[cancer] And yet another potential problem rears its ugly head

Yesterday I got my CEA (carcinoembryonic antigen) results from Thursday’s bloodwork. They are 1.9 ng/mL (on a scale of roughly 0-10). A month ago, at my first post-op assessment, they were 0.5. That’s a quadrupling of the value in four weeks. CEAs are a protein marker that can indicate the presence of active tumors given my kind of cancer.

The level itself is not too alarming in principle, as anything below 3.1 is considered within normal range. There are non-cancer processes, including inflammatory bowel problems, that can produce measurable CEA levels. The trend, however, concerns me a great deal. And historically, my personal non-cancer baseline values are down around 0.2 or 0.3, so even in an absolute sense these numbers are a potential issue despite the clinical guidance.

Here are some graphics that may help visualize this.

cea_levels_2011_09

This one shows the trend line since my pre-op blood test in July. You can see the recent uptick. The pink line at the top of the chart was superimposed by me to show the 3.1 cutoff.

cea_levels_2_2011_09

This graphic shows the trend line since last November. You can see the appearance of the tumor, the drop-off once chemo starts, the drop-off from surgery. I’ve annotated it in orange to show some of those points, and again included the pink reference line for the 3.1 cutoff.

One potentially benign explanation is measurement error and/or normal fluctuation, which I find unlikely given a swing of 1.4 points on a 10 point scale. Another potentially benign explanation is a CEA spike based on my recent lower GI problems. That’s a bit more likely, though I’m unsure of the mechanism. However, given my history, you can imagine my mental and emotional state right now.

My oncologist tells me that as my levels are still within normal ranges, she is not concerned. We’re going to wait until November for the next planned CT scan. I am not especially reassured as (a) I can read a trend line and (b) the current values are high compared to my historical values, regardless of the clinical cutoff for normal range. Obviously the next couple of blood tests will tell us a lot.

In any case, even if this entire business is a false alarm, this is just another reminder of my essential helplessness in the face of this disease. Coming hard on the heels of recent events, I’ve been taking this one pretty tough.

8 thoughts on “[cancer] And yet another potential problem rears its ugly head

  1. Laurie Mann says:

    I’m sorry to hear the levels are up. It’s always frustrating and scary.

  2. My historical body temperature used to be 97.6, almost unvariably. It was just 98.3, which the nurse thought seemed perfectly normal, and I thought was the beginning of a fever. She’s probably right.

    Yours probably is, too. Even if it’s historically weird for you, they do this all day, every day, with hundreds or even thousands of people over the years.

    I know that doesn’t really help you chill out, but I had to point it out anyway just in case she’s reading your journal. I want to suck up to her because I heard she’s a tiger in the sack.

  3. Matte Lozenge says:

    It’s just hard to be worrying about stuff like this and a lot easier for someone who’s not personally involved to think the trend can just as easily change and go down or stay flat. If there’s anything I could wish you, it is some calmness in your emotions.

    Oh heck, if there’s anything I could wish you, it is a full and fast recovery!

  4. Charlie says:

    Jay, I don’t comment often on your blog but I follow your posts and think about you often. Your ability to focus your thoughts and emotions this way, and then share them in public, as a record of your experience, is remarkable. I’ve learned more from it, about living and writing, than I would have ever expected, primarily from your example and in particular your ability to transform what could be an unimaginable situation for most of us into something tactile and quotidian, made up of minute surmountable moments. It feels like I’ve received an unexpected and undeserved gift, and one I appreciate, perhaps even need, but one I would rather not have only because of what you have to go through to give it. Thank you for it, all the same.

    1. Jay says:

      Thank you, Charlie. Your words have very much moved me.

  5. …Now I really hope she ISN’T reading this. hahaha!

  6. Cora says:

    I’m still keeping my fingers crossed for you.

  7. Stevie says:

    Jay

    There is little to be gained, and a great deal to be lost, by second-guessing your oncologist on this. You do not possess the skill set which would enable you to comprehend whether this is significant, and you are too emotionally wound up in it to stand back and recognise that fact. That’s one of the reasons why doctors don’t diagnose and treat themselves.

    As an alternative you could sacrifice a chicken and examine its entrails; that way you at least get dinner out of it. And, judging from the amount you have accomplished since you put this post up, you may be emotionally down but as a writer you are most definitely not out…

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