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Ovarian Cancer (Expert Forum)
CA-125 Test helpful?
Answered by
Annekathryn Goodman, M.D. - Gynecologic Cancers, Complex Gynecologic, Surgeries, Palliative Care, Acupuncture
Massachusetts General Hospital Cancer Center
Boston - MA
This forum is for questions and support regarding ovarian cancer issues, such as: Biopsy, Chemotherapy, Clinical Trials, Genetics, Hysterectomy,Immunotherapy, Ovarian Cancer Types, Radiation Therapy, Risk Factors, Screening, Staging, Surgery.
CA-125 Test helpful?
by JulieAM, Jan 31, 2007 12:00AM
Hello--I had laparoscopic surgery to remove a 5cm ovarian cyst in November. My doctor referred me to an oncologoist at a large hospital in another city because I had a CA-125 test result of 360 and I have a family history of ovarian cancer. However, because the oncologist believed the cyst to be an endometrioma, I was assigned to an ob/gyn for surgery instead. After the surgery, my husband was told that severe endometriosis was found which included the bowel, and some of the lesions on the bowel could not be removed. I was also given a 3-month dose of Lupron Depot immediately after the surgery. I have just gone in for a follow up appt and learned that although a sample of the endometriosis was submitted for pathology, the ovarian cyst was not. I am pretty upset about this, as my main objective for the surgery was to rule out ovarian cancer. Do you think there is any point in retesting the CA-125 level to see if it has gone down, in terms of ruling out cancer. If so, should it be normal, or can I expect it still to be high since I have endometriosis remaining? Is a visual diagnosis of endometrioma always accurate? Thank you very much for reading my question and providing this service.
Doctor's Answer
by Annekathryn Goodman, M.D., Feb 14, 2007 12:00AM
, Feb 14, 2007 12:00AM
Dear Julie,
Again, sorry about my delay.
thank you for your excellent questions. i would divide the issues into three different parts:
1. What exactly was the pathology from the tissue that was removed? It may be worthwhile to ask for a copy of your pathology report. if you do that and don't mind typing it here, we can review it together. Endometriosis is a condition where tissue that looks like the lining of the uterus (endometrium) is found on the ovaries and surrounding structures (the peritoneum, the bowel, the bladder). In the ovary, a swelling (called an endometrioma) can form that contains blood and endometriotic tissue. the blood occurs because during your period, the endometriosis bleeds. During surgery, if the endometrioma is removed but the ovary is preserved, it is not possible to remove all the endometriosis. It may not be possible to remove the lining of the cyst that forms the endometrioma without losing the ovary. So , it is quite possible that an actual 'cyst wall' is not found during the pathology analysis.
2. CA 125 can be a very good marker for endometriosis. since your level was elevated, it makes sense to me to check again and see if it has dropped after surgery and lupron
3. If you have a family history of ovarian cancer, are you planning on having your ovaries removed after you have finished having your family? Presently that is the recommendation for women at risk for ovarian cancer. Unfortunately, there is no effective screening test for ovarian cancer
take care
akg
Again, sorry about my delay.
thank you for your excellent questions. i would divide the issues into three different parts:
1. What exactly was the pathology from the tissue that was removed? It may be worthwhile to ask for a copy of your pathology report. if you do that and don't mind typing it here, we can review it together. Endometriosis is a condition where tissue that looks like the lining of the uterus (endometrium) is found on the ovaries and surrounding structures (the peritoneum, the bowel, the bladder). In the ovary, a swelling (called an endometrioma) can form that contains blood and endometriotic tissue. the blood occurs because during your period, the endometriosis bleeds. During surgery, if the endometrioma is removed but the ovary is preserved, it is not possible to remove all the endometriosis. It may not be possible to remove the lining of the cyst that forms the endometrioma without losing the ovary. So , it is quite possible that an actual 'cyst wall' is not found during the pathology analysis.
2. CA 125 can be a very good marker for endometriosis. since your level was elevated, it makes sense to me to check again and see if it has dropped after surgery and lupron
3. If you have a family history of ovarian cancer, are you planning on having your ovaries removed after you have finished having your family? Presently that is the recommendation for women at risk for ovarian cancer. Unfortunately, there is no effective screening test for ovarian cancer
take care
akg
Member Comments (2)
by JulieAM, Feb 02, 2007 12:00AM
I forgot to tell you that the abnormal CA-125 test was done in June 2006. I haven't had one since then. Thanks again.
