Elevated Ca-125 Levels in Endometrial and Ovarian Cancer - Oncology

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Elevated CA-125 levels can be a significant indicator in the context of gynecological cancers, particularly endometrial and ovarian cancers. CA-125, or cancer antigen 125, is a protein that is often found in higher concentrations in women with certain types of cancers, especially ovarian cancer. However, it is important to note that elevated CA-125 levels are not exclusively indicative of cancer; they can also be elevated due to various benign conditions, such as endometriosis, pelvic inflammatory disease, and even during menstruation.

In your mother's case, the initial diagnosis of endometrial and ovarian cancer, followed by the surgical removal of the uterus, ovaries, and lymph nodes, indicates a serious condition that requires close monitoring. The subsequent CA-125 levels post-surgery (3xx) and during chemotherapy (56, 39, 41, 49) show a downward trend, which is generally a positive sign. A decreasing CA-125 level often suggests that the treatment is effective and that the tumor burden may be decreasing. However, it is crucial to understand that CA-125 is not a definitive marker for cancer recurrence or remission. It is one piece of the puzzle, and clinical correlation with imaging studies and symptoms is essential.

Regarding your concerns about recurrence, the fact that CA-125 levels are decreasing is encouraging, but it does not completely rule out the possibility of recurrence. Continuous monitoring and follow-up with the oncologist are vital. If there are new symptoms or if the CA-125 levels begin to rise again, further investigation may be warranted.

As for the suggestion of undergoing a PET scan (positron emission tomography), this imaging modality can be beneficial in assessing the presence of active cancer cells in the body. If your current facility does not offer this service, it may be worthwhile to discuss with your oncologist whether a referral to a facility that does is appropriate. The decision to pursue additional imaging should be based on clinical judgment, considering your mother’s overall health, treatment response, and any new symptoms.

In terms of treatment options, including the use of targeted therapies such as angiogenesis inhibitors and PARP inhibitors like niraparib, these are increasingly being integrated into treatment regimens for ovarian cancer, especially in cases with BRCA mutations or other homologous recombination deficiencies. It is essential to discuss these options with your oncologist, as they can provide insights into the availability of these treatments in Taiwan and whether they are suitable for your mother’s specific case.

In summary, while elevated CA-125 levels can indicate the presence of cancer, they are not definitive on their own. Continuous monitoring, open communication with healthcare providers, and consideration of additional imaging and treatment options are crucial in managing your mother’s condition. Always consult with her oncologist for personalized medical advice tailored to her specific situation.