CA125 and cysts

[LILYBUG]

Hello, my question is really surrounding the CA125. Mine has been monitored for 18 months now. It has been anywhere from 40-80, and declining with most 3 or 6 month check-ups. I've had u/s every 3 or 6 months as well. Because I have another kind of cancer, I also had a ct every 3 months last year. All tests stated the cysts they find appear to be normal functioning cysts. In October the CT and ultrasound didn't even mention any cysts. I just got rechecked last month and my ca125 went up to 176. I had it checked again a few weeks later and it was down to 57. My ct again stated it appears to be normal functioning cysts. I am scheduled for the u/s tomorrow. I had an exam at MD Anderson a few weeks ago. My question is this: Is it possible my ca125 was so high because I was on my period and had very infected wisdom teeth? Am I being too optimistic about it going down? Also, is it time to have surgery to explore? How do they know these cysts are coming and going and not there all the time? I'm just concerned that we are missing something and can't figure out why my ca125 is always elevated and yet the scans and u/s for 18 months show nothing. Any suggestions on what else should be done? At what point should they quit monitoring the ca125? It's been over 18 months. I do have a lot of right sided pain in ab (lower and upper), side and back that everyone wants to call nerve damage from other abdominal surgeries in the last 18 months. I'm just afraid we're missing something. Should we do surgery or if the u/s tomorrow is good then just accept that my ca125 is always elevated?

[akg]

dear Lilybug,
Thank you for your complete information. So it sounds like you have had two abdominal surgeries int he past  2years (appendix and gallbladder) that is very reassuring. If there had been any suspicious finding on the ovaries, it would have been seen st that time. it sounds like you are doing the right thing. It is possible that your Ca 125 is mildly elevated because of inflammation.
i am happy to hear that your recent scans are fine
best wishes to you

[LILYBUG]

I had melanoma on my arm. No treatment other than surgery. The cancer has not spread. I did my ultrasound and transvaginal ultrasound last week and all they found was the same fibroid I've had all along. The cysts that were on the CT 3 weeks ago are now gone. The CA125 is back down to 57. Dr. has again advised to get the CA125 checked again in 6 months and do u/s if necessary. It will then be 2 years. I've had 2 check-ups with no cysts found throughout this ordeal. Neither of the Oncologists I'm working with think surgery is necessary.

[LILYBUG]

Since I posted my question here, I have had the u/s and got results. It all looks fine, just a fibroid. I also posted the info below to someone on the board to share my story. This gives more detail:
I first must clarify myself. I don't work with gyn/oncs, so I'll tell you how this all unfolded. In '05, I had horrible ab pains. Couldn't figure them out. My GP was sending me to my OB and said to do the ca125 test first so she'd have results at appt time. Ended up in ER that weekend to have my appendix removed instead. In Sept of '05, I found out I had melanoma. I travel to MD Anderson for treatments and tests. I once had to have a bloodlevel rechecked at home for melanoma stuff and they accidentally pulled that old CA125 order and checked it by mistake. It was elevated, and so the gyn roller coaster began. I spent every 12 weeks in 2006 having chest ct, ab ct, pelvic ct, brain mri, and chest x-ray to monitor the melanoma and because I had other ab pains. I got to add the ultrasound and transvag ultrasound to the list every 3 months because of the ca125 and cysts and fibroid. In May of '06 I had my gallbladder removed because it was not functioning. Before that had to have a heart work-up due to family history before surgery would be done.That still did not stop the pains.I also had a liver test. I then had a colonoscopy. Although I have spots in my liver and lung, they are stable and haven't grown in over 15 months. I also had several mammos and u/s and biopsy of breast. Everything checks out fine. Still can't figure out why I have so much right sided pain and elevated ca125 but I certainly feel as though I've been check thoroughly. They think it is nerve damage from one of my surgeries. I am now on 6 month check-ups and just passed my last one with flying colors. Good luck to you.

[Annekathryn Goodman, M.D.]

Hi Lilybug,

Could you please review what your cancer was and what therapy you had for it?

I usually recommend a laparoscopy to evaluate the ovaries when a CA 125 is persistently high. This may also be a good time to review what  your risk factors for ovarian cancer are such as family history, personal history of breast, colon, uterine, ovarian cancer, etc

How old are you? Should you consider a prophylactic removal of your ovaries if your have risk factors for ovarian cancer?

thank you. I will look for your answer
take care