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

thanks caryn..i have a feeling they will tell us the same thing so im looking for second opinion options..thanks so much for the information and prayers for you for a successful surgery.

@mcendroski

After 8 folfirinox treatments and 28 radiation treatments I was told I was not a candidate for the Whipple due to arterial involvement. My surgeon, who had seemed enthusiastic about my chances for resection prior to radiation, declined to operate after reviewing the final CT scan. This was at an NCI comprehensive cancer center, rated top 50 in the US. (My CA 19-9 dropped from a high of 94 unit/mL to 7 at my final blood test).

I came to Mayo Jacksonville for a second opinion. After an MRI my new surgeon said he saw no arterial involvement. I'm due for surgery on Nov. 10.

I highly endorse second opinions!

my husbands ca19 9 number started at 125 in June they are now 36 and normal range is 0-35. He had scans after 6 treatments which showed the tumor still there it also was close to sma artery dr said it had not pulled away enough for surgery..after treatment 7 his ca 19 9 numbers where 36 so im hoping this means its shrinking and he can have surgery. The onocologist says sometime the tumors decenegrate..so being hopeful that after chemo is complete he can have surgery.

@annebauer19
My wife went to Johns Hopkins for her SBRT. She also had her surgery there since they are a pancan center of excellence. She also had IORT (intra operative radiation therapy during her pancreatectomy). JH is one of the few operating theaters with this capability. IORT is used to treat the surgical margins and was apparently succeful in my wife's case since she has had no recurrence in the extensive surgical bed. She has experienced skip-metastasis to the ovary but that start of that tumor likely predated her pancreatectomy.

SBRT is ideal for localized therapy since it doesn't overdose large areas of the body but it is limited to use when there is a well localized target.

Once again, I'm not a clinician, just relating experience through my wife's treatment. Please be sure to check with your medical team and get second opinions. JH was our second opinion source and continues to review her scans while undergoing treatment locally.

Hello again. Thanks for the info about sbrt. I have been reading about. It seems like it accomplishes what regular external radiation does in a much shorter time. I don't know if there is a downside..I would also like to know which treatment centers are doing it..sorry to hear about metastasis. For your wife she has been through so much..wishing you both well.

I appreciate the explanation, @beachdog . It sounds like a very effective treatment method. Do you mind sharing the facility where your wife was treated?

Sbrt is focused radiation treatment. Gold fiducials are implanted in the target area of the pancreas via EUS. The fiducials are targeted during the radiation which creates a pattern like the spokes of a bicycle wheel. That way the target gets the main radiation and the rest of the body receives minimal exposure. In my wife's case, they used photon radiation and the tumor was 100% necrotic after 5 treatments. There are a limited number of facilities with the technology to perform sbrt.

Hello @beachdog

I appreciate you offering some perspective to the CA19-9 numbers as it relates to the progression of pancreatic cancer. You provided some great personal examples. You mentioned your wife having "chemo, sbrt. and surgery." I'm not sure what "sbrt" stands for. Can you explain?

My experience is due to my wife's pancan treatment which started upon diagnosis in July 2019. A significant drop in CA19-9 as you've had could be a good sign. There are no absolutes with the meaning of the number and one person's 900 can mean something different for another patient. In my wife's case she was at 2000 when diagnosed at stage 3 and dropped to 28 after chemo, sbrt and surgery. She hit 3000 when metastasis was identified then after more surgery and chemo hit a low of 180. Without verification of a scan, we don't know what the CA19-9 is telling us yet. Good luck and prayers for you.

He gets pretty nauseated after the chemo and for a week doesnt care about eating but makes himself. He has diarhea allot because of the chemo and the cancer...he takes creon it helps a little.