CA 19.9 level of 38.1

[wabbit66]

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,

[naki2avi4u]

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.

[ban1824]

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).

[Fernando Roque, MD]

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?

[ban1824]

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?

[mahendra9]

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.

[Fernando Roque, MD]

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!