CA 19-9 Levels: What High Readings Mean for Your Health

Q: CA 19-9 Levels: What High Readings Mean for Your Health

Hello： CA 19-9 levels may be elevated in patients with pancreatic cancer, cholangiocarcinoma, liver cancer, gastric cancer, and colorectal cancer. <br>However, elevated CA 19-9 levels can also occur in patients without cancer, such as those with liver cirrhosis, cholangitis, hepa

Pancreatic cancer index

Hello, Doctor! I am 34 years old this year.
I discovered an elevated CA19-9 level (64) in 2009.
At that time, I underwent various tests, including MRI and endoscopy, which revealed a 9 cm benign focal nodular hyperplasia (FNH) in the liver, while the pancreas and other organs showed no issues.
After that, I monitored my CA19-9 levels for over a year, which remained between 60 and 80.
After three years without follow-up, a health check in November 2013 showed a spike in CA19-9 to 117.
A few days later, a retest still showed an elevated level of 98, and in December, the level was 95.
An initial ultrasound examination did not reveal any abnormalities, and I have not experienced any discomfort or unusual symptoms.
I would like to ask the doctor: 1.
I have heard that if it were cancer, the CA19-9 levels would significantly increase upon retesting after a month.
Since my CA19-9 levels did not change much in the following month, can I feel more reassured? 2.
Given that I have had elevated CA19-9 levels since 2009 and have had no issues for over four years, does this recent increase still fall within a range that can be monitored, or do I need to undergo another detailed examination? Thank you!

Wing, 30~39 year old female. Ask Date: 2014/01/10

Dr. Cai Anshun reply Gastroenterology and Hepatology

Hello: CA 19-9 levels may be elevated in patients with pancreatic cancer, cholangiocarcinoma, liver cancer, gastric cancer, and colorectal cancer.
However, elevated CA 19-9 levels can also occur in patients without cancer, such as those with liver cirrhosis, cholangitis, hepatitis, pancreatitis, and benign gastrointestinal diseases.
Therefore, CA 19-9 should only be used as an auxiliary tool and cannot serve as definitive evidence for the presence of malignant disease.
It is recommended that any questions be directed to a clinical physician to determine if further examination or observation is necessary.
Changhua Hospital cares about your health.
Dr.
Tsai An-Shun.

Reply Date: 2014/01/10

More Info

CA 19-9 is a tumor marker primarily associated with pancreatic cancer, but it can also be elevated in other conditions, including benign diseases and other malignancies. Your case presents a complex history of elevated CA 19-9 levels, and it’s understandable to have concerns about what these readings mean for your health.

1. Understanding CA 19-9 Levels: Elevated CA 19-9 levels can indicate the presence of certain cancers, particularly pancreatic cancer, but they can also be elevated in conditions such as cholangitis, pancreatitis, and liver diseases. In your case, the initial finding of a benign focal nodular hyperplasia (FNH) in the liver is significant. FNH is generally considered a benign condition and does not typically lead to elevated CA 19-9 levels.
The fluctuation of your CA 19-9 levels from 64 to 117 and then back down to 95 suggests that while there is some variability, it is not necessarily indicative of cancer progression. It is important to note that CA 19-9 is not a definitive test for cancer; rather, it is used in conjunction with other diagnostic tools and clinical evaluations.
2. Interpreting Changes in CA 19-9 Levels: You mentioned that you have heard that if cancer is present, CA 19-9 levels would significantly rise within a month. While this can be true in some cases, it is not a hard and fast rule. The stability of your CA 19-9 levels over the subsequent months (from 117 to 98 and then 95) may provide some reassurance, but it is essential to consider this in the context of your overall health and any symptoms you may experience.

3. Follow-Up and Monitoring: Given your history of elevated CA 19-9 levels since 2009 and the recent fluctuations, it is prudent to continue monitoring these levels. Regular follow-up with your healthcare provider is essential. They may recommend periodic blood tests to track your CA 19-9 levels and possibly imaging studies to monitor the liver and pancreas for any changes.
If your healthcare provider believes that the current levels are still within a range that can be monitored, they may not recommend immediate additional imaging. However, if there are any new symptoms or if the levels continue to rise, further investigation may be warranted.
4. When to Seek Further Evaluation: If you experience any new symptoms such as unexplained weight loss, jaundice, abdominal pain, or changes in bowel habits, it is crucial to seek medical attention promptly. These could be signs of a more serious condition that requires further evaluation.

In conclusion, while your CA 19-9 levels have shown some fluctuations, the absence of significant symptoms and the benign nature of your previously identified liver condition may suggest that immediate concern is not warranted. However, continuous monitoring and open communication with your healthcare provider are key to ensuring your health remains stable. Regular check-ups and being proactive about any changes in your health will help in managing your situation effectively.

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