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CA 19.9 level of 38.1
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CA 19.9 level of 38.1

My test showed a CA 19.9 level of 38.1.  My lipase levels have been in the mid 400's for several months.  The ultra sound showed just a "fatty " pancreas.  I have had mid-left back discomfort for months.  No pain. No jaundice.  Appetite seems ok.

What is my next step?   Doctor said come back to be retested in two months.  After checking the web, I realized I could be dead in two months (unlikely, but let's play this safe)

I live in Europe.  I hope you can give me advice.  Female, age 62, family history breast, ovarian & prostate cancer.  Renal insufficiency.  

Many thanks,
Tags: pancreas
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Avatar_dr_m_tn
Hi.  CA 19.9 cannot be used as a screening procedure for detecting pancreatic cancer in people who don't have any symptoms which would point to a possible cancer (e.g. weight loss, mass in pancreas detected on ultrasound or CT).  Several studies have already been done which proves that CA 19.9 can't be used for screening.  There's a Japanese study involving 12,840 people without symptoms aside from an elevated CA 19.9.  In this group, only 4 were found to have pancreatic cancer. Another study done by Kim, et. al (J Gastroenterol Hepatol 19(2):182-186, 2004) involving 70,940 asymptomatic patients with elevated CA 19.9 also detected only 4 people positive for pancreatic cancer.  

The proper use of CA 19.9 is in monitoring response to treatment of a known case of pancreatic cancer.  The levels usually come down after surgery or chemotherapy.

So in all probability, you don't have pancreatic cancer.  CA 19.9 levels can also increase due to some non-cancerous conditions like gallstones, pancreatitis and liver cirrhosis.

If you wish, you can have it retested after two months just to see if the elevated level is persistent, but personally, I don't think this is even necessary.
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504967_tn?1334502858
Dear Dr. Fernando,
I went for a full health check in a Pathology Lab. I was shocked when the Patholgist told me that I may be having pancreatic Cancer as the Tumour Marker CA 19.9 shows a result of 51.7 (the normal being <31.0).
I was shocked. So I requested the Pathologist for another test. He told me to come back again in 2 weeks time to repeat the CA 19.9 test.
This time the CA 19.9 level reading was 43, a drop of 7.7. The Pathologist told me to come back again in one months time.
For your information I feel normal from the time I walked in for the above health test. Even now I am feeling normal. Could you please advice me
should my level go down to below normal, should I go for another CT Scan or just ignore the whole process of repeating the CA 19.9 test
again.
Please advice, as I do not any form of sign as I feel normal.
Thank you.

K. Mahendra Malaysia
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Avatar_dr_m_tn
Hi.  Again, I wish to emphasize that CA 19-9 cannot be used as an initial screening tool for pancreatic cancer in a previously asymptomatic individual.  If, for example, you had an  abdominal CT scan and a mass was found at or near the area of the pancreas, then subsequently doing serial determinations of CA 19-9 may be justified.  But if an initial imaging procedure does not prove the presence of a mass, testing for CA 19-9 afterwards is useless since it is not sensitive or specific enough to detect cancer which has not been detected by a more sensitive test (the CT scan).  

So my question for you is: what was the result of your initial CT scan? (since you're asking to go for another one, I'm assuming you already had an initial scan).  If your initial abdominal CT scan did not show any abnormalities, then I think you should stop having further CA 19-9 tests.  The results are meaningless and will only serve to confuse you.
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504967_tn?1334502858
Dear Doctor Fernando,

Thank you so much for your prompt reply.
I have NOT DONE  the CT scan yet. The Pathologist asked me to go for a CT Scan
but after reading a few of the articles re Tumour Markers, I was trying to seek medical
advice from professional medias  and I was fortunate to read some of your valuable articles re this Tumour Marker. Until todate I have NOT GONE FOR ANY CT SCAN YET.
I am feeling normal and I do not have any symptoms. I CASUALLY went for a  helath
check and was surprised that my tumuor marker level was 51.7 . I requested for the Tumour Marker level to be repeated and after 2 weeeks the Level went down to 43.0.
What I am upset is - AM I SUFFERING FROM PANCREATIC CANCER.
SHOULD I GO FOR A CT SCAN? I feel normal as all the other tests are normal
except for this CA 19.9 level. I am also curious to know as to why the CA 19.9 level should fall from 51.7 to 43.0 in 2 weeks time.IS IT NECESSARY FOR ME TO GO FOR A CT SCAN since I notice that the Tumour Level is falling, hopefully to < 37.0 level.
Please advice.

