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

Posted by lisarlee @lisarlee, Feb 1, 2020

What is your opinion on these numbers? Was diagnosed in September 2019 and my ca 19-9 was 7500. New number yesterday was 909 after 9 chemo sessions. Is this good news or a wasted test?

@afaqsworld

in Year Nov-2013 my dad was diagnosed with CA colon and was operated straight away and 12cycles FolFox was followed. Oct-2018 due to increase in CEA level to 12 my Dad was again diagnosed with malignant Solitary lesion between the tail of Pancreas and Spleen. It was the reoccurrence…Again operated in Nov-2018 and has been on oral chemo for last 21months now…All went well… Prior to this CEA was only matter of concern as it was 12 before he got operated and now its 5.7. all along his CA19-9 has been well under normal range less than 37… we repeat his blood test every 21days. on 18Sep2020 his CA19-9 was 15 but today we did his routine blood test and to our shock CA19-9 has shot up to 158.9… last PET was done in July and all was fine apart from mild Fdg uptake at the tail of Pancreas and our Onco was not worried for that. My dad never had cancer of Pancreas and now I wonder what made this CA19-9 rise with 21days 10times from 15 to 158….. its frightening… my dad has been through a lot since last 7years now… can anyone help!!!!

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Hi @afaqsworld, welcome to Mayo Clinic Connect. You'll notice that I moved your message to this existing discussion about CA19-9 levels. I did this so you can connect with other members more easily. Click VIEW & REPLY to scroll through past posts and see replies to your questions from members.

CA19-9 is only one indicator to signal the possible need for further investigation. Will your father have additional tests to find out what is going on?

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@marvinjsturing

@afaqsworld My doctors tell me that there are many things that can cause .CA 19-9 to go up one of which is pancreatic cancer. I was diagnosed with pancreatic cancer 6 years ago. For 5 1/2 years my scans came back clean. Last December they found out that my cancer has come back. If my .CA 19-9 took a jump like that, I would be calling my oncologist asking about more testing to find out what was going on.

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But my dad never have pancreatic cancer…he had colon cancer that was resected in 2013 and then had reoccurrence in 2018 and it was again of same nature i e CEA was raised NOT CA19-9… ever since 2018 my father is on oral chemo with 3weekly blood test and 3months PET SCAN..CEA 5.8 where as CA19-9 has risen up to 158.9 all of a sudden…till now CA19-9 has never crossed 24 since 2018..

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@ginathemom

Did you have surgery to resect tumor?

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But my dad never have pancreatic cancer…he had colon cancer that was resected in 2013 and then had reoccurrence in 2018 and it was again of same nature i e CEA was raised NOT CA19-9… ever since 2018 my father is on oral chemo with 3weekly blood test and 3months PET SCAN..CEA 5.8 where as CA19-9 has risen up to 158.9 all of a sudden…till now CA19-9 has never crossed 24 since 2018..

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@marvinjsturing

@afaqsworld My doctors tell me that there are many things that can cause .CA 19-9 to go up one of which is pancreatic cancer. I was diagnosed with pancreatic cancer 6 years ago. For 5 1/2 years my scans came back clean. Last December they found out that my cancer has come back. If my .CA 19-9 took a jump like that, I would be calling my oncologist asking about more testing to find out what was going on.

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Onco suggests all is fine with my father…just repeat in 1week..he is expect all to be normal…but I am stressed like hell till we get this test done…

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@colleenyoung

Hi @afaqsworld, welcome to Mayo Clinic Connect. You'll notice that I moved your message to this existing discussion about CA19-9 levels. I did this so you can connect with other members more easily. Click VIEW & REPLY to scroll through past posts and see replies to your questions from members.

CA19-9 is only one indicator to signal the possible need for further investigation. Will your father have additional tests to find out what is going on?

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Thanks ever so much dear…my father has been told to repeat the blood test and his PET is due as well next week…

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@afaqsworld

Onco suggests all is fine with my father…just repeat in 1week..he is expect all to be normal…but I am stressed like hell till we get this test done…

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@afaqsworld, I bet you're stressed. That's understandable. One step at a time. Worry rarely solves problems, but putting our worries aside is much easier said than done. I get that. Whatever is causing the rise in CA19-9 levels will not dramatically change between now and when he has additional testing. It's good that his doctors are on it. Once they and you have all the results, a plan will be made.

Until that time, we're here. We're listening. If you just felt a light pressure on your shoulder, that's the virtual hand reaching to support you.

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@colleenyoung

@afaqsworld, I bet you're stressed. That's understandable. One step at a time. Worry rarely solves problems, but putting our worries aside is much easier said than done. I get that. Whatever is causing the rise in CA19-9 levels will not dramatically change between now and when he has additional testing. It's good that his doctors are on it. Once they and you have all the results, a plan will be made.

