Elevated CEA Levels: Should You Be Concerned?

Q: Elevated CEA Levels: Should You Be Concerned?

Hello： An elevated CEA (Carcinoembryonic Antigen) level can occur in various malignancies such as colorectal cancer, lung adenocarcinoma, breast cancer, cervical cancer, ovarian cancer, gastric cancer, and pancreatic cancer. <br>Additionally, other non-malignant conditions like c

The CEA level is 17.78?

Hello Doctor, five years ago I was hospitalized due to duodenal obstruction and was found to have a 4.5 cm benign cyst in the tail of the pancreas.
I underwent surgery to remove the affected part of the pancreas that same year, and I was hospitalized for 35 days for intravenous nutrition to recover from the intestinal obstruction.
This May, I experienced discomfort and significant weight loss, so I went to the hospital for blood tests, abdominal ultrasound, and abdominal CT scans.
The CT results indicated a recurrence of intestinal obstruction, but it is not complete.
The doctor advised me to gain some weight to increase my body fat percentage, and hospitalization was not necessary.
The abdominal ultrasound was normal, and the blood tests were generally normal (including CA-19-9), except for a significantly elevated CEA level of 17.78.
The doctor mentioned that the elevated CEA level is not a concern, so no further tests were conducted.
I would like to ask you, is a CEA level greater than 10 generally associated with a higher probability of cancer? Should I seek further evaluation at another hospital? Thank you.

Xiao Xue, 40~49 year old female. Ask Date: 2016/12/22

Dr. Xie Rongyuan reply Internal Medicine

Hello: An elevated CEA (Carcinoembryonic Antigen) level can occur in various malignancies such as colorectal cancer, lung adenocarcinoma, breast cancer, cervical cancer, ovarian cancer, gastric cancer, and pancreatic cancer.
Additionally, other non-malignant conditions like chronic bronchitis, peptic ulcers, pancreatitis, hypothyroidism, liver abscess, and alcoholic cirrhosis can also lead to increased CEA levels.
Therefore, the sensitivity and specificity of CEA are not optimal, making it unsuitable for early cancer screening.
If you have concerns, it is advisable to follow up with a hospital for further examination.
Thank you for your message!

Reply Date: 2016/12/22

More Info

Elevated levels of Carcinoembryonic Antigen (CEA) can indeed be a cause for concern, particularly when they are significantly above the normal range. CEA is a glycoprotein involved in cell adhesion and is primarily used as a tumor marker in various cancers, especially colorectal cancer. However, it is important to understand that elevated CEA levels are not exclusively indicative of cancer; they can also be influenced by a variety of non-cancerous conditions.

In your case, with a CEA level of 17.78, it is understandable to feel anxious, especially given your medical history of a benign pancreatic cyst and recent health issues. Generally, a CEA level above 10 ng/mL raises suspicion for malignancy, but it is not definitive on its own. Many factors can contribute to elevated CEA levels, including smoking, inflammatory diseases, liver disease, and even benign tumors.
Given your history of gastrointestinal issues and the recent findings of a recurrent intestinal obstruction, it is crucial to approach this situation with a comprehensive evaluation. While your doctor may have indicated that the elevated CEA is not a concern, it is essential to consider the context of your overall health and symptoms. The fact that you are experiencing significant weight loss and discomfort warrants further investigation.

Here are some recommendations based on your situation:
1. Seek a Second Opinion: If you feel uncertain about your current doctor's assessment, it is perfectly reasonable to seek a second opinion from another healthcare provider, preferably a specialist in oncology or gastroenterology. They can provide a fresh perspective and may recommend additional tests or imaging studies.

2. Further Testing: While your doctor may not see an immediate need for further testing, you might want to discuss the possibility of additional diagnostic procedures. This could include a PET scan, which can help identify areas of increased metabolic activity that may indicate cancer, or a colonoscopy if there are concerns about colorectal cancer.

3. Monitor Symptoms: Keep a close watch on any new or worsening symptoms, such as changes in bowel habits, abdominal pain, or any other unusual signs. Documenting these changes can provide valuable information for your healthcare provider.

4. Lifestyle Considerations: Since you mentioned significant weight loss, it may be beneficial to consult with a nutritionist or dietitian. They can help you develop a dietary plan that supports your health and may assist in weight gain, which is crucial for your overall recovery.

5. Regular Follow-ups: Ensure that you have regular follow-ups with your healthcare provider to monitor your CEA levels and any other relevant markers. This will help track any changes over time and allow for timely interventions if necessary.

In conclusion, while an elevated CEA level can be concerning, it is essential to interpret it within the broader context of your health. Engaging in open discussions with your healthcare team, seeking second opinions, and advocating for further evaluations can empower you in managing your health effectively. Remember, early detection and intervention are key in addressing potential health issues, so do not hesitate to pursue the necessary steps to ensure your well-being.

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