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[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.


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.


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.

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