With appreciation and gratitute to you.

Thank you.
Yours truly,
Mahendra - Malaysia
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Avatar_dr_m_tn
Hi.  Based on those CA 19-9 results alone, I really don't think you're suffering from pancreatic cancer.  The CA 19-9 should not have been done in the first place if you don't have any symptoms which would make the doctor suspect pancreatic cancer! If you've read my earlier post closely, I've already cited two studies involving thousands of people without symptoms, but with elevated CA 19-9.  If you take the Japanese study and compute the probability of an asymptomatic person with elevated CA 19-9 having pancreatic cancer: that's 4/70,940 or a 0.005% (less than a hundredth of one percent) chance of having pancreatic cancer!

If you're really anxious about the whole thing, then you may wish to have an abdominal CT scan done.  But I don't think this is even necessary, given the very low probability of pancreatic cancer in your case.  I think the CA 19-9 test was unnecessary, and has only caused you needless anxiety and confusion.  I repeat, CA 19-9 is not useful as a screening tool!
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504967_tn?1334502858
Dear Doctor Fernando,

Thank you very much for your clarification.
My family and I are most grateful for the immediate response you have furnished
to the mental agony my family and I was undergoing on this CA 19.9 Tumour Marker
Issue.
I now understand the validity of CA 19.9 in relation to healthy individuals.

I would also be grateful if you could enlighten me as to the signs I have to look forward
to suspect that I may have a Pancreatic Cancer Problem in the future, so that I could
go for a CT Scan.

Once again Thank you.

Yours truly,

K. Mahendra - Malaysia.
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Avatar_n_tn
My father has a ill defined mass in the neck of pancreas
( CT scan report) but CA 19.9 level is 36. Is there a chance of the mass being benign?
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Avatar_dr_m_tn
Hi.  A CA 19-9 value of 36 is still within normal (the normal range is 0-37 Units/ml).  Now, since the CA 19-9 level is normal, does this mean that the mass is likely benign?  What you need to understand is that a diagnosis of pancreatic cancer is made not on the basis of the CA 19-9 result alone, but by looking at the patient's entire constellation of signs and symptoms as well as the laboratory results.  

If your father has, in addition to the pancreatic mass, symptoms suggestive of cancer such as abdominal pain, jaundice (yellowing of the skin and eyes), weight loss, and lack of appetite, then a diagnosis of pancreatic cancer may be considered in spite of a normal CA 19-9.  Surgical excision of the pancreatic mass may be warranted in this case.  If your father does not have any symptoms aside from the pancreatic mass, he may opt to observe and have the CA 19-9 as well as the abdominal CT scan repeated after 2-3 months to see if there are any changes.

How large is the mass anyway?
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Avatar_n_tn
Thank you very much for the prompt response.
The mass size is 1.4 * 1.7 cms. My father is not having any stomach pain but having mild jaundice (bilirubin 1.46). Otherwise, he doesn't have any discomfort. But he has lost weight (about 6 kgs in the last 7-8 months).
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Avatar_f_tn
My father is suffering from Pancreatic cancer (CA - 19.9) and has been losing his wait very fast and have very badly stomach pain,  I dont know his pancreatic range. In March 2008 he has removed his balladeer because of Stone problem. what should be his diet at this time.
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Avatar_n_tn
Hi,

I have been unable to locate the ca 19-9 studies you mention in this post.  Can you please clarify the authors and titles?
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Avatar_dr_m_tn
Hi,

Here are the bibliographic entries for the two studies I mentioned in this post. The Korean study can be accessed online.  Here's the link: http://www.medscape.com/viewarticle/466811_1

1.  JE Kim, et al. Clinical Usefulness of Carbohydrate Antigen 19-9 as a Screening Test for Pancreatic Cancer in an Asymptomatic Population. J Gastroenterol Hepatol 19(2):182-186, 2004

