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

Which chemo is he getting? How sick has it made him? Does he have "good days" between chemo treatments?

They are tumor markers and show growth of tumors. Mine barely went up but most people have hundreds and thousands.

My dad's CA 19-9 level was 4999.9 when he was diagnosed with cancer, after 6 chemo the CA 19-9 level went down to 258 now after 1.5 months CA 19-9 level again increased to 450 . Does that mean that he can is coming back?

Hi @palvi,
Here's information about Cancer Antigen 19-9 (CA 19-9) https://labtestsonline.org/tests/cancer-antigen-19-9
CA 19-9 is primarily used to monitor response to pancreatic cancer treatment and to watch for recurrence. In the section called "What does the test result mean?" it states:
"Levels of CA 19-9 that are initially high and then fall over time may indicate that the treatment is working and/or that the cancer was removed successfully during surgery. Levels that remain high or rise over time may indicate that treatment is not working and/or that the cancer is recurring."

It is really important that you check with your father’s cancer care team before assuming that his slight rise in levels mean recurrence. The CA 19-9 test is only one test. To confirm a recurrence, they would perform further testing. It is possible that this rise is an expected fluctuations based on treatment. His team can counsel you more accurately.

Is your father currently in treatment? Are you able to communicate with his oncologist?

my sister has had the whipple surgery and her numbers went from 22.4 that day of the surgery to 10,513.2 this past week the surgery was donr on june 8 th this year so about 6 weeks ago how high should she be before she stops this new chemo

Hi Scooter,
I can imagine you are very worried about your sister and the swings in her CA 19-9 numbers. Allow me to tag fellow members @palvi @rtw007 @buckslayer @allboyzoo @beachdog @baileycody, who can share their experiences.

Scooter, when did you sister start chemo? How many treatments has she had?

Everyone's ca19-9 reading is unique to the individual. I understand that there are people who have completely "normal range" CA19-9 despite active pancan. My wife's CA19-9 was over 3000 when the recurrence (ovarian tumor) was spotted in 2/21 CT having shot up from under 200 in 1/21. Immediately after surgery with clean margins, her CA19-9 rose to over 3300. The oncologist wasn't concerned since she was scheduled for chemo as soon as she was recovered from the surgery. According to a friend, a retired pancan researcher, the CA19-9 can increase in response to dead cells. After 8 GAC treatments, her CA19-9 is below 200. She's completed 10 treatments now with 2 more scheduled. Won't have another CA19-9 until after treatment 11.

In my wife's case, CA19-9 seems to track well with the presence/absence of active cancer cells but it is not foolproof. Ongoing scans and paying attention to symptoms are key to detection. BTW, we've had almost all of my wife's CT and MRI scans re-read for second opinion. Our insurance covers second opinions.

my husband has locally advanced pancreatic cancer. After he had 6 treatments his tumor which is close to the sma artery had not pulled away far enough for surgery...kinda feeling hopeless at this point. His Ca 19-9 number where dropping they started at 124 andwent to 54 but only dropped to 52 dont know whats going on but hoping his chemo will kill this tumor hes got 5 more to go.

Which chemo regimen is your husband receiving? Has he been told that he should get radiation also before surgery? Are you seeing a surgeon that specializes in pancreatic surgery? The skill and experience of the surgeon is a major determinant of whether a resection is possible. Praying that his chemo goes well and is effective.

He is on what they call modified Folfirenox ...the surgeon is the one that keeps delaying it..dr has metioned he might get second opion if he has to and also has mentioned radiation...thank you for your prayers i do feel he will have surgery in the future.