CA19-9 is elevated!!
Hello Doctor: I previously consulted you about my elevated CA 19-9 levels, which have been high since 2009.
After a recheck at the end of November last year, my CA 19-9 level was 117.
Two and a half months later, in early February this year, it was 109.
I also had an abdominal MRI, which showed no issues with my pancreas or other organs.
After an 8-month interval, I had another blood test today, October 27, and my CA 19-9 level is now 130.
I would like to ask you, given the slight increase in CA 19-9 levels over the year (from 117 to 130), can I feel reassured? Or should I undergo further testing? Thank you!
A-Mao, 30~39 year old female. Ask Date: 2014/10/27
Dr. Chen Qifeng reply Gastroenterology and Hepatology
Hello: Generally speaking, if there is indeed a tumor, the markers would already be in the hundreds, or even thousands, and there would be other symptoms present as well.
If an MRI has already been performed, the next step would be to continue monitoring.
Wishing you peace and good health.
Dr.
Chen Qi-Feng, Gastroenterology Department, Taoyuan Hospital, Ministry of Health and Welfare.
Reply Date: 2014/10/27
More Info
Elevated CA19-9 levels can indeed be a source of concern, but it is essential to understand the context in which these levels are elevated. CA19-9 is a tumor marker primarily associated with pancreatic cancer, but it can also be elevated in other conditions, including cholangiocarcinoma, colorectal cancer, and even benign conditions such as pancreatitis, liver disease, and certain gastrointestinal disorders.
In your case, you have a history of elevated CA19-9 levels, with recent measurements showing a slight increase from 117 to 130 over the span of a year. It is important to note that while a rising CA19-9 level can indicate a potential issue, it is not definitive for cancer diagnosis. The specificity and sensitivity of CA19-9 are not high enough to be used as a standalone diagnostic tool. Therefore, it is crucial to interpret these results in conjunction with clinical findings and imaging studies.
Since you mentioned that you had an abdominal MRI that did not reveal any issues with the pancreas or other organs, this is a reassuring factor. Imaging studies are critical in evaluating the presence of any masses or abnormalities that could correlate with elevated tumor markers. If the MRI was thorough and no abnormalities were found, this suggests that there may not be an immediate cause for concern regarding pancreatic cancer or other malignancies.
However, the slight increase in CA19-9 levels does warrant continued monitoring. It is common practice to follow up with regular blood tests to track the trend of CA19-9 levels over time. If the levels continue to rise or if you develop any new symptoms, further investigation may be necessary. This could include additional imaging studies, such as a CT scan or endoscopic ultrasound, which can provide more detailed information about the pancreas and surrounding structures.
In your situation, it would be prudent to discuss your concerns with your healthcare provider. They can help you determine the best course of action based on your overall health, medical history, and the results of your previous tests. If your doctor believes that the increase in CA19-9 is significant or if there are any changes in your clinical status, they may recommend further evaluations.
In summary, while a slight increase in CA19-9 levels can be concerning, it is essential to consider the broader clinical picture. Given that your MRI did not show any abnormalities, you may not need to panic. However, regular monitoring and open communication with your healthcare provider are key to ensuring that any potential issues are addressed promptly. Always remember that tumor markers like CA19-9 are just one piece of the puzzle in diagnosing and managing health conditions.
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