CA-125 Results Went Up: Should I be concerned?

A pet scan and a car scan nothing found

Most oncologists don’t use CA-125 as more than an indicator to look further. They do use it to track the effectiveness of treatments in active patients such as my wife. For what it’s worth, your
20..3 with no other negative indicators is considered being in the normal range

I believe there was a study done for ovarian cancer, treating people whose CA 125 was up but no physical evidence of recurrence, comparing them with people who were not treated until there was physical evidence. Treating early on the basis of CA 125 did not help, at least in terms of mortality. Counterintuitive, but OC seems to be very tricky.
So that's probably why nobody wants to start aggressive treatment on the basis of rising CA 125. The doctors don't want to trade good months where you're physically feeling okay, for bad ones when you're beat up by chemo, if the outcome is no different. I think they don't take into account the misery of knowing something's wrong and not having anything to do about it. I think if this happens to me (I'm in remission right now) I will take myself to a beach or jungle resort before the next scan.

My mother was diagnosed with stage 4 Ovarian cancer at the age of 75. Her CA 125 levels was 577 and she had tumors and enlarged lymph nodes all over her thoracic area. After 6 round of Chemo the growth of the tumors stop and started shrinking and her CA 125 level went to 13.9. Over the past 6 months the CA125 levels started rising again. A CT was done and no change in tumor size or lymph nodes. They are now up to 455. I asked her oncologist if they should do a CT of the neck and brain but he said it is very rare that ovarian cancer rarely goes to the brain, but he has offered not any explanation as to why her levels keep rising. I would appreciate any information concerning this matter.

Hi christyhh. I was also diagnosed with ovarian cancer when I was 76 — in fall of 2021. My CA 125 has been measured and, like your mother’s, my CA 125 values do not seem to coordinate with the amount of cancer found in my CT scans. I have been told by my oncologist that CA 125 is not always a perfectly accurate measure of the amount of my ovarian cancer. An increased CA, 125 he said, could, for example, reflect an inflammation rather than ovarian cancer growth. Nevertheless, CA, 125 is measured every time I have an infusion of chemotherapy drugs. Be sure to keep after your mother’s oncologist to get it clear what value testing for CA 125 is in guiding your her treatment. You have inspired me to ask questions again!! 🙂 Good luck. Marian

@christyhh and @1mbaldy, I encourage you to also see this related discussion:
- CA-125 Results Went Up: Should I be concerned? https://connect.mayoclinic.org/discussion/ca-125-results-rose/

Tumor markers, such as CA-125, alone are not enough information to make conclusions, but can indicate the need for further investigation. @1mbaldy, you're right that this is a reminder to keep asking questions.

Christy, did your mom have further testing? Was any explanation offered in the meantime?

My mom is 2 years and 3 months post total hysterectomy for endometrial cancer. This past winter she had a perforated bowel which required her to have a temporary colostomy. She is scheduled to have reversal surgery next month. Her oncologist had sent her for regular follow up blood work and a CT scan but that was delayed because she came down with COVID. She did have the blood work done in April and her tumor marker was 30. She had repeat blood work done on Monday and the result is now 61. It this an indication that the cancer is back or can this just be because of inflammation due to her colostomy surgery?

@ldubevna, I moved your question about rising tumor markers to this discussion:
- CA-125 Results Went Up: Should I be concerned? https://connect.mayoclinic.org/discussion/ca-125-results-rose/

If you click the link, you'll see in my reply to @stparker54 a rising CA 125 level may indicate a return or continued growth of the cancer. Please focus on the word "MAY." Inflammation can also cause a rise in CA 125.

What did you and your mom learn with follow-up? How is she doing with her colostomy?

I know it's been a year, but I just joined here and saw your post. I know it's a year later, but I did want to comment on one thing you mentioned. The oncologist said it was very rare that ovarian cancer to to the brain. That may be true, but it can happen, especially if your mother had enlarged lymph nodes. My brother had Stage IV bladder cancer and enlarged lymph nodes. Did chemo for little over a year. The last three CT scans he had were "clean". Then he started having balance issues and falling. Took him to ER when things got really bad. They did MRI and found tumor mass at base of brain and it was inoperable. He passed two months later. His oncologist told us, after it was found, that it was rare to spread to brain. Because of my concern, I advised my oncologist (I have Stage III-C OC) and she scheduled an MRI of neck and brain. Mine came out okay, but I still plan on asking for another one at some point, just in case. Because it's rare, they just don't regularly schedule scans of the brain - just the area where your cancer started. It seems once it's in the lymph nodes, it can go anywhere at anytime.

Just wanted to add that this was the situation that a dear friend of mine faced as well. She had OC then a while later brain cancer. The docs said the two were unrelated. Were the two unrelated? No one can be entirely sure.