CEA > 400, asymptomatic - 1270017

beorht
Posts:2

Hello! I'm writing not with a problem of my own but rather about my dad.

For the last 3-4 weeks my father (67 years old) has had diarrhoea which started to slowly disappear after metronidazole treatment was administered. A USG examination of the abdomen revealed two cysts in the outer parts of the kidneys and a shadow with a hypoechoic capsule (circa 2 cm) on the liver. No enlarged lymph nodes.

Blood examination yielded the following results: blood morphology - no abnormalities; ESR - 8; slightly elevated total cholesterol level; glucose - OK, creatinine - OK; Liver function test (ALT+AST+ALP+GGTP+bilirubin+albumin) - OK; PSA - OK; AFP- OK and CEA 404 .

My father has no previous history of cancer, nor have I heard about cancer in our family. Apart from the diarrhoea I mentioned there hadn't been any abdominal or other symptoms whatsoever. He quit smoking a year ago - not because of health-related issues but because he hated the fact he was addicted to cigarettes. The only stomach-related problem he has had is heartburn after eating certain types of food.

My question is: is an acute bowel infection capable of raising CEA to the aforementioned levels or is it more likely that it's cancer? Let me stress that apart from the diarrhoea which, apparently, is of bacterial origin he's always been asymptomatic.

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JimC
Posts: 2753

Hi beorht,

Welcome to GRACE. I'm sorry to hear of your father's symptoms, and I hope they continue to reduce.

CEA does not tend to be a reliable indicator of cancer, especially when used in the context of diagnosis, as many conditions including inflammation and infection can cause it to rise. It tends to be most reliable in patients whose CEA has already been shown to track the course of cancer.

As Dr. Pennell has stated:

“CEA is a blood test and is called a “tumor marker”, but in truth is very non-specific and can be elevated in benign conditions (even just with smoking). It can also be completely normal despite having lots of cancer.

It is used often in patients with colon cancer, where is can be helpful in tracking the disease if it was elevated prior to surgery and then goes down after surgery. In these cases, if it starts to rise it can help guide us to look for an early recurrence.”

JimC
Forum moderator

beorht
Posts: 2

Hello again JimC!

Thanks a lot, you lifted my mood. In fact, before writing to you I did a small research and read similar things about CEA going up and down due to various reasons and I found out, just as you said, that the discussion on the matter is still inconclusive. What I read, however, is that an 'elevated CEA' would be something like 10, 20... or 40. That's why I'd like to know if you've heard (or maybe you know somebody that has heard) about CEA going not two or three but almost 100 times above the norm due to, say, bowel infection or a collection of simultaneous infections.

I'll be very happy if you could refer me to some sources or simply ask around because I'd like to avoid putting my dad through unnecessary CT and similar examinations without sufficient reasons. To my best knowledge aggressive diagnostics can contribute to the development of cancer in otherwise healthy people so I'd like to do only the things that are completely necessary. Thanks in advance!