Elevated CA-125 Levels: What You Need to Know

Abnormal CA-125

This year, I went to a large hospital for a health check-up, and one of the tests was a CA-125 blood test.
At that time, I was on my menstrual period and informed the nurse, but she said it wouldn't affect the results.
The test result showed elevated levels, consistent with last year’s results (which were also taken during my menstrual period at a health check clinic).
I subsequently visited a gynecology clinic for follow-up, where I had two ultrasounds, and both my uterus and ovaries appeared very normal.
However, the doctor mentioned that it’s possible that small cysts might not be visible on the ultrasound, which was quite alarming to hear.
I have already undergone another blood test and am currently waiting for the report.

I would like to ask the doctor what to do if the results are abnormal again.
I generally do not have any health issues; my menstrual cycle is very regular, and I do not experience menstrual pain.
After a breast ultrasound, I was found to have a very small fibrocystic lesion, which the doctor said should just be monitored regularly.
I also do not have any insomnia or psychological issues.
If my CA-125 levels come back the same (around 46), should I just continue to monitor for any sudden increases, or should I pursue further testing? Thank you very much, doctor!

Lai Xiaojie, 20~29 year old female. Ask Date: 2022/03/29

Dr. Wu Xianghui reply Obstetrics and Gynecology

1.
Whenever the peritoneal lining is stimulated, CA125 levels will increase.
In other words, benign conditions or even healthy individuals can also have elevated levels.
For example, women during their menstrual period, those experiencing diarrhea, or individuals with gastroenteritis may show increased levels.
Benign conditions such as pelvic inflammatory disease, uterine fibroids, adenomyosis, endometriosis (chocolate cysts), or benign ovarian tumors can also result in elevated levels.
2.
It is recommended to wait for further test results and physician evaluation.

Reply Date: 2022/03/29

More Info

Elevated CA-125 levels can be a source of concern for many individuals, especially when it comes to the potential implications for ovarian cancer and other gynecological conditions. CA-125, or cancer antigen 125, is a protein that is often found in higher concentrations in women with certain types of cancer, particularly ovarian cancer. However, it is important to note that elevated CA-125 levels are not exclusively indicative of cancer; they can also be influenced by a variety of benign conditions.

In your case, you mentioned that your CA-125 levels were elevated during your menstrual period, which is a crucial factor to consider. Menstruation can indeed affect CA-125 levels, leading to temporary increases. Other non-cancerous conditions that can cause elevated CA-125 levels include endometriosis, pelvic inflammatory disease, and even benign ovarian cysts. Therefore, it is essential to interpret the results in the context of your overall health, medical history, and any accompanying symptoms.

Given that you have undergone ultrasounds that showed your uterus and ovaries to be "very clean," this is a reassuring sign. However, the concern about "one grain at a time" suggests that there may be small lesions or cysts that are not easily detectable via ultrasound. This is where follow-up testing becomes important. If your CA-125 levels remain elevated upon retesting, it may warrant further investigation.

In terms of next steps, if your CA-125 levels are still elevated (e.g., around 46), it is generally advisable to continue monitoring the levels over time. Regular follow-up blood tests can help track any changes in the CA-125 levels. If there is a significant increase or if you begin to experience new symptoms (such as abdominal pain, bloating, or changes in your menstrual cycle), further imaging studies or diagnostic procedures may be necessary.

It is also worth discussing with your healthcare provider the possibility of additional tests, such as a transvaginal ultrasound or even a CT scan, if there is a concern that something may be missed. These imaging techniques can provide a more detailed view of the pelvic organs and help identify any abnormalities that may not be visible on a standard ultrasound.

In summary, while elevated CA-125 levels can be concerning, they are not definitive for cancer, especially when other tests show no abnormalities. Regular monitoring and open communication with your healthcare provider are key components in managing your health. If you have any further questions or concerns, do not hesitate to reach out to your doctor for personalized advice and guidance.

Similar Q&A

Understanding Elevated CA-125 Levels: Next Steps for Diagnosis

Hello Doctor: My CA-125 tumor marker level is 95.8. I have undergone a gynecological examination, and there are no issues with my uterus or ovaries. The doctor suggested that I look for the cause from other aspects. I would like to ask you: which specialty should I start my exami...

Dr. Cai Jueren reply Family Medicine
Hello: Since you did not provide the unit, it is difficult to accurately determine whether the value is indeed elevated. There are many conditions that can cause an increase in CA-125 levels, such as liver cirrhosis, gastrointestinal diseases, renal failure, pleuritis or effusion...

Understanding Elevated CA 125 Levels: Next Steps for Women

I am an unmarried female, and my cancer antigen CA 125 test result is 45.52, which is above the reference value. What further tests should I undergo?

Dr. Liu Jinyong reply Family Medicine
The reference value for CA-125 is <35 U/mL. CA-125 is used for screening ovarian cancer, fallopian tube cancer, and endometrial cancer. Individuals with elevated levels should undergo evaluation by a physician and further examinations such as abdominal ultrasound. Other possib...

Understanding Elevated CA-125 Levels and H. Pylori Antibodies in Women

I would like to inquire about a health check-up I had at a hospital in Taichung in July. The report indicated that my CA-125 level was elevated, approximately 53.53. Could you please explain what this means? Additionally, I tested positive for Helicobacter pylori antibodies; what...

Dr. Wu Linting reply Obstetrics and Gynecology
Hello, there are many reasons that can cause an elevation in CA-125 levels, such as endometriosis, menstruation, pelvic inflammatory disease, and ovarian tumors. It is essential to consider other clinical examinations and medical history for proper assessment.

Managing Elevated CA-125 Levels in Oncology: What You Need to Know

What should be done if tumor marker levels are too high?

Dr. Lin Zongzhe reply Oncology
Hello! Different patients, varying conditions, and different tumor markers can all affect the interpretation of results. It is recommended that you consult the physician who ordered your tests for a detailed explanation. Sincerely, Dr. Lin Tsung-Che, Oncology Department, Taoyuan ...