Understanding CA-125 fluctuations

[TwoForOne]

I was diagnosed with what is likely synchronous ovarian and endometrial cancers in May 2004. Because both are endometrioid cell type, I was told it's possible it's just one cancer, but more extensive. If it's the two cancers, the ovarian is 2C and the endometrial is 2B.

I had the usual 6 rounds of carbo and taxol and then 28 sessions of external radiation.

My CA-125 had been around 8 or 9 since that time. However, it jumped from 8 to 11 in April, and I will have it retested in a few weeks. My medical oncologist told me it was just a "normal fluctuation,"  but I can't help but be paranoid it's the beginning of a recurrence. I had a CT scan at the same time, which showed nothing, but I understand that my CA-125 would likely go up before anything shows up on a scan.

Can you give me your insight on how much CA-125 bumps around while you are in remission? What  if it goes up another 3 points?

Thank you for your thoughtful answers to the other posters. They have been very helpful for me.

[Annekathryn Goodman, M.D.]

Hi There,
CA 125 is a protein that is secreted by tissues of the female genital tract.  It is also in the lining of the abdomen (peritoneum) and lung (pleural). Everyone has a certain amount of this protein in their blood. In premenopausal women, the cutoff for normal is 35 milli international units (mIU). After menopause, the protein level is usually lower than that like 6 to 15.

While CA 125 is a poor test for screening for ovarian cancer, it is a very sensitive marker for recurrence in someone who has experienced ovarian cancer. There are other reasons for the protein level to go up such as infections or inflammations in the lungs or abdomen.

You have been living with the fear of recurrence since your diagnosis. It sounds like it has been about a year and half since you finished your therapy. I know from my patients that waiting for a test result is sheer agony. And it is also very frightening when the result is slightly different from previous reports. I would agree with your oncologist that values of 8 and 11 are probably pretty much the same thing. However, I understand your concern. My approach is to repeat the CA 125 in a month  to be sure that the 11 is not a trend upwards. I not think so because it is so low. Usually in the setting of a recurrence, I will see the value double or triple. So for you, if a repeat comes back in the 8 to 15 range, I would be happy. Anything over 20 would be a reason to think with your oncologist about how to evaluate this further.
Best wishes to you.

[titti73]

A related discussion, ca125 fluctuation was started.

[kathy o]

AMEN to that!!!!

[TwoForOne]

Thank you for your very helpful explanation of CA-125. Your answer made me feel so much better about what might be going on that I went and had the test done yesterday, and I'm back down to 9.