Why is this happening?

[Sunes]

Hello Dr Goodman.
I have a question in regards to my  CA 125 was 171 and after one chemo - Single agent Carboplatin,  went down to 98.7 .............BUT my CA15-3 is on the rise from 73.9 to 114.3 and CA19-9 is high 47.5 from 22.3. I know this CA test is not a diagnostic tool but it is widely used as a indicator after chemotherapy.

Can you tell me why would  numbers  change so drastically both ways?  
Thank you, Sunes.

[Annekathryn Goodman, M.D.]

Dear Sunes
thank you for the additional information. In that case, I would suggest waiting and seeing with time and additonal therapy.
please let us know how things are going
take care

[Annekathryn Goodman, M.D.]

Hi There,
I would ask, why are all these tumor markers being checked? For ovarian cancer, CA 125 is the main marker to follow.
Tumor markers are substances, usually proteins, that are produced by the body in response to cancer growth or by the cancer tissue itself. Some tumor markers are specific, while others are seen in several cancer types. Many of the well-known markers are also seen in non-cancerous conditions. Consequently, these tumor markers are not diagnostic for cancer.
CA 125 is the current gold standard test for the management of ovarian cancer. It is used to monitor patients for recurrence and for response to therapy and treatment. CA 125 is a protein that is present in the majority of ovarian cancers. The protein is released by these cells into the blood stream and the concentration of the CA 125 protein can be measured with a simple blood test. CA 125 is elevated in about 80% of women with ovarian cancer, however not all elevations indicate a malignancy. .

Cancer antigen 15-3 (CA 15-3) is a normal product of breast cells; it is produced by a gene that is often overexpressed (i.e., the body makes too many copies) in cancerous breast tumors, leading to an increased production of CA 15-3 and the related Cancer antigen 27.29 (which measures the same marker but in a different way). CA 15-3 is a protein that is shed by the tumor cells, making it useful as a tumor marker to follow the course of the cancer.
CA 15-3 is elevated in about 30% of women with localized breast cancer and in about 75% of those with metastatic breast cancer (cancer that has spread to other organs). CA 15-3 also may be elevated in healthy people and in individuals with other cancers, conditions, or diseases, such as colorectal cancer, lung cancer, cirrhosis, hepatitis, and benign breast disease.

Cancer antigen 19-9 (CA 19-9) is a protein that exists on the surface of certain cells. CA 19-9  is a protein that is shed by the tumor cells, making it useful as a tumor marker to follow the course of the cancer.

CA 19-9 is elevated in most patients with advanced pancreatic cancer, but it may also be elevated in other cancers, conditions, and diseases such as colorectal cancer, lung cancer, gall bladder cancer, gall stones, pancreatitis, cystic fibrosis, and liver disease. Other causes of bile duct obstruction may also cause very high CA 19-9 levels, which fall when the blockage is cleared.

[Annekathryn Goodman, M.D.]

Dear SMPRENTISS,

The decision to remove your ovaries should be based on clinical symptoms such as pain, swelling or xray findings that are abnormal.  Please see my discussion above in this thread on tumor markers.
Ultimately the diagnosis of cancer only happens after the ovary is removed and evaluated microscopically.

I hope all works out.
best wishes

[SMPRENTISS]

I was told that I had cancerous cells in my cervix along with fibroid tumors and heavy bleeding. I was told after having a colposcopy test, that I was not bleeding from a menstrual period but the cervix.  I had a hysterectomy 11 years ago but my ovaries were left due to my age.  Now I am being told that I have complex cysts showing on my ovaries. The CA-125 test was preformed and was negative, however I was sent to a gyne specialist who also took a CA-19-9 test, and I was recently told it was high and that my ovaries will need to come out as a result. My question is: Why is the CA-19-9 test done as we are talking about my ovaries. IF the CA-125 test for ovarian cancer is negative, why did the CA-19-9 test now suggest that my ovaries should be removed.

Thank You
SMPRENTISS

[Sunes]

Thank you very much, I will let you know what's happening.
Sunes.

[Sunes]

Thank you very much, I will let you know what's happening.
Sunes.

[Sunes]

Thank you for the information.
I was tested in Cancer Centre in 2005 for the second time and all these markers were on my report all the time since, plus CEA too. I don't know why my ONC  decided to measure all of them. As I recall they were thinking that because I had TCC of the ovary they did not think this was my primary site.  After surgery pathology test came back after 3 weeks instead of 1 -2 weeks standard time.