Contrast and MRI: Did you have a reaction? How was it handled?

Congratulations on that tumor marker. That is awesome!!

Thank you. One step at a time.

Was your CA19-9 ever elevated over 35 U/mL? PDAC tumors secrete CA19-9 but 10% of the patient population are non-secretors. That marker is genetically coded by the Lewis antigen that plays a role in determining blood group factor. Individuals that do not have the genetic sequence to code for the Lewis antigen will not secrete CA19-9. The sensitivity of measurement of the CA19-9 test is +/- 3. If a non secretor, one’s reported value will be reported out as -3 up to +3 because of measurement error inherent to the assay method.

PACC and PNET tumors do not secrete CA19-9 nor do many of the pancreatic cysts. In patients with these neoplasms, CA19-9 is not useful in tracking disease treatment. Adding ctDNA is a blood assay that can augment surveillance. It has its own shortcomings. It has its highest sensitivity of detecting disease reoccurrence of 89% in patients with the BRCA mutation to a low of 64% with other mutations. In those with the highest sensitivity, it can detect reoccurrence months before conventional imaging such as CT, MRI or PET. In the BRCA cohort, up to 11% won’t be detected any earlier than by conventional imaging. For those that can benefit from it, it can alert the clinician of reoccurrence well before the methods currently being used.

During the height of my PACC metastatic disease, my CA19-9 presented in a range of 5-7. Since being cured it ranges between 4-5. That indicates I am a secretor but it could not be used to track efficacy of chemotherapy or as surveillance for a PACC or PNET tumor.

Thanks for the very detailed response, very informative

@judithbramson12, I'm bringing @mepowers @rarelybees2889 into this discussion. They, too, have had allergic reactions to the contrast used in imaging and may be able to offer tips of how it was managed for future imaging studies.

Thank you. It seems important that I receive the imaging. Any information is much appreciated. Again, thank you. So much.

I threw up almost immediately after the contrast was infused. No one I spoke to (complained) offered anything to help. I tried eating, not eating, they would infuse slowly, etc.. Unfortunately, I have nothing to offer you. I had a lot of MRIs with contrast during my treatments and for five years afterwards. If someone does offer you something, I’d love to hear it too even though I’m done with regular MRIs.

OMG, that scares the hell out of me. Meds were suggested prior to and after the MRI. I didn’t throw up, but my lower legs did have a reaction. My primary cleared it pretty quickly. I think I’m going to give it a try with the meds. I never had any reaction prior to surgery. I’ll let you know how it turns out.

Thank you for telling me your experience. Vomiting is the last thing I want to occur. I guess we all react differently.

I also have a reaction to contrast. You have to tell your oncologist and mri dept. they had me take Benadryl the night before and day off. Next mri mention before and they will guide you. Good luck, it is a horrible reaction.

Was the hobbible reaction after you tookk the meds or before? Did the meds help?

Thanks. That;s what they are giving to me.