Rising CA19-9 Levels: What It Means for Cancer Detection

Elevated CA 19-9 levels?

Hello, doctor.
Three years ago, my CA 19-9 level was over 5, and recently it has increased to over 15 in the last two months, and then to over 17 two months later.
All of these values are within the normal range (below 37), but it seems to be rising.
I would like to ask, if high-level imaging or ultrasound did not reveal any tumors: 1.
Is it possible that the tumors are still very small and therefore not detectable? 2.
Can DR70 be used to detect such a condition? Thank you.

Mr. Long, 30~39 year old female. Ask Date: 2023/04/24

Dr. Chen Sirong reply Oncology

Mr.
Long / 37 years old / Male
The normal values are within range.
Don't be too hard on yourself; his name is a tumor marker, but it is also a substance naturally produced in the body, so it won't be zero.
Wishing you a warm spring and good days every day.
Taoyuan Hospital, Dr.
Chen Si-Rong.

Reply Date: 2023/04/24

More Info

Understanding rising CA19-9 levels can be quite complex, especially when considering the implications for cancer detection. CA19-9 is a tumor marker primarily associated with pancreatic cancer, but it can also be elevated in other conditions, including various gastrointestinal cancers and benign diseases. The normal range for CA19-9 is typically considered to be below 37 U/mL, and while your levels of 15 and 17 are still within this range, the upward trend is noteworthy.

1. Possibility of Early-Stage Cancer: It is indeed possible for a tumor to be present but not yet detectable through imaging techniques such as ultrasound or CT scans. Early-stage tumors can be very small and may not yet have caused any significant anatomical changes that would be visible on imaging. However, it is important to note that CA19-9 is not a definitive diagnostic tool for cancer. Elevated levels can occur due to a variety of non-cancerous conditions, such as pancreatitis, liver disease, or even certain infections. Therefore, while a rising CA19-9 level can be concerning, it does not automatically indicate the presence of cancer, especially if imaging studies do not show any abnormalities.

2. Use of DR70 for Detection: The DR70 test is another tumor marker that is sometimes used in conjunction with CA19-9 to provide additional information about the presence of cancer. However, it is important to understand that no single test can definitively diagnose cancer. The DR70 test is not widely used in standard clinical practice for pancreatic cancer detection and may not be as reliable as other imaging modalities or biopsies. It is essential to discuss with your healthcare provider whether this test is appropriate for your situation, as they can provide guidance based on your overall clinical picture and history.

Given your situation, it is advisable to continue monitoring your CA19-9 levels over time. Regular follow-ups with your healthcare provider are crucial. They may recommend additional imaging studies or other diagnostic tests if your CA19-9 levels continue to rise or if you develop any new symptoms. It is also important to consider other risk factors, such as family history, lifestyle factors, and any symptoms you may be experiencing, as these can provide valuable context for interpreting your CA19-9 levels.

In summary, while rising CA19-9 levels can be concerning, they are not definitive for cancer diagnosis, especially when levels remain within the normal range. Continuous monitoring and further evaluation by your healthcare provider are essential to determine the appropriate next steps. Regular check-ups and open communication with your doctor will help ensure that any potential issues are addressed promptly and effectively.

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