Elevated CA19-9 Levels: Causes and Concerns

CA19-9 index

I would like to ask about a 20-year-old female who does not smoke or drink, but has a CA 19-9 level close to 1800.
Could this indicate pancreatic-related diseases? Is it possible that the elevated level is due to inflammation in the body at that time? Additionally, could the presence of at least an 18 cm cyst and ascites in the abdomen also affect the levels? The significantly elevated result is causing me a lot of anxiety.
I have lost five kilograms in weight over the past week, and I am unsure if this is influenced by psychological factors.
Both my stool and urine are normal, and my appetite is also normal.
A few days before the blood test, I experienced persistent pain in the right abdomen for three days, and my previously large cyst-like abdomen suddenly deflated.
On the fourth day, after taking medication, it gradually improved.
Two weeks later, I am now experiencing dull pain in the left upper abdomen below the rib cage.

Chen, 20~29 year old female. Ask Date: 2023/08/30

Dr. Chen Sirong reply Oncology

Chen / 20 years old / Hello, of course benign conditions are possible, but the levels are really too high.
Generally, it is still suspected that there may be an underlying issue that you are not aware of.
However, you cannot obtain a definitive answer through online consultations.
It is advisable to seek a physician, who can perform a thorough examination and arrange for further tests.
Only after a diagnosis can appropriate management be provided.
Wishing you good physical and mental health.
Dr.
Chen Sih-Rong, Taoyuan Hospital.

Reply Date: 2023/08/30

More Info

Elevated CA19-9 levels can be a source of concern, especially when they reach significantly high values, such as 1800 in your case. CA19-9 is a tumor marker primarily associated with pancreatic cancer, but it is not specific to cancer alone. It can also be elevated in various benign conditions, including pancreatitis, cholangitis, liver diseases, and even certain inflammatory conditions.
In your situation, several factors could contribute to the elevated CA19-9 levels. First, the presence of an 18 cm cyst and abdominal fluid (ascites) can certainly influence the CA19-9 levels. Cysts, especially if they are inflamed or infected, can lead to an increase in this marker. Additionally, abdominal pain and inflammation can also cause a rise in CA19-9, as the body responds to inflammation by releasing various substances into the bloodstream.

Your symptoms of abdominal pain, weight loss, and the presence of a large cyst warrant further investigation. While the normal results of your stool and urine tests are reassuring, they do not rule out the possibility of underlying issues related to the cyst or other abdominal organs. The weight loss you experienced could be multifactorial, including psychological stress due to your health concerns, but it is essential to consider that significant weight loss can also be a symptom of underlying pathology, especially in the context of abdominal pain and elevated CA19-9.

Given the complexity of your situation, it is crucial to follow up with a healthcare provider who can perform a comprehensive evaluation. This may include imaging studies such as a CT scan or MRI to assess the cyst and any potential complications, as well as further blood tests to monitor CA19-9 levels over time. It is also advisable to consult with a gastroenterologist or an oncologist, who can provide specialized care and guidance based on your specific circumstances.

In summary, while elevated CA19-9 levels can be alarming, they do not automatically indicate cancer, especially in the presence of benign conditions such as cysts or inflammation. However, due to the significant elevation in your case and the accompanying symptoms, it is essential to seek further medical evaluation to determine the underlying cause and appropriate management. Regular monitoring and follow-up with your healthcare provider will be key in addressing your concerns and ensuring your health is closely monitored.

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