CEA tumor marker

[Benson]

I was diagnosed with colon cancer (cecum) last year and it had
gone to my liver.  The colon tumor was small and had not gone
out of my colon....the liver tumor was small and right on the
edge (2cm) I think.  The Dr. removed both and was optimistic.
I started chemo and my original number of 9 went down to 6 and
then to 2 and 3 almost immediately.  I had my last tumor marker
in September.  I had another this last week and it was 19.9 and
a backup the next day and it was 20.2.  I go in next week for
a full body bone and body scan.  I did have a pet scan in august
which was clear.

My question......I am having some severe bleeding in my gums...
probably periodontal desease.  I know inflammation can affect
this number...can severe periodontal disease affect the cea tumor
marker?

Thank you.     Judy

[surgeon]

CEA is far from a perfect tumor marker, and its use in the management of colon cancer remains controversial. It can elevate for various reasons; I'm not aware of gum inflammation being on the list, but certainly other gut inflammatory processes can do it. And your example is not unusual: what to do when the number rises, especially if testing finds nothing specific. Give more chemo? Wait? Is there a different outcome if there is recurrance but it's not detected and treated until later? The questions remain unanswered at this stage of our understanding.

[Deb195446]

A related discussion, Tumor marker was started.

[Charlee2]

A related discussion, CEA marker was started.

[Summer8935]

A related discussion, Rises in CEA and Negative PET-scans was started.

[lisamd5]

Recently my CEA was test and came back 12.5.  I was being watched and tested for a MPD witch a bone marrow biopsy done.  The blood disorder was ruled out.  Now the doctor is concearned by the CEA number and has ordeded some additional tests.  What tests should I be having?
lisamd5

[Kevin Pho, MD]

I am not aware of gingivitis increasing the CEA levels - but it may be possible, since as you said, inflammation can raise the markers.  

That being said, this test has a specificity of between 75 and 98 percent in studies.  This means that when the CEA is positive or rising, there is a 75 to 98 percent chance that colon cancer is present.  However, this leaves room for other causes that can raise the levels.  

Followup with your personal physician is essential.

This answer is not intended as and does not substitute for medical advice - the information presented is for patient education only. Please see your personal physician for further evaluation of your individual case.

Kevin, M.D.
Medical Weblog:
kevinmd_b

[Benson]

This is an addition.  I went to the DEntist today and I had
moderate gingivitis....no periodontal desease.  He said this
inflamation can get into the blood stream.  My question is the
same can that much inflammation affect the cea?  All of my
blood test (except that one) were normal....I feel and look
fine.  Drs. exam was good....no lymph node involvement.

Thanks again, Judy

[Benson]

Thank you for your comments.  I read somewhere that if the
cecum was removed, there could be bacteria buildup.....othere
than that remote possibility, I have not had any fever, antibiotics, I don't smoke and I have not been around smokers.

I am, of course worried, and just hanging on to straws until
monday.

I would like to know if that is unusual to come up from a count
of 4 to 20 in a little less than two months.

Thank you for your time....Judy