CA19-9 decreasing post surgery: Chose active surveillance over chemo

Posted by caughey @caughey, Apr 8, 2022

Just got my first results back after having Whipple surgery 4 months ago and the CA 19-9 was 13.20 Had Stage 1A pancreas cancer and elected to do surveillance which was an option for doing chemo. Not sure if right decision but did it. The first CA 19-9 test three months ago was 10.90. I am lucky so far. Any comments

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@caughey that is great news that your surgery was successful and that you have the option to opt for active surveillance over chemo at this time. It sounds like it is the right decision for you at this time with the information that you have. If there is any doubt, continue to talk with your oncologist.

Can you clarify the timeline for me? After surgery your CA19-9 was 13.20 and the first follow-up CA19-9 decreased to 10.90? Or the other way around, the CA19-9 is increasing?
May I also ask how your cancer was detected at such an early stage?

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Hi Colleen, Had a Pancreatitis attack in July and with CT scan they said nothing about anything on pancreas. In Dallas in November on the way to Colombia I decided to request an MRI to see if pancreas was healed which showed I had a cyst on head of Pancreas. Surgeon did Whipple on December 13 and next to cyst was a small cancer Stage 1a. January CA 19 showed10.90 and April showed 13.20 but still well within normal of 0 to 47

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@caughey

Hi Colleen, Had a Pancreatitis attack in July and with CT scan they said nothing about anything on pancreas. In Dallas in November on the way to Colombia I decided to request an MRI to see if pancreas was healed which showed I had a cyst on head of Pancreas. Surgeon did Whipple on December 13 and next to cyst was a small cancer Stage 1a. January CA 19 showed10.90 and April showed 13.20 but still well within normal of 0 to 47

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You might want to get more frequent CA19-9 tests. We heard all kinds of explanations for tiny increases in CA19-9. Ultimately, my wife had active cancer cells that were causing the increase despite very good surgical results. I know that taking a pass on chemo is very tempting, but if even one member of your team thinks you should reconsider getting chemo, take the cautious route.

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Thank you for your input. I had surgery and oncologist is at Texas Health in Dallas. I only have one oncologist but per your message will send him a message asking him questions about retesting. Am in London until next check up in Dallas which is first of July. When did your wife have Whipple and how is she doing now. I am going to be 78 tommorrow so in a different bucket than a 40 year old. Nasty cancer to get for sure and thanks again for response. Jack

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