2. Satake K, Takeuchi T, Homma T et al. CA19-9 as a screening and diagnostic tool in symptomatic patients: the Japanese experience. Pancreas 1994; 9: 703-6.
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Avatar_n_tn
Thank you for providing the online link!  I was able to find the Korean article there, and also found the Japanese study (which is published in "Pancreas" vol 9, no 6, 1994).  I'll verify that the findings in those studies do reflect that while 1.5% of Korean and .2% of the Japanese population had ca 19-9 levels above 37 u/mL, only .04% of THOSE patients were found to have pancreatic cancer.  It should be noted that other conditions were found, but this is being posted to confirm the questions in this community regarding PC.  For those still very curious or unsure, there is a brand new study out in June '08 from Fred Hutchinson Center (A Mouse to Human Search for Plasma Proteome
Changes Associated with Pancreatic Tumor Development -- PloS medicine June 2008 | Volume 5 | Issue 0953 6 | e123) that may be helpful in the future for earlier detection.

Lastly, I came to this forum as a patient who does have a moderately elevated ca 19-9 at ~38-40 u/mL.  Dr, can you comment on a raised amylase level of about 170 combined with this ca 19-9?  (other findings have shown a small simple hepatic cyst and .19 crp).  Would you guess any relation(s)?  MRI showed no pancreatitis or other findings, but the hepatic cyst was found in that MRI.  I look forward to your thoughts.
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Avatar_dr_m_tn
Hi.  The hepatic cyst is most probably unrelated to the amylase result.  The enzyme amylase is produced by the salivary glands and the pancreas.  Increased levels of this enzyme can be seen in cases where there is disease either in the pancreas or the salivary glands, not the liver (e.g. pancreatic cancer, acute pancreatitis, mumps or any infection of the salivary glands).  Amylase also increases when there is obstruction or disease in the ducts through  which the enzyme is secreted (e.g. bile duct obstruction, cholecystitis, intestinal obstruction).  If the MRI shows no signs of any pancreatic disease, one possibility is that the increased amylase level is coming from the salivary gland, not the pancreas.  Maybe this should be checked.
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504967_tn?1334502858
Dear Doctor Fernando,

Is there a posibility of the Tumour Marker CA 19.9 to fluctuate in an asymptomatic person i.e. from 51 to 43 and again rise to 57. Can these kind of results in an asymptomatic person due to any particular food intake he has taken prior to his blood test  that could  have aggravated the rise of the CA 19.9 level. In cases of this nature, is there a possibility of the CA 19.9 level to go down to the below normal level of <37.
Hope to hear from your kindslef soon.
Thank you.

K.Mahendra


Thank you.
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Avatar_n_tn
Thank you again for the reply.  Sorry that I originally omitted that elevated salivary amylase has been ruled out, and that it is pancreatic.  Can you offer any specific disease/concerns you would think to be a possiblity?
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Avatar_dr_m_tn
Hi.  I am not aware of any particular food which can affect the serum level of CA 19.9.  When interpreting CA 19.9 results, incremental fluctuations like the results you posted (51, 43, 57) are really meaningless.  In the context of pancreatic cancer diagnosis, I would only consider the CA 19.9 result as significant if there is a huge increase in CA 19.9 levels from the baseline. For example, if your initial CA 19.9 were 51, a significant result is if your levels increase to more than 100 or 200 on the next determination. The CA19.9 result can also be considered as significant if there is a consistent and progressive increase in levels on serial determination.  You also have to remember that the CA 19.9 level has to be seen in the context of a patient's overall clinical picture.  In the presence of a pancreatic mass, then increased CA 19.9 may truly be significant in confirming pancreatic cancer.  In the absence of a pancreatic mass in a person without symptoms, increased CA 19.9 is virtually insignificant, as shown by the Japanese and Korean studies I have cited earlier in this post.

So in your case, the CA 19.9 levels most probably do not signify the presence of disease. It's quite possible that your CA 19.9 levels will go down below 37 in subsequent determinations, but why bother having yourself retested if you don't have any symptoms?
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Avatar_f_tn
Hello.  My father in law has inoperable bile duct cancer.  His latest CA 19.9 results was over 500.  Does this indicate the cancer has spread to the pancreas?  He had a stint put in the bile duct 3 months ago today.  His jaundice is starting to return and he has continued to lose weight.  We suspect the tumor has grown over the stint.  We are just wondering if the cancer has spread further?
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504967_tn?1334502858
Dear Doctor Fernando,

Thank you for your clarification.