Until that time, we're here. We're listening. If you just felt a light pressure on your shoulder, that's the virtual hand reaching to support you.

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thanks ever so so much…my dad means world to me…he has been battling Cancer since last 7years and when everything seemed to be getting better we are facing it again….I hope not…

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@colorafo19

My husband started out at 24,000!!!! He is now down to 64.

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That’s so great! My husband’s is 22,000. He’s had just two cycles of Folfirinox so it hasn’t been repeated yet. I’m praying for something hopeful!

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My wife's CA19-9 dropped to below 30 after her surgery 2/20/20 but has been increasing ever since. Surgical margins were 100% clean and every surgical biopsy was negative. She's has blood work every month and scans every 6 weeks. Every scan has shown nothing. She's also had circulating DNA tests also negative. Two months ago the CA19-9 doubled and last month it quadrupled. The scans from last week now show a mass on the left ovary. Prior scan that visualized that area was in August and was clear.

We won't know for sure if this is pancan spread or something else entirely until it is removed, but due to the CA19-9, it is likely.

Bottom line, for people who's CA19-9 tracks the progression of their disease, it is an indicator worth paying attention to.

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@beachdog

My wife's CA19-9 dropped to below 30 after her surgery 2/20/20 but has been increasing ever since. Surgical margins were 100% clean and every surgical biopsy was negative. She's has blood work every month and scans every 6 weeks. Every scan has shown nothing. She's also had circulating DNA tests also negative. Two months ago the CA19-9 doubled and last month it quadrupled. The scans from last week now show a mass on the left ovary. Prior scan that visualized that area was in August and was clear.

We won't know for sure if this is pancan spread or something else entirely until it is removed, but due to the CA19-9, it is likely.

Bottom line, for people who's CA19-9 tracks the progression of their disease, it is an indicator worth paying attention to.

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My husbands CA19-9 is definitely an indicator that something is coming back, I know that’s not the case for everyone but for him it is. Pancreatic Cancer is fast moving, he had clear scans in September 2019, but his numbers were trending up, but never high, in January 2020 he was having abdominal pain and with a scan a tumor was visible.

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@beachdog

My wife's CA19-9 dropped to below 30 after her surgery 2/20/20 but has been increasing ever since. Surgical margins were 100% clean and every surgical biopsy was negative. She's has blood work every month and scans every 6 weeks. Every scan has shown nothing. She's also had circulating DNA tests also negative. Two months ago the CA19-9 doubled and last month it quadrupled. The scans from last week now show a mass on the left ovary. Prior scan that visualized that area was in August and was clear.

We won't know for sure if this is pancan spread or something else entirely until it is removed, but due to the CA19-9, it is likely.

Bottom line, for people who's CA19-9 tracks the progression of their disease, it is an indicator worth paying attention to.

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Beachdog our stories continue to align. My husband 's ca 19-9 has also been rising fast the past few months and we fear a drop metastasis to his colon. Scans and a biopsy so far are inconclusive but the lab marker usually doesn't lie, so we will likely be starting a new chemo regimen this week or some type of immunotherapy. He already had neuropathy from the folfirinox regimen so wants to avoid any drugs that might worsen this. PC is known for spread even after clean surgical margins, so I guess we just roll with the punches 😔. We are being told at Mayo that additional operations to remove further cancer after PC are not advised since there is likely cancer in other places as well – if it spread to one place it has or will spread to others, hence the chemo route to try and kill it off instead. Prayers to all.

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@buckslayer

Beachdog our stories continue to align. My husband 's ca 19-9 has also been rising fast the past few months and we fear a drop metastasis to his colon. Scans and a biopsy so far are inconclusive but the lab marker usually doesn't lie, so we will likely be starting a new chemo regimen this week or some type of immunotherapy. He already had neuropathy from the folfirinox regimen so wants to avoid any drugs that might worsen this. PC is known for spread even after clean surgical margins, so I guess we just roll with the punches 😔. We are being told at Mayo that additional operations to remove further cancer after PC are not advised since there is likely cancer in other places as well – if it spread to one place it has or will spread to others, hence the chemo route to try and kill it off instead. Prayers to all.

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The Johns Hopkins tumor board will be reviewing my wife's case tomorrow. Next week, we'll have a call the the JH oncologist who oversaw her folfirinox treatments. We're hoping that there's a clinical trial she can qualify for because she's probably not up to more folfirinox. The neuropathy is already debilitating. Folfirinox was effective for the particular mutation in the original tumor but we'll need new biopsies to see if the new tumor has different mutations before deciding on treatment. According to her local oncologist, the small size of the tumor on the ovary will require removal of the ovary rather than just a biopsy. We'll also schedule a consult with an ob/gyn oncologist. Lots of decisions but we need to act fast.

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