Elderly Mom, CEA Test

[nojoking]

My mother was diagnosed with colon cancer 14 yrs ago.  A portion of her intestine was removed and no chemotherapy was required. She has regular colonoscopies, first annually, now every 3 yrs.

A few months ago she moved from CT to ME to live w/me as she ages.  She takes good care of herself, never smoked, drank, etc.  Naturally, she has a new doctor and a physical and blood work were performed including a CEA test.  Upon the return visit for test results the doctor noted that the CEA results were elevated (10.0A) and suggested we visit an oncologist.  I was concerned but was told that it was just precautionary measure.

I don't understand. Why does she need an oncologist if she doesn't have cancer?  My father died of colon cancer a year before she was diagnosed.  He had an oncologist, but he was very sick.

Now my mom is 84.  I don't know how to explain the trip to the oncologist without worrying her. What should I say?  Maybe you have cancer again, maybe not?  What can I do to try to reassure her? What are the chances based on the CEA results?
Thank you so much.

[michelle1128]

as what you said on your post, your mom had never gone to chemo and yet she still is surviving after 14 years from colon cancer. it seems to me that by not going through the ordeal of chemotherapy she had extended her life far beyond the 5 years "waiting period" of some cancer patients who had gone through extensive deals of treatments. how I wish I would be able to reach that 14 year remission as your mom's. btw, had she had CEA testings before during that 14 year span?

[Fernando Roque, MD]

Hi.  An elevated CEA result (at least 5 ng/ml) is not a sure indication of the presence of cancer.  However, since your mother had a previous history of colon cancer, a CEA value of 10.0 should make us highly suspicious of colon cancer recurrence.  When you go to the oncologist, what the doctor is likely to do is to perform additional tests (e.g. abdominal CT scan, colonoscopy) to look for evidence of cancer.  You can reassure her by saying that at this point, we really don't know if she has cancer again.  But because she has an abnormal CEA, she needs to be examined by the doctor to investigate what's causing this. You can tell her that CEA can also be elevated in non-cancerous pancreatic and liver disease, as well as in cases of ulcerative colitis.