Where in the world can we look forward for Medical Opinion as that provided by your kindself, representing MedHelp.

With choicest Blessings To You, The Management Staff
and families.

Mahendra (Malaysian Indian)
Johore, Malaysia.

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Avatar_dr_m_tn
Hi.  CA 19.9 may also be elevated in bile duct cancer or in instances where there is obstruction in the bile duct.  Both of these situations are present in your father in law, which is the reason why his CA 19.9 is elevated. The elevated CA 19.9 level does not necessarily mean that the cancer has spread to his pancreas.  You are probably right in saying that the return of your father-in-law's jaundice and his continued weight loss indicate that the tumor has most likely grown over the stent and is progressing.  But the elevated CA 19.9 has nothing to do with it.
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504967_tn?1334502858
My friend is also asymptomatic as I am. He too recently went in for a Blood Test.
His CA 19.9 was 57.5 and after a week he was tested again and his level went down to
53. I did tell him vide the many replies I have received from you  that the Elevation of Tumour Marker CA 19.9  is insignificant in an asymptomatic person. I told him not to
bother about this CA 19.9 tumour marker unless he experiances symptoms like Jaundice, Diabetis, Loss of weight and so forth. He wants to go for another test in a months time for which I told him to just ignore the test as the tumour marker fluctuates
in all normal persons. The normal level in healthy persons should normally be <37 but according to the various results explained  to me vide this section,  I told him that it is his choice to go for further cheks if he is not convinced.

Have you any advice for my friend. Thank you.

Mahendra.
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Avatar_dr_m_tn
Hi.  I don't have any additional advice for your friend other than the ones I have already posted here.  The facts speak for themselves.  If your friend wants to undergo further testing, then that's his prerogative.
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Avatar_m_tn
Dear Dr. Fernando,

My wife was diagonosed Pancreatic Cancer in January 2006 and after initial investigation and ERCP twice, was operated for Whipple's in February 2006. She reovered remarkably and was given a clean chit by the surgeon who operate afetr some four months of monitoring. On a foll up, an oncologist erroneuosly diagonosed of recurrence of disease and wanted to start chemotherapy. After obtainng a few "second" opinions and after massively educating myself through the net, and taking route of some alternate medicnes, a CT scan and and agresive Endocopic examination resulted in categorical "No recurrence of disease at all".

Ever sinse, a constant monitoring of the patient's LFTs, Blood Chemistry, CA 19.9 have shown a remarkable sustained health but on and off attacks of unrelated nature such as asthma etc. Her CA 19.9 level has always come as <2.5.

I would like your opinion as recently my wife has shown fears as if the disease is recurring although her latest blood test sho no such indications.

What particular test you would suggest to re-ensure her confidence.

She is 52 years old of Asian origin.
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Avatar_dr_m_tn
Hi.  If your wife is still worried about recurrent pancreatic cancer in spite of the low CA 19-9 results, a negative endoscopic examination and CT scan, then she could consider having a PET scan (positron emission tomography) of the whole body done.  This imaging procedure is even more sensitive than CT scan in detecting very small aggregations of cancer cells.  If the PET scan is negative, it's highly unlikely for her to have cancer recurrence.  The PET scan however, is a rather expensive test, so you should think first before having it done.  
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Avatar_m_tn
sir,

my ca 19.9 test show result of 15.5 uiml. Is it normal,, i were found pancrettis when ct scan made on last year. That time i was having pain in stomach when take food. but from last six months no pain, i go to doctor and he told me to take ca 19.9 test and the result is 15.5 U/ml. pls advice me whether the range is normal or not
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Avatar_dr_m_tn
Hi.  The normal value for CA 19-9 is 0-37 units/ ml.  A value of 15.5 is well within the normal limit.  You do not need to have the test repeated.  It is not useful in the diagnosis and treatment of pancreatitis.
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Avatar_n_tn
Hi.. I am very thankful for this website n the info provided. This is very useful n informative for me. Recently from my blood test report my reading on CA 19.9 is 46.6 units/ml. I was very scare and afraid and lonely till I found this website.

