CA125 up to 1,800 now

[Setter]

Hi Dr., I wrote to you back in FEB. then i did 7 doxils ended in May 08 & now ca125 up to 1,800 any idea what is going on??  A little background 04/05 treated 5 months by family doc for CONSTIPATION, i knew it was more, gyno found it 11/05 surgery by very uncaring male dr, who i no longer see all he wanted to do is chemo ( would not answer any ??"S about other treatments, (hyster. & appendix removed) 3 rounds carbo/taxil stage 1C, 10 months 6 more carbo/taxol,10 months 7 doxil, now trying tamoxifen 7 days now,  ct & pet & colonoscopy CLEAR, doing brain mri & spine/lumbar mri next week , why is this # going up so high, i feel ok but ca125 is causing lots of anxiety etc. My tumor was NEGATIVE for est/prog receptors what else could be going on here, tamoxifen so far causing night sweats, weight gain, crabbiness, etc..any suggestions would be helpful do you think tamoxifen will help get that # down or do you know any alternatives??  Thank you so much you are an amazing woman for helping us..God bless.  

[Annekathryn Goodman, M.D.]

Hi Setter,

again, if you feel well, closely following up with exams and possibly a repeat CT scan in 3 months is an option.

Another option is looking inside the abdomen surgically by laparoscopy.

Please let us know how you are doing
best wishes

[Setter]

Hi Dr. and thanks for the response, I have spoken to Dr. Jensen and heres the following: no heart failure, no pneumonia, no lung problems, no COPD, no barb's., no liver disease ,no gall bladder issues, pet scan, catscan, colonoscopy, mammo., and labs are ALL clear, and liver function, ekg and cardio OK ,ca125 today was 4,200, waiting on mri results from brain,spine,lumber and pelvic region done on friday, no supplements other than calcium, vit c, glu & condr., lysine, CoQ10, melatonin, multi vitamin, I have been tested everyway possible, also pelvic ultra sound, rectal exam also a pap to check for any abnormal cells, whats left?? Any idea's? I am baffled and I think the doc's are too, she has consulted with many different ones? HELP??

[Annekathryn Goodman, M.D.]

Dear Setter,
thank you for letting us know what is going on.
That CA 125 will most definitely cause anxiety.
It is reassuring that your scans are normal and that you feel well.
The reasons for such an elevation are as follows:

1.There is a recurrence of the ovarian cancer but it is too small to see of scan. This can happen if the cancer cells are just coating the lining of the abdomen or lungs without causing a mass
2. You have a lung problem such as COPD or pneumonia and are having an exacerbation
3. Congestive heart failure
4. liver disease such as cirrhosis, obstruction of the bile ducts, drug effect on the liver metabolism (certain herbs, general anesthesia, barbiturates, etc)
5. Inflammation such as gall bladder disease

Ultmately, with time it will be become clear. I would check liver function, chest xray, and heart scan  (potentially doxil which is adriamycin may cause heart dysfunction although we usually do not see this with doxil - we deinately see this with adriamycin.).
You should also ask your doctor about the role of laparoscopy to give a definate answer
best wishes