CA19-9 levels

Vilarob….Great posting and so informative. Thanks

Tumor marker tests are subject to wide variation, and are only meaningful when taken in context of multiple diagnostic tests. When viewed by themselves, they are almost meaningless. Different cancers will express certain antigens and proteins when they are active and growing. For instance cholangiocarcinoma often expresses the carbohydrate 19-9 antigen. 40 is considered a normal level. Some cholangiocarcinomas express this antigen at high levels, some express it just above normal, and some variants will not express it at all even when it is growing. The CA19-9 must be viewed in sequence over a period of months, and then compared with CT scans and liver function tests to give an overall picture.

In my case, my CA19-9 was around 65 when I was first diagnosed. Since I have been on chemotherapy over the last 6 months, it has fallen to 40. This has been supported by multiple CT scans which show no growth over the same 6 months, and liver function tests which are perfectly normal.

Unfortunately, one will see certain cases where the CA19-9 normal or only minimally elevated, yet scans show consistent disease progression and deteriorating liver function tests. So, CA19-9 needs to be evaluated only in the context of the overall big picture.

This is also the case with other cancers. For instance, regular hepatocellular carcinoma (HCC) expresses alphafetoprotein, or AFP. AFP of 9 or less is normal. AFP of 400 or more may indicated a rapidly growing cancer. However, there are some cases where the cancer is growing, but inexplicably is not expressing elevated levels of AFP.

Likewise for prostate cancer, which expresses PSA, or prostate-specific antigen.

I hope this helps to make some sense out of a confusing subject. I have spent much time researching this to try to understand this elusive lab test. Please don’t take my explanation as professional. Ask your onco doc, and don’t let him/her go until it is explained to your satisfaction!

Violarob in Texas

Teddy’s had been about 17, in February, then 37 in April and 70 in June. That is when they DX that the cancer had returned. We will find out Friday when he goes to the ONC what it is now. So, like Jeff said, everyone is different. I am beginning to see that this monster strike everyone is so many different ways. Truly what goes for one is different for another.

Hi Suzanne, Charlie’s was in the 1000’s one time last year I think, then it went way down. But now at Wake Forest Medical Center, his oncologist doesn’t even use that or if he does, he sure won’t tell me so we’ve decided that’s fine with us. Just like Jeff said, it’s just one of the tools. We’re paying more attention to how Charlie feels, looks, is eating, regular or not and of course the scans are the main indicator of what’s going on inside. I wonder if there’s no clear answers on it because the medical community doesn’t have clear answers on whether it really gives good information or not?? I sure don’t know. I wish you all the best and let us know if you find out anymore about it.

Carol