CA 19-9 and pancreatic cancer: What do the numbers mean?

My husband was diagnosed in Nov 2017. He start chemo in Dec 2017. He had 8 months of chemo and 6 weeks of radiation and a chemo pump. Our surgeon at Mayo Rochester wanted the CA 10-9 at 200 or lower before he would perform the Whipple. In Nov 2018 the Whipple was done at mayo in Rochester. It was a success. He handle the chemo and radiation very well. Yes there were times that he felt yucky but knew he had to keep on pushing!!! And he did. His CA19-9 continually went down throughout treatment. Maybe not as fast as we would have liked but it did go down. That number is not the only piece of the puzzle that we need to look at but in his case it was a very important piece. His tumor did shrink also with the chemo/radiation. He had 9 months after the surgery with no chemo/radiation and no signs of any new cancer. That was until Feb 2019 when on a chest X-ray they found nodules on his lungs. Further imaging and a biopsy confirmed it was the same cell make up as the pancreatic cancer. So now it as metastized to his lungs. So more chemo. It has been a journey but with many prayers and support and the great Doctors and Mayo Rochester things are looking up.

Believing in healing

My wife's ca19-9 dropped consistently throughout 9 folfironox treatments and further after sbrt prior to surgery. During surgery, the biopsies and margins were all negative. The surgeon said that the tumor was fully necrotic and no further chemo or radiation required. The first ca19-9 after surgery was under 30. In 3 ca19-9's in the 5 months since surgery it has risen a bit to almost 60. Her MRI's and CT scans have all been clear. The oncologist says that her liver numbers are still far out of whack from the chemo and that has an effect on the ca19-9 readings. Assuming the oncologist's assessment is accurate, liver function also impacts the ca19-9 reading.

This is interesting information. Thank you for sharing.

I don’t believe CA19-9 values have any meaning. When I was first diagnosed with stage 1 pancreatic cancer my CA19-9 was 256. After 8 rounds of chemo and radiation my CA19-9 is 13.8, but yet I now have stage 4 with mets to the liver, tumors continue to grow. I, like most of you, was encouraged by the counts, but to no avail.

It’s very good news, you want to see the number trending down. My husbands CA19-9 is very indicative of how the chemo is working.

Hi @pepaw, please accept my belated welcome. You're right CA19-9 values are only one measure. Their value has to be substantiated by further investigations, and in your case the value was actually deceiving. Can you share how the mets was discovered?

prior to scheduling Whipple surgery, I had CT scan that showed three areas of concern in liver. Then had MRI and PET scan followed by EUS with liver biopsy. Now I am on another chemo regimen with another CT in October to assess.

Hi @pepaw, I thought I'd check in with you. How is chemo going? Have you had the CT scan this month?

Chemo is going very well. My CA19-9 continues in the normal range. My next scan is in 2 weeks . Waiting to see if the chemo is working is very hard. In the meantime, i’m investigating clinical trials.