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What Causes Slightly Elevated CEA Level After Bowel Cancer Surgery?

Posted on Sat, 28 Jun 2014

Question: My father had surgery march for bowel cancer .......he was a dukes c1. His cea blood test in may was 3. But the cea reading in XXXXXXX was 4. Does this mean a reoccurence or may b cancer cells lurking about? We are quite concerned by this

Answered by Dr. Monish De (49 minutes later)

Brief Answer:
Colonoscopy

Detailed Answer:
Hi XXXXXXX
The normal range of CEA varies from 2.5 to 5 ng/mL.
Your fathers current CEA is 4 ng/ml meaning it is still within normal level.
You do not need to be concerned about it right at this moment but i would suggest u do a colonoscopy test exactly 1 year after surgery to check for recurrence.
You now only need to do a CEA blood test 3 monthly and if the CEA level goes on increasing above 5 ng/ml with symptoms like pain abdomen,per rectal bleeding or altered bowel habits then u need to a CT scan of whole abdomen.
Hope I have answered your query. If you do not have any clarifications, you can close the discussion and rate the answer. Wish you good health.

Regards
DR DE

Above answer was peer-reviewed by : Dr. Vaishalee Punj

Follow up: Dr. Monish De (16 minutes later)

The prob is he refusing chemo so thats why we more worried as cea increasing ? But in 1
Month can it increase from 3 to 4?

He does smoke

Answered by Dr. Monish De (53 minutes later)

Brief Answer:
Adjuvant chemotherapy

Detailed Answer:
Your father has dukes c1 bowel cancer meaning stage 3A cancer.
When discovered at stage 3A, colon cancer has reached the middle layers of the colon and spread to as many as three nearby lymph nodes.
Treatment for stage 3 bowel cancer generally consists of a surgical resection followed by chemotherapy.
This chemotherapy is called adjuvant chemotherapy which kills the remaining cancer cells that may have left behind even after surgery.
Since CEA has increased by 1 in 1 month your father needs immediate adjuvant chemotherapy to prevent recurrence.
Get in touch with oncologist in your hometown for chemotherapy

Regards
DR De.

Above answer was peer-reviewed by : Dr. Vaishalee Punj

Follow up: Dr. Monish De (1 hour later)

He is being fussy and saying dont want chemo. He shud have it right.?

Should we also request a pet scan as operation was may?

They have offered oral form chemo tablets which he refusing

Answered by Dr. Monish De (10 minutes later)

Brief Answer:
Adjuvant chemotherapy a must

Detailed Answer:
Hi
Stage 3 bowel cancer will need adjuvant chemotherapy be it injectable or oral tablets.
So i would advise some form of chemotherapy for your father otherwise chances of recurrence are high.
PET scan at this stage is not necessary.
If you do not have any clarifications, you can close the discussion and rate the answer. Wish you good health.

Regards
DR De

Above answer was peer-reviewed by : Dr. Raju A.T

Follow up: Dr. Monish De (4 hours later)

So should cea not go up by 1 point in 1 month ?

Answered by Dr. Monish De (14 hours later)

Brief Answer:
Adjuvant chemotherapy

Detailed Answer:
Hi
Your father CEA was 3 in may and and in XXXXXXX it is 4. So exactly in 1 month CEA has gone up by 1.
The standard treatment protocol for stage 3 bowel cancer is surgery followed by adjuvant chemotherapy.
So if a person refuses chemotherapy then their will be recurrence and your fathers CEA has already started increasing .So i recommend atleast 6 months of chemotherapy so that the remnant cancer cells which are still their are killed.
Chemotherapy after surgery should be started within 8 weeks after surgery. Delaying the initiation of adjuvant chemotherapy for more than 8 weeks after surgery significantly increased chances of recurrence.
If you do not have any clarifications, you can close the discussion and rate the answer. Wish you good health.

Regards
DR De

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Above answer was peer-reviewed by : Dr. Prasad