ? Months , years ? Can he be cured ?
I
Was
Confussed to that it's a small
Single lesion so why not being removed.
But f chemo don't work then it's risky as it can grow and spread right ?
Like with this situation ? Months , years ? Can he be cured ?
I
Was
Confussed to that it's a small
Single lesion so why not being removed.
But f chemo don't work then it's risky as it can grow and spread right ?
Brief Answer:
hi
Detailed Answer:
generally, for Dukes C, 5 year survival is about 35-50% depending on number of lymph nodes that were involved, and 1 year survival is about 80%. however,this is statistics when there is no sign of disease outside the bowel. in this particular case there is liver metastasis(if this is confirmed) and this may lead to bit more poor prognosis,but since it is detected in early phase and seems to be resectable,then it shouldnt affect these survival rates I ve mentioned.
But if aortocaval lymph node is confirmed to be malignant and chemoth dont work then survival rates are almost similar to those in Dukes D and this is about 8% for 5 year survival and 20% for 2 years survival.
in this case only chemotherapy+surgery may improve survival rates and in case of maximal chemotherapy effect,I would say that survuval rates are: 30% that he will live more than 5 years, 50% that he will live 3 years.
hi
Detailed Answer:
generally, for Dukes C, 5 year survival is about 35-50% depending on number of lymph nodes that were involved, and 1 year survival is about 80%. however,this is statistics when there is no sign of disease outside the bowel. in this particular case there is liver metastasis(if this is confirmed) and this may lead to bit more poor prognosis,but since it is detected in early phase and seems to be resectable,then it shouldnt affect these survival rates I ve mentioned.
But if aortocaval lymph node is confirmed to be malignant and chemoth dont work then survival rates are almost similar to those in Dukes D and this is about 8% for 5 year survival and 20% for 2 years survival.
in this case only chemotherapy+surgery may improve survival rates and in case of maximal chemotherapy effect,I would say that survuval rates are: 30% that he will live more than 5 years, 50% that he will live 3 years.
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
Even if node malignant , can it be resected / radiated ? Would that improve survival then ? Also would he still be classed as dukes c?
Brief Answer:
hi
Detailed Answer:
if node is malignant then this is very bad sign and chances that all cells can be killed by radiotherapy or cehmotherapy are very low. surgery is also commonly not possible in these cases. such malignant distal lymph nodes are actually sign that tumor cells are spread through lymphatic system and it is very difficult to achieve complete cure unless in 5-10% of cases where chemotherapy lead to maximal effect.
hi
Detailed Answer:
if node is malignant then this is very bad sign and chances that all cells can be killed by radiotherapy or cehmotherapy are very low. surgery is also commonly not possible in these cases. such malignant distal lymph nodes are actually sign that tumor cells are spread through lymphatic system and it is very difficult to achieve complete cure unless in 5-10% of cases where chemotherapy lead to maximal effect.
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
But if radiologist has stated that the node
Contains mestases , then it must right ? The scans were looked at at the mdt meeting and 1 node and met is confirmed . So would not need biopsy right ?
Contains mestases , then it must right ? The scans were looked at at the mdt meeting and 1 node and met is confirmed . So would not need biopsy right ?
Brief Answer:
hi
Detailed Answer:
sometimes it is hard to determine nature of such nodes since PET scan shows pathologic contrast accumulation which can be caused by tumor but also by inflamamtion,infection or some other diseases. Sometimes there are some specific features of such nodes which can almost for sure indicate malignancy. Of course, in his case, malignancy is the first thing to think of and chemotherapy should be started, even without definite confirm by biopsy. So generally, it doesnt change thing, chemotherapy must be started, if nodes decrease,this is good sign,but liver met should be removed sooner or later. if nodes dont decrase on chemo then this is bad sign and prognosis is poor unfortunately.
hi
Detailed Answer:
sometimes it is hard to determine nature of such nodes since PET scan shows pathologic contrast accumulation which can be caused by tumor but also by inflamamtion,infection or some other diseases. Sometimes there are some specific features of such nodes which can almost for sure indicate malignancy. Of course, in his case, malignancy is the first thing to think of and chemotherapy should be started, even without definite confirm by biopsy. So generally, it doesnt change thing, chemotherapy must be started, if nodes decrease,this is good sign,but liver met should be removed sooner or later. if nodes dont decrase on chemo then this is bad sign and prognosis is poor unfortunately.
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Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
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