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What Does Rise In CEA Level Indicate?

Posted on Tue, 18 Feb 2014

Question: Hi ..I have had a raised cea since my bowel cancer in 2007. I had a resection but it never went back to normal. I have had a pet scan and a hot spot has shown up near my bladder ..I do have spondylitis and a lot of pain in groin and down left flank and in jaw..can spondylitis cause cea to rise currently 16. And I have also taken up smoking again due to stress...they did laparoscopy and found nothing. Colonoscopy clear also..could hot spot be this spondylitis and should I be referred to a rheumatist thank you

Answered by Dr. Ashish Verma (48 minutes later)

Brief Answer: its colon cancer only Detailed Answer: Hi, Thankd for writing to XXXXXXX This is Dr. Ashish Verma, a general surgeon, answering to your query. A cea level of 16 is definitely cancer, in smokers the normal level is upto 5. If after surgery the cea level had not come down to normal, it means that a part of it was left behind... also your pet scan shows hot spots near bladder, and not the spine...meaning the cancer is involving the bladder and surrounding area...this explains your pelvic pain. Also the bladder lies outside the peritoneal cavity and is not connected to the bowel....so laparoscopy and colonoscopy won't see it...you need to get an mri scan for it.... Further management will depend upon the extent for the residual tumor... namely surgery or chemotherapy... I would advice you to get a contrast mri done and show to an oncologist for further management... Hope that i have answered all your queries. If you have further queries, i will be glad to answer them. Regards Dr. Ashish Verma

Above answer was peer-reviewed by : Dr. Prasad

Follow up: Dr. Ashish Verma (11 hours later)

I have had an MRI and says bladder urethra and kidneys normal. No mass seen in pelvis or anywhere. Grade 2 anterooms thesis on L 4 on 5 associated with pars defects and quite prominent end plate inflammatory change. Will ring tomorrow to see if it was contrast or not

Answered by Dr. Ashish Verma (2 hours later)

Brief Answer: i would still say its cancer only Detailed Answer: Hi, CEA levels in rheumatoid arthritis or spondylitis does not differ significantly from the normal population. So a high level of 16 can't be explained on that. So it is highly advisable that you show to a oncologists and start on chemotherapy... as surgery wont help much as your mri is normal. But PET scan is more reliable than an mri. And it is showing uptake...hot spots... Hope, that i have answered to all your queries. If you dont have further queries you may close this discussion and rate the response. Regards Dr. Ashish Verma

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Above answer was peer-reviewed by : Dr. Yogesh D