CA 19-9 Levels - What is High Enough to Cause Concern for Prognosis?

Posted by denip @denip, Sep 30, 2023

Hello,

My husband was recently diagnosed with pancreatic cancer. He presented with bad gastritis and quickly became jaundice. He was admitted to the emergency room where several tests revealed a mass at the head of his pancreas. There does not seem to be evidence of spread. The recommendation is for 3 months of chemo (on 3 different drugs) to shrink the tumor, then surgery to remove the tumor followed by 3 more months of chemo. His CA 19-9 level is over 2,000. Should we be concerned about this tumor marker on its own? I have read conflicting things. Has anyone had success at shrinking the tumor so that it can be removed?

Any insight would be so helpful!

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kakalena | @kakalena | Jul 26 10:43am

My Ca19-9 levels have bounced around between 138 at beginning of gem-brax to 30, to 85 after 6 months. Lots of things can affect your levels. I had mine change by 40 points in 3 days. Also, different readings from different labs. Now I treat it as just another number, but not THE NUMBER.

scooter369 | @scooter369 | Jul 26 5:54pm

In reply to @lynandjohn "I’m 5 years passed my whipped surgery and have been having regular blood tests and ct..." + (show)

As I understand it 34 is a number that can naturally appear in ordinary people without pancreatic cancer. CA 19–9 of 15 should not be alarming but it should be monitored and tracked to see if the trend continues upward overtime. My CA 19–9 marker is at 59 and this has come down from about 1500 last year, which was a peak. I underwent chemotherapy and proton radiation therapy to bring it down from 1500 to 59. God bless you and good luck. 🙏🏼🌈💜🍀

lynandjohn | @lynandjohn | Jul 27 2:07am

Thank you for your reply. I turned down the chemo as side effects seemed horrendous! I’m so pleased I did. Where does the high figures come from ie 1500, 59?

mayoconnectuser1 | @mayoconnectuser1 | Jul 27 1:38pm

In reply to @scooter369 "As I understand it 34 is a number that can naturally appear in ordinary people without..." + (show)

My understanding is that CA 19-9 of 15 means it is below threshold so (likely) no pan can. A reading decrease to 8 does not really mean anything. Nor, at least from what I can tell, does an increase to 16, or 17 - since one is still below the threshold for this test.

Now, if you have a test and it is 45, then your likelihood of pan can is high (other things can cause this, too), and if it increases in two months to 4500 it means something like the tumor is growing. If however, you have two more CA 19-9 tests over the next two months that come back at 20 and 22 ... it could mean ... well, you can see why it is not used much as a screening tool.