Why are cancer markers 15-3 and 19-9 rising while CA-125 isn’t?

@greatgrandma2025
that's wonderful news

@mtstack This is why I don't understand why they want me to go on such aggressive chem. My
primary expressed that to me on my recent visit. Again he is not an oncologist. Because of a few other health issues I need taken care of I have refused. The three doctors, oncologist, Chemo, & radiologist don't seem to be on the same page. My experience made me feel this was my only route. On my first 3 month app. he wasn't aware I had Not started chem. On the next appt he asked the PA to come in and she was telling me I need to do this as she is trying to sell it to me. Chemo called me several times a week about starting when I went in for consultation I told them I am researching it I will let them know this has been four months. Radiologist was pressuring me the same way during that time. I finally agreed to a consultation with the radiologist and I made it clear that I am not starting radiation until after chemo if I decide to do it. He should have known this. Then he ask for a physical at that consultation and wanted to put a port in my neck and during the exam he placed two gold markers in. He said we are just glamming up your popo? He was not the Dr. I was going to be seen but I guess training a new Dr. All this after my CT scan was good and every doctor says I'm in excellent health. I'm concerned, but afraid to move forward yet. I'm going to be 81 soon. Right now I have vein problems and did explain it to my oncologist and asked for a referral but he referred me to my primary Dr. Here is the other issue my Primary is in Wilmington health and all my three doctors are in Novant Health. I hope my concerns stay here as these people have my life in their hands. My second opinion in the beginning recommend Lesser Carboplatin and no Taxol. The oncologist recommended Taxol/+ EBRT and I asked about immunotherapy. Sorry a venting day. My veins are leaking into my legs causing blisters and swelling. I have a serious issue with incontinence and a nurse said I needed to see a urologist another referral. Thank you for your replies I needed a moment to reflect on this situation as I may be over reacting. This on top of my personal life issues are overwhelming.

Rising tumor markers can definitely be confusing, especially when some go up and others don’t. Each marker reflects different tissues and different types of inflammation, and they rarely move in perfect sync.

What each marker generally reflects:

CA 15-3 – most commonly associated with breast tissue, but can rise with benign conditions (liver issues, inflammation, even certain medications).

CA 19-9 – linked mainly to the pancreas, biliary system, and GI tract, but also rises with non-cancer causes like gallstones, pancreatitis, liver disease, or even blocked ducts.

CA-125 – more tied to ovarian and pelvic tissues, but can rise with endometriosis, infections, or fluid around the lungs/abdomen.

Why some rise while another stays normal

1. They aren’t universal cancer indicators
Each marker is connected to different types of cells. If something (cancerous or not) is irritating breast, pancreatic, liver, or GI cells, CA 15-3 and CA 19-9 can rise without affecting CA-125.

2. Benign conditions commonly raise CA 15-3 and CA 19-9
Liver irritation, pancreatitis, biliary obstruction, hepatitis, and even heavy inflammation can make these two increase. CA-125 doesn’t usually respond to those.

3. CA-125 is sensitive to pelvic/gynecologic processes
If there’s nothing happening in the pelvis, that marker may stay normal even when others shift.

4. Lab variability and normal fluctuations
Tumor markers can bounce around due to lab differences, recent infections, smoking, or even recent procedures.

5. Cancer markers are not reliable alone
Doctors treat them as “signals,” not diagnoses. It’s very common for one or two to rise without any actual cancer appearing on scans.

What usually happens next medically:

Rechecking the markers after a few weeks to confirm the trend.

Looking for benign causes (bile duct issues, gallbladder disease, pancreatitis, liver function problems).

Imaging only if the pattern stays persistently elevated.

A reassuring point!

It’s actually more common for CA 19-9 and CA 15-3 to rise from non-cancer causes than from cancer—especially if:

the rise is mild to moderate.

imaging has been normal.

CA-125 stays normal.

@greatgrandma2025 Chemo after surgery is to clean up any cells that escaped after or during surgery. i was going to have surgery and was told that I would have chemo after 3 weeks to prevent spread.
i decided against surgery as they would not be able to remove all the tumour, and if they took part i would risk the cancer spreading.
i dont know if I made the right decision. I feel that now I am waiting to die. I amnot ready to leave as I have things to do first.

@maghera Welcome to Mayo Clinic Connect and to our Gynecological Cancers Support Group.

May I ask if you have been diagnosed with a gynecological cancer and if yes, what kind? Ovarian? Endometrial?

I don't know that any of us are 100% confident with decisions we've made to treat our respective cancer diagnoses. Many of us have sought out second or third opinions to help us decide. And yet we may still wonder if we made the right choice for ourself.

Are you still in active treatment with chemotherapy?

@maghera Hi there,
I had a hysterectomy to remove tumors. It was a difficult operation due to severe stenosis from previous radiation 14 years ago for another type of cancer. Surgeon couldn't get it all. proceeded to chemo therapy and it zapped the remaining tumor and newly formed tumor in the vagina cuff. It also reduced pelvic lymph nodes to "normal" size. Today I'm NED. But, I still need the treatments for an undetermined amount of time. The miracle treatment is Enhertu. At first I had paclitaxel/carboplatin, which was relatively useless: had recurrence 4 months after treatments.
All this is to say that surgery will reduce the tumor and presumably make less work for the chemo treatments that follow. Some people report getting chemo before surgery to reduce the tumor, and then after surgery to "clean up" the residual tumor and/or circulating cells (many, most? of which cannot be seen on CT scans, btw).
Hope this helps.

@i was diagnosed with stage 3 Ovarian cancer in August.
I have had 6 rounds of chemo. My market has decreased to 30 from 80.
Surgery was my next treatment, but all the advice I got said that it would not improve my life, so I decided against it.
Was I right?

@maghera This was a very difficult decision for sure. Please keep researching your situation. There are many other treatments that my help. Focus on the things you need to do. Prayer helps and a second opinion is always valuable. I will be thinking positive thought for you!

@naturegirl5 111C2 endometrial cancer. Never took the treatment as my scan show no cancer at this time< On a three month testing with my Oncologist. Last one February 13th, three more months to try and get things done in case and prepare my family just in case. Some days I get overwhelmed but other days it energizes me to stay more positive. C 125 is confusing at times, but are in the normal range.

@maghera I can't say. If the advice you got was from doctors and medical professionals, then I'd say go with that. They know what they're doing. Put your trust in them and believe. The advice I got was to get a 1) hysterectomy and 2) go straight to chemo. The surgeon and my oncologist said that further surgery would result in morbidity (bad medical outcome.) So, systemic therapy was the only way forward. But I still had the majority of the tumor removed before that through the hysterectomy.
Again, trust your doctors.