Sharp increase in CA19-9

Posted by vector @vector, 3 days ago

Wife had Whipple surgery in December 2023. Pathology was stage 2b. Post-surgery, she was considered cancer free (not to be mistaken for cured). After some recovery, she had PAC for six months, Gemcitabine. The PAC was started a bit later than desired due to complications of surgery, i.e., TPN feeding. PAC course was completed mid-September 2024. In August 2024 CA19-9 registered 42.7. In November 2024, CA19-9 registered 33.7. Now in January, CA19-9 registered 96.3.

That recent jump seems odd to us. Is it not unusual?

Thank you,

Vector

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joiedevivre | @joiedevivre | 17 hours ago

In reply to @montyd "How long does the oncologist expect your husband to be on chemo? A year post surgery..." + (show)

The phrase used is ‘long-term’. It has been rather depressing. Oncologist and surgeon are two separate doctors; prognosis of both different. Surgeon says no metastasis while oncologist says otherwise based on 2 lumps (one on liver and one on the abdominal bed where tail of pancreas used to be) ‘of concern’ found by one radiologist in an early PET scan post-surgery. Those lumps have not done anything significant in last 8 months - no growth, no reduction in size. Oncologist says cancer will return if chemo stops. It is not even ‘may’ return. But she’s very well-respected where we are so as long as side effects are minimal, we will stay the course. For now.

marienewland | @mnewland99 | 13 hours ago

In reply to @joiedevivre "The phrase used is ‘long-term’. It has been rather depressing. Oncologist and surgeon are two separate..." + (show)

Just wondering if you know the size of those nodules? Has the PET scan been repeated, and if so do they still show up? At some point, it is nice to get a break from the chemo.

joiedevivre | @joiedevivre | 12 hours ago

In reply to @mnewland99 "Just wondering if you know the size of those nodules? Has the PET scan been repeated,..." + (show)

Both about 1.2x1.0cm. Surgeon is of the opinion that the one on the abdominal bed is post-surgery hypodensity; and he said that the one on the liver was not cancerous and was there pre-surgery. A few scans after that picked up the one in the liver to be 1.0x1.0cm but that could be due to the angle of the scan and not because it had shrunk. In all the PET scans, the lumps never 'glowed'; they were just slightly darker than the surroundings. My husband does PET scans every 2 to 3 months - I reckon he has had 6 or 7 since surgery (I have lost count!). I tabulate his CA19-9 results only 🙂