AboutClaes-Gustaf Nordquist, M.D. Expertise I`m a doctor of medicine and a specialist in radiation therapy and medical oncology. I have long experience with regards to this cancer.
Experience I'm a Doctor of Medicine. Licensed/certified physician and surgeon and specialist in Medical Oncology and Radiation therapy in Sweden, Denmark, Finland, Iceland, Norway and the European Union. Background in Radiation Therapy, Medical Oncology, Radiation Protection, Nuclear Medicine, Diagnostic Radiology, Gynecological Oncology, Clinical Pathology, Clinical Cytology,Hematology and Internal Medicine. M.D. from the faculty of medicine, Royal Karolinska Institute, Stockholm, Sweden. Have also been an exchange student at the Hebrew University, Hadassah Medical School, Jerusalem Israel. Former medical consultant, Swedish National Board of Radiation Protection. Former Police Surgeon and Medical Examiner, Stockholm Police Department. Former Chief Medical Officer, The Royal Guards, The Royal Horse Guards and the Royal Household Brigade, Royal Swedish Army Medical Corps. Now in private practice in Stockholm, Sweden.
Question My father is 75 years old was diagnosed with colon cancer (poorly differentiated adenocarcinoma, tumor size 4 cm)) in August 2007. CEA was 3.43 at that time (normal reference 3.0). In September 2007 he had a surgical resection to remove the tumor, biopsy of resected portion indicated Stage III with 3 out of 11 lymph nodes positive.
Considering his age, and his other existing medical problems, as also the side effects of chemotherapy, my father declined to go for adjuvant chemotherapy.
He has been taking some alternative medicines (homepathy, etc) in the mean time. 6 months after surgery his CEA level came down even more - 3.04 (normal reference 3.0). And nine months after surgery, i.e. in June 2008, his CEA level came down to normal - 2.75 (normal reference 3.0).
Now 10 months have passed since his surgery. On about 2 occasions, once after about 2 months of surgery, once after about 6 months, he had terrible pain in abdomen resulting from constipation, which needed to alleviated through pain killers and laxatives. CEA was around normal on both these occasions.
Currently, over past 2 days, he has started having that pain intermittently. CEA was last checked 1.5 months back as mentioned earlier is normal.
One thing I need to mention here, his Liver funtion tests done after every 3 months have been showing a rising bilirubin level (unconjugated), and in the last LFt done 1.5 months back, showed bilirubin level, as well as SGOT, SGPT readings well above normal.
My question is, since his serum CEA levels are normal, is it possible that he may have had a metastasis or recurrence in the colon, liver or else where, which is causing this abdominal pains?
Answer Yes unfortunately it is possible. CEA is not a sure method. In this case since it NEVER showed any increased levels even when we know he had his cancer that even had spread to a few lymph nodes I would even state that we KNOW that it is without any value in his case! I do suggest urgent ultrasound, CT & MRI scans of his liver combined with needle biopsies of any lesions seen. I deplore the fact that he did not have chemo therapy directly after his surgery. A stage III (3) tumor - on top of it a rather big poorly differentiated (more malignant) cancer - SHOULD have had it THEN! Then was the time for it! If cancer from his colon tumor is found in his liver he is now a stage IV (4) cancer case which in principle at present is incurable. That does not mean that it is untreatable. But no cure can be expected. Chemo therapy may however slow down the process. I'm sorry I have nothing better to tell you!
