Different values for the CA - 125???

[Neta100]

Dear Doctor:
I have posted here in this forum before due to the presence of a fibroid and ovarian cysts.  In the left ovary, there is a septum so the doctor ran the CA - 125 in January .  It came elevated (95 UI/ml) so he told me that I needed to get operated and depending on the frozen biopsy of the left ovary they would decide if they needed to do a total hysterectomy.  

Since then, they have repeated the marker several times and it continues being in the same range.  But before the normal value was less than 35 UI/ml.  Now, they ran the test again and it is elevated (137 UI/ml), but the normal value is less than 21 UI/ml.  

I know that based on the reagent, they change the normal values, but the doctor doesn't know how to compare this result with the previous ones.  So my question is, how can the previous results be compared to this new one?  

I went to another doctor and he suggested he could do a laparoscopy to see how my uterus and my ovaries were, but doesn't want to risk removing the ovary and the myoma via laparoscopy due the high value of the CA - 125.  Would it be safe to do a biopsy via laparoscopy and then, decide on what to do??? He is worried that the myoma has damaged the walls of the uterus and I may not be able to have kids.

Thanks in advance for your help.

Regards,

Neta

[Annekathryn Goodman, M.D.]

Hi Neta,

I would agree that it is important to look inside with laparoscopy. It is reassuring that your Ca 125 value has not been doubling. However, 95 and 137 are distinctly abnormal values. Even though you are only 37, there is a risk that the ovarian cyst is malignant. You can definately have an elevation of the CA 125 protein with myomas (fibroids) and endometriosis.

A biopsy of the cyst can be taken at laparoscopy to determine if the cyst is malignant. There are times when it is better to take out the whole cyst or the whole ovary in a manner so as not to spill any of  the cyst contents.  If a cyst is malignant, we try not to spill any of it so as to reduce the risk of spreading a cancer.
Please let us know what you decide to do.
best wishes

[Neta100]

Thanks for your advice.  I have to go to the doctor tomorrow and see what he decides to do, since he sent me to do some labs and I hope that everything turns out for the better.  He says he believes it's  a dermoid cyst or teratoma, but he wants to see first how everything is inside.

I'll let you know how it goes and again, thanks for your help.


Neta