But I am considering to go for a through checkup on this n to ease my mind I am thinking of going for ultra sound or CT scan later.

Do hv any advise for me ?
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Avatar_dr_m_tn
Hi.  I agree with your course of action.  Even if you do not have symptoms, it might be best to have that check up and probably an abdominal CT as well.  But I doubt if any abnormalities will be found on CT.  I'm glad that you have found our forums useful.  Good luck.
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Avatar_n_tn
Thank you for your prompt reply.

What would u advise shld i go for ultra sound or CT scan for both abdominal n stomach ?
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Avatar_dr_m_tn
Hi.  For a more definitive test, I would suggest that you have a whole abdominal CT scan done.  This is a more sensitive test than ultrasound for detecting masses in the abdomen, particularly in the pancreas.  If no pancreatic mass is present on CT scan, and if you don't have any other symptoms, then there is no need to have the CA 19-9 repeated in the future.
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Avatar_n_tn
hi ..
My aunt had symptoms of gallstones. On conducting a CT scan, doctors saw a alongwith 4 calculi of 1 cm each, a neoplasm of size 4cm * 2.1cm.  They suggested to take a CA19.9 test. The CA 19.9 level report shows a level of 6.68. Now this figure looks to be normal.

Please suggest what can be the next course of action, Doctors initially suggested a removal of Gallbladder, some part of deodenum and stomach and some part of small intestine.

The symptoms were a severe abdominal pain and acidity, also a weight loss of around 10kgs in a month.

Now I need to consult some good doctors, but I need to go prepared, as their claims seem to have faultered.

Your suggestions will be a great help. I live in India.
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Avatar_n_tn
Hello,

My mother-in-law has just received her CA 19.9 test results.  The level was 1,002.  Her pancreas is enlarged as well as her liver.  The dr. put a stint in the pancreas to get the bile flowing again.  Her jaundice has reduced, but she is still having back pain.  She isn't loosing weight.  With that elevated level, do you consider it to be cancer?  

She is 74 years old.

kdb
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Avatar_n_tn
CA19-9 =72 in Jan;CA19-9=85 in Feb; ESR, CRP, Amylase, Lipase within normal limits;should I be worry(I am freaking out, really), any sugestions?
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Avatar_n_tn
Dear Fernando, MD.

I think that is very usefull to have this open line to advice people concerned with their parents (the most of the cases i´ve read).

My father has stomach cancer; we both know 6 moths ago.
Today, i´ve experienced a comment from my father´s docter that let me very confused - the ca-19.9 level is HIGHER THAN 120.000 (yes 120.000 units per ml). The doctor is a senior oncologist MD, and he told me that he doesn´t ever seen something like this. My father is making chemotherapy, once a month, since November of 2008. I don´t know what i should tell to my father and what i should think, because this huge number (usually < 37un/ml) is greater than 120.00 (not measured, i mean than could be 200.000 or 300.00). Very thanks in advance and  Very best regards Paulo (from Portugal)
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Avatar_f_tn
I am new on this site and i am sorry i don;t know to whom i will address my query at all... i really need comments/answers for my fiance's condition... pls..

My fiance in this past few months (approx. 2 months) has been suffering from too much gas in the stomach esp. after eating, pain. bloated stomach, he is losing weight as well, fatigue and body malaise... apparently, he went to a physician to check himself coz it is really anoying. his blood test is ok except for elevated Alkaline phosphate and sadly, after performing scan on his stomach they found a pea-size lump. i am not sure whether in which organ particularly the doctor didnt mentioned as well, they just said lumpin the stomach.... Moreover, after he found out that he has this lump, he was advise to do endoscopy and to take sample as well for biopsy. the problem now is that the doctor is inconclusive of what is really the problem or whether he is having cancer or no. He was advise to take this Ca 19.9 test. and we are still waiting for the result...

We are so worried... we are suspecting him of having cancer... cancer of what probably? we still don't know...the doctor's inconclusion is adding agony to us as well... we are in the middle east and sorry to say health care system here is not that well...

Anybody can give me his best opinion on my fiance's case? what else do we need to do? I need any information, suggestions, advise that u may have....

