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Is CA 19-9 a lagging indicator? How is it used?

Posted by juneday @juneday, Dec 23, 2024

My husband has had pancreatic cancer for over three years. Every time his Ca 19-9 markers rise, his oncologist says they’re a lagging indicator and not reflective of his current health at the time of the test. Would anyone confirm if this is true? After he had liver oblation surgery a month ago, his markers were tested today and they have tripled. Does this mean the surgery failed?

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amy | @asugent | Jan 3 2:51pm

My mom's CA 19-9 has been all over the place since her diagnosis over 5 years ago. It is worth noting that this test is merely a tool and not definitive. For instance, those with fatty liver or inflammation can have higher CA-19-9 numbers. There are other things that can cause this test to jump around. What counts is the trend. If the trend is consistently upwards, it's a good indicator of PC.

There is a new test called Signatera which is a like a blood biopsy able to find cancer cells in the blood. I recommend this test to anyone searching for a clearer indication of whether they have cancer in their blood. But, as any skilled oncologist will tell you, the scan tells the story. Blood tests are not always accurate.

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joiedevivre | @joiedevivre | Jan 3 7:38pm
In reply to @carneydh "When I was diagnosed in July 2023 my CA19-9 was 9700. I did 3 months of..." + (show)
@carneydh

When I was diagnosed in July 2023 my CA19-9 was 9700. I did 3 months of GA chemo before my surgery in January 2024. At that time my CA19-9 was 150. My pathology report was clear. Two months after the surgery it was 1820. I did 3 more months of GA chemo and it was 35. I have did Pet CT scans every 3 months since the surgery and they have always been clear. My oncologist stopped my chemo and told me to do scans every three months, and check my CA19-9 monthly. That was in October 2024. My CA19-9 has went from 35 to 371 in 3 months. My oncologist wants me to start chemo again even though my scan in November was clear. I am really confused about the numbers. I don’t really want to go back on chemo.

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My husband has done 9 months of Gem-Abraxane and our oncologist is not stopping. His PET scans had been clear for 9 months (or since surgery over a year ago - depending on which dcotor or radiologist we listen to) but like @juneday said, the cancer cells could be 'hiding'. Chemo is depressing but if it keeps the cancer under control, my husband and I will stick to the course our oncologist has charted.

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199 | @199 | Jan 4 11:26am
In reply to @carneydh "When I was diagnosed in July 2023 my CA19-9 was 9700. I did 3 months of..." + (show)
@carneydh

When I was diagnosed in July 2023 my CA19-9 was 9700. I did 3 months of GA chemo before my surgery in January 2024. At that time my CA19-9 was 150. My pathology report was clear. Two months after the surgery it was 1820. I did 3 more months of GA chemo and it was 35. I have did Pet CT scans every 3 months since the surgery and they have always been clear. My oncologist stopped my chemo and told me to do scans every three months, and check my CA19-9 monthly. That was in October 2024. My CA19-9 has went from 35 to 371 in 3 months. My oncologist wants me to start chemo again even though my scan in November was clear. I am really confused about the numbers. I don’t really want to go back on chemo.

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Go back on the chemo. Been there. Done that & was not wanting to go back on chemo. You may be able to stop it again when the numbers trend within normal limits again. I have been back on since May and in October finally got to 29.4; had pneumonia; shot up to 93.9 & 105.2 & just now on Jan 2. started to trend down to 82.4! Hoping that will continue so I can look forward to another time when I can stop for a while 🙂

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marienewland | @mnewland99 | Jan 4 11:59am

For me, the imaging is the lagging indicator and CA19-9 is the leading indicator that cancer may be processing (though it can be due to inflammation also). Images lagging in MY case as it takes awhile, relative to growth, what one can see in an image. CA19-9 is an antigen, I believe; so its specifics differ according to internal responses.

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mcharlesfrancis | @mcharlesfrancis | Jan 4 12:51pm
In reply to @carneydh "When I was diagnosed in July 2023 my CA19-9 was 9700. I did 3 months of..." + (show)
@carneydh

When I was diagnosed in July 2023 my CA19-9 was 9700. I did 3 months of GA chemo before my surgery in January 2024. At that time my CA19-9 was 150. My pathology report was clear. Two months after the surgery it was 1820. I did 3 more months of GA chemo and it was 35. I have did Pet CT scans every 3 months since the surgery and they have always been clear. My oncologist stopped my chemo and told me to do scans every three months, and check my CA19-9 monthly. That was in October 2024. My CA19-9 has went from 35 to 371 in 3 months. My oncologist wants me to start chemo again even though my scan in November was clear. I am really confused about the numbers. I don’t really want to go back on chemo.

Jump to this post

My radiation oncologist told me that they can’t see the cancer unless there’s 50,000 thousand in one place

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