CEA Fluctuations

[Believeit]

My husband has just completed his 3rd cycle of Carboplatin and Etoposide for prostate cancer liver mets.

Before the first cycle his CEA was 38 (should be <5) This number is being used as baseline.

After 1st cycle it was 30.3 but after his 2nd cycle it rose to 32.7. Is it normal for CEA to fluctuate? We were hoping it would decrease with each cycle or is it still ok just to be below baseline?

His PSA decreased from 0.72 to 0.68 but I understand that this is not as important anymore as the cancer is now small cell.

Scans are in the next 2 weeks so we will know then if chemo is working or not.

Any advice would be greatly appreciated.

[Ahk1]

although my CEA is not as high as your husband but it’s very concerning to me. No one seems to know why it’s high and above the normal level. did your husband do the colonoscopy? One of my MO mentioned, since I have Mets in the abdomen area, the cancer there causes inflammation and that makes the CEA marker goes high. How the small cell was diagnosed?

[Believeit in reply to Ahk1]

My husbands has mets on his liver. (This is the reason his CEA is high) They were able to carry out a biopsy on the largest one which showed small cell type. We are hoping the chemo mix of Carboplatin and Etoposide will keep the cancer from progressing. He also has bone mets but they seem to have remained unchanged.

He did have a colonoscopy which was clear.

He is scheduled for a PSMA scan (and hopefully an FDG scan) at the end of August to see if he would be suitable for Pluvicto.

Thank you for your reply and I hope you get some answers as to why your CEA is rising. It can be frustrating not know what’s happening.

[j-o-h-n]

For those who care CEA = Carcinoembryonic antigen

CEA is a type of protein in the body. Babies in the womb have high levels of it. After birth, levels drop way down. Healthy adults have a very low level, but some types of cancer can cause it to rise.

Your doctor can use CEA as a “marker” to learn more about your cancer.

The test can often help predict whether the cancer is growing or spreading to other parts of your body. It can also help tell how well your treatment has worked and predict your outlook.

Your doctor might give you a CEA test if you're diagnosed with one of these cancers:

Bladder

Breast

Colon and/or rectal

Lung

Ovarian

Pancreatic

Stomach

Thyroid

When Is the Test Done?

Doctors don't use the CEA test to make a first-time diagnosis of cancer. This test isn't an accurate way to screen for it because many other diseases can cause the levels of this protein to rise. And some people with cancer don't have high CEA levels.

This test can help your doctor plan and monitor your treatment once you know you have cancer. You might get the test:

After your diagnosis to help your doctor find the right treatment

During treatment to see how well chemotherapy, radiation, surgery, or other therapies have worked

After treatment to help find out whether the cancer has come back.

Good Luck, Good Health and Good Humor.

j-o-h-n Saturday 08/05/2023 2:45 PM DST

[Believeit in reply to j-o-h-n]

Thanks for explaining CEA j-o-h-n, I should have done that. I don’t think too many people on this forum have prostate cancer liver mets that are neuroendocrine. Not sure if CEA rising after 2nd cycle of chemo has any relevance as it is still below baseline of 38?? Scans scheduled in next couple of weeks. Hopefully will show chemo is working. 🤞. Thanks again. Best wishes.