Please...
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504967_tn?1334502858
On the 24.4.2008, i went in as a asymptomatic person and did my complete blood test.
All the other result were in the normal range except for the Tumour Marker CA 19.9  showed up as 55.  After having waited for a year with no symtoms (symptoms) whatsoever I went in
to check my CA 19.9 level on 20.4.2009 and to my dismay it shot up to 71 with no symptoms. I was rather upset and went in for another CA 19.9 level test on 18.8.2009 and my CA 19.9 level dropped to 53.
The only problem which I am having for sometime is a swolllen thyroid nodule. I have got this espirated on the 15.7.2009 and the Doctor tested my TSH, T3 and T4 which was also within the normal range. The result showed that it is a benign cyst (not malignant).
The Doctor (Endocrinolgist) told me to come next month to medicate me on the Thyroid Nodule.

Looking at my above case, is it necessary for me to go for another CA 19.9 test or just treat the thyroid nodule. I also wish to know wetghr the swollen thyroid nodule has in a way increased my CA 19.9 reading.

Thank you,

Suresh
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Avatar_n_tn
My mother suffers from Pancreatic cancer stage 3. She has had 8 sessions of chemotherapy including gemcitabine, and her ca level is rising every month. its now above 500. Does it mean the cancer is spreading? she is asymptomatic at the moment. Once the ca level rises rapidly does it mean we are losing her rapidly too?

P
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Avatar_m_tn
Sir
           I am furnishing the following details about my case

• Started with the pain in upper abdomen in Jan, 2010
• C T scan conducted on 20/1/2010 showed “ Enlarged Lymph nodes in Porta with dilated pancreatic duct with CBD at upper limit of  normal”.
• Diagnosed as chronic alcoholic pancreatitis. Amylase  and lipase  were found as 290  and  310    respectively. Since 201/1/2010 to today the amylase has varied from min  57 to max 385 and lipase min 51 and max 3763.  
• Started medicine ‘Panlipase”
• Improvement in Pain
• Meanwhile in February (  5/2/2010 )  metabolically active enlarged lymph nodes were seen in the upper middle and lower deep cervical region .
• FNAC and pet scan done on 11/2/2010. Diagnosed as Hodgkins II B .
• Stated chemotherapy with ABVD on 13/2/2010 .
• After 3  cycles  of chemotherapy on Whole body PET –CT  (10/5/2010 )  Showed
(i) Total Metabolic and Morphological response to lymphnodal disease.
(ii) Metabolically active pancreatic abnormality which was not a part of the original disease process needs further Evaluation.
• For further evaluation CT was conducted on 22/5/10 .CT scan Showed
“Compared with old CT The pancreatic duct and lymph nodes in Porta  has decreased in size Nacrotic area has appeared in uncinate process of pancreas with



sub mucosal collection seen in second part of  duodenum( not seen in the old Scan) – likely post chemotherapy necrosis.
• Advised to continue  Chemotherapy  -- Total 6 cycles
• Liver function Test  Report conducted on 29/5/10 showed normal  parameters.
• EUS  Guided FNAC conducted on  4/6/2010. Report is being enclosed.
• Chemotherapy as due  conducted on 11/6/2010.
• Recently Developed jaundice . CT scan conducted on 18/6/2010. showed
“Compared  to previous CT scan done on 22/5/2010 there is increase in size of the ill defined heterogeneously enhancing  area involving pancreatic uncinate process along with significant obstructive biliopathy that was not present in the previous scan. The size of the lymphnod in the porta reveals no significant time interval change . The submucosal duodenal collection has mildly decreased in size. Pl correlate clinically “
• A 10 F x 10 Cm stent was placed across papilla to drain the bile into duodenum. Slide of Brushing taken during ERCP on 12/6/2010 shows benign mucosal fragments  NEG: no evidence of cancer in the specimen.
• Already undergone  C5 D1 of chemotherapy and left with 3 more sittings of chemotherapy.
Please advice next course of action/ treatment .
   avis

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Avatar_n_tn
After reading all the comments above I am more confused and fearful now. For the past 1.5.years I have tested my ca19.9x 6 times, and they are all above normal reading. My GP has advised to seek specialist opinion or ask for a colonoscopy. I just feel so violated, yet I am fearful.
I have no symptoms at all. I am a 54 year old menopausal woman, who has the history gastric issues and H-Pyloric positive for 2 years, and finnaly rid it off last year.  
Please advise. I am so fearful of anymore of biopsy, as I am scared of the results as well.
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Avatar_n_tn
My mother had a stone in pancreas and was suggested for ESWL treatment.She had undergone the treatment 5 times but no results were found and it lead to chronic pancreatitis and 10 days ago had gone under a surgery named pancreatic jujonomy.In may her CA 19.9 was 88.8 but now it is 526.26.Is it more and is it developed to pancreatic cancer and if yes is it treatable through pancreas removal i.e.whipples procedure or through chemotherapy.Waiting for reply.Thank you.
Mail id  ***@****  
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Avatar_m_tn
sir,
my father had jaundice . ultrasound suggested obstruction in gall bladder.the
doctor found a lesion while doing ercp and took brushings. the brushings have come out to be non malignant but CA 19 9 shows 89.5. what should i do..i m really worried now..  please reply at the earliest...
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Avatar_f_tn
My Whipple's procedure was done in December 2010. The preoperative CA 19-9 was 140. After the operation pathology results showed that my lymph nodes were negative and the margins were clear too. The tumor was staged as T3.  A month after the operation the CA 19-9 was 42.

Since then the CA-19-9 is checked on a monthly basis and it fluctuates a bit ( 40, 44, 44, 47, 29, 32, 32, 40). My CT scans results always came clear. I am feeling good and have a great appetite.

Should I be expecting my CA 19-9 to be under 37 at all times or the reading I have is normal for someone with my history?

Thank you kindly.
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Avatar_f_tn
My Whipple's procedure was done in December 2010. The preoperative CA 19-9 was 140. After the operation pathology results showed that my lymph nodes were negative and the margins were clear too. The tumor was staged as T3.  A month after the operation the CA 19-9 was 42.

Since then the CA-19-9 is checked on a monthly basis and it fluctuates a bit ( 40, 44, 44, 47, 29, 32, 32, 40). My CT scans results always came clear. I am feeling good and have a great appetite.

Should I be expecting my CA 19-9 to be under 37 at all times or the reading I have is normal for someone with my history?

Thank you kindly.
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Avatar_m_tn
First, Doctor, you are an Angel to provide this mental and emotional comfort to us for free. Thank you.
My friend used a Rife machine and also used chemotherapy to become cancer-free from Stage 4 adenocarcinoma of the pancreas as of March 2011. His CA- 19-9 was very close to 37. Now it has increased in the past few months to over 300 but his CT and PET scans are negative and he feels and looks great!!?? There are other reasons for eleavted CA 19-9 values besides malignancy. Is it merely wishful thinking to explore those non-malignant possibilities before letting his doctors ramp up his chemotherapy?
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Avatar_f_tn
Dear doctor Fernando , I done a full body check up at path lab a week before after caeseraen . I had my caeseraen four months before and still on breast feeding . The cancer marker ca 19.9 was increased to 72.3 which I was told I might got a small intestine cancer. I was told its very high. I am worried but I don't have any symptoms expect constipation. Please advice me .
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Avatar_m_tn
Hi Dr Fernando

My father age 62 is having dilated bile and pancreatic ducts since one year . It started with a sudden abdomen pain later diagnosed as pancreatitis pain on 12 may 2011 . This time CBD was dilated and doctor did the ERCP and stenting, however there was no fever or signs of jaundice this time and CA19.9 was normal 22 . Nothing remarkable was found in CT scan except dilated CBD and inflamated Pancreas . After 3 months we got stent removed and he stated living normally unless after 3 months of stent removal he showed signs of Cholangitis with fever and itching .
He was immediatley hospitalised and was done Endoscopic Stenting and EUS . Through EUS they took the Biopsy sample which was negative . However doctor suspected it as a tumor since there was some swelling in Preampullary region .
Now recently he was again hospitalised due to low fever and was diagnosed a small absess (abscess)/infection in preampullary region They again had the CT scan and EUS done with stent replacement and they drained the absess (abscess) . This time again Brushing from bile duct and multiple biopsies were taken that again returned negative .

Yestreday we had the CA19.9 done which measured 60 and LFT and other tests normal .
Doctors are advicing Whipple Surgery for the safer side

However we are still not ready since surgery is very big and his overall health is good .
He is stable in weightloss since he weights 74-75 KG from past 6 Months .

Even when stent is there he still has dilated CBD and MPD . CBD: 14 MM  and MPD :7 MM .

The time when he was first admitted in May 2011 MPD was not dilated and Doctors said he just have a stricture in lower end of CBD with bulky papilla .
We do not have a cancer family history with NO alchohol and Smoking .
My father overall health is OK and he lives a normal life .
He is Non Diabitic
Twice EUS biopsies have been negative with negative Brush Cytology .
Every one is very tensed and my heart does not say that there can be cancer as he lives a very active and healthy lifestyle with every Day Exercises and Yoga Since 20 Years .
It is almost one year now when he was first hospitalised doctors are still not sure why he had this problem .

Really need some professional advice what we need to do now?
Whipple is Big Surgey and dont know when Doctors are not even sure how they can do it ?


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Avatar_m_tn
I was suffering from jaundice and right upper stomach pain.Ultrasound was done and result was pancreatic head mass  visible. CA-19.9 is 25.1.No weight loss,no family history of cancer.Age 27,Male.
MRCP also done subsequently and still showing the mass.
CECT was done and they told there is no mass.I underwent Diagnostic lap and lower CBD stricture(benign) was identified and corrected with hepaticojejunostomy.There was no pancreatic mass observed during surgery.
My doubt is that How the mass suddenly got disappeared?(Mass in USG and MRCP and no mass in CECT and diag lap)
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Avatar_m_tn
Hi doctor, my CA19.9 is 40U/ml, what am I suppose to do? My doc say its normal.. But is that really normal? Am I need to go for treatment? My age is 29..pls advice me
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Avatar_m_tn
Respected sir,

My wife is suffering in pancreas cancer. Before   chemo and radiation her CA 19.9 was 481 but after chemo and radiation its rise up to 1862.32 within 3 months and not only this, the pancreas tumors spread on liver also. fFirst on pancreas head and size was more than 3 cm. after chemo and radiation its on pancreas ( size-2.5) and spread on liver in eight section ,last section( 8th) size is 2.2 and others are less than 1 cm. After this incident she become more week and feeling uneasy and i stop her chemo which was recomand her doctors for further high doses chemo. I start the diet therapy of Dr. kelly and stopped direct sugar and glucose based foods to eat. I notice within 2 monthes that she feels good , I also used, creon 25000 as the replace enzym of pancreas for her proper digest and its work  after 15 tin days, I test her CA 19.9 and seen that its still rising from 1862.32 to 1901.30. I am using half hot chilly also in the morning with hand made bread. According to previous report of CA 19.9 ,it was increas from 481 to 1862.32 within 4 months, that means monthly increas ratio was 345.33, that means in 15tin days it was increased 172.665, but at present i notice that using this diet therapy its increas in 15 tin days only 38.98. So tell me please is it a good sign?
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Avatar_m_tn
Respected sir,

My wife is suffering in pancreas cancer. Before   chemo and radiation her CA 19.9 was 481 but after chemo and radiation its rise up to 1862.32 within 3 months and not only this, the pancreas tumors spread on liver also. fFirst on pancreas head and size was more than 3 cm. after chemo and radiation its on pancreas ( size-2.5) and spread on liver in eight section ,last section( 8th) size is 2.2 and others are less than 1 cm. After this incident she become more week and feeling uneasy and i stop her chemo which was recomand her doctors for further high doses chemo. I start the diet therapy of Dr. kelly and stopped direct sugar and glucose based foods to eat. I notice within 2 monthes that she feels good , I also used, creon 25000 as the replace enzym of pancreas for her proper digest and its work  after 15 tin days, I test her CA 19.9 and seen that its still rising from 1862.32 to 1901.30. I am using half hot chilly also in the morning with hand made bread. According to previous report of CA 19.9 ,it was increas from 481 to 1862.32 within 4 months, that means monthly increas ratio was 345.33, that means in 15tin days it was increased 172.665, but at present i notice that using this diet therapy its increas in 15 tin days only 38.98. So tell me please is it a good sign?
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