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ca125 test

i had an ovarian cyst, blood work was done prior to the gyno draining the cyst, he said it was 60...he drained the cyst, sent me back for the ca125 test again to see if the level lowered, it did not he said 3,000 something. he referred me to a gyno oncologist and i have an appt. tues nov. 2. my question is
1.why did the ca125 level skyrocket and could the cancer cells have been released from the ovary with the procedure of draining the cyst.
2. how fast would these cells travel, my concern is having to wait until tuesday's appointment and that is just for consultation....
3. i read that an abnormal ca125 level can have many different causes, not necessarily ovarian cancer.
obviously i am very concerned and do not understand most of the research that i have done.
3 Responses
1242509 tn?1279120864
I am sorry you have to go threw this it is very stressfull to have this hanging over your head. Keep in mind most cysts are benign!!  
My wife was recently Dx with granulosa Cell cancer( GCT) Jan 2010 and I know what it feels like to not know what the next step is. Here is a quick overview.

Tests like sonograms, Cat scans and MRI's along with blood tests like CA125, Inhibin A&B, MIS and CEA are just used as a guides for the Dr's to help assist in making a diagnoses(Dx). A transvaginal ultrasound (TV) is the most valuable diagnostic study in the evaluation of an adnexal or pelvic mass/suspicious cysts.  
An MRI is usually the next test that should be given as they are more precise when read by the right radiologist.
The blood test CA-125 is a test used by Dr's as a guide to determine if you have the most common form of ovarian cancer, approximately 80% of all ovarian cancers are epitheal ovarian cancer which is cancer of the cells on the surface of your ovary. Please keep in mind that CA-125 can be elevated if your menstruating and some other causes of inflamation..
There are other types of ovarian cancer that are hormone driven and depending which form a person has there will be excess symptoms of that specific hormone. This is the type my wife was Dx with granulosa cell ca. These group type are called sex cord -stromal tumors. These type of tumors have specific markes that the Dr's use just like ca-125 to aide in their dx of epitheal ovarian ca. They are Inhibin A&B and MIS. Please keep in mind if and only if you have a dx of these form of tumors there is a missconception that these tumors are always benign, which is completely false> They are just slow growing tumors as opposed to epitheal.
Unfortunately with any type of suspected ovarian mass/tumor/ suspicious cyst(s) surgery will be the only way for the Dr's too make a definitive Dx.
*****It is NOT recommended to biopsy any ovarian mass/tumor/suspicious cyst as it can rupture and seed the pelvis with cancer cells if that what it turns out to be. **********
Since there is some suspicion  I would immediately find a good GYN/Oncologist surgeon. I am not suggesting what you have is cancer but studies have shown that treatment of ovarian cancer by nongynecologic oncologists and by low volume surgeons is associated with suboptimal surgical management. I would reccomend going to a large tiertiary hopsital where they see large volumes of patients.  This is not to make you worry even more but to make sure that the Dr who treats you has vast experience with diagnosing and treating various types of GYN / Onc issues if that is what it turns out to be. If the Dr wants to remove the cyst/mass via laprascopic procedure #####PLEASE make sure they have much experience with removing these INTACT! All too often I read posts from patients who say their Dr thought it was a cyst and removed it haphazardly causing a rupture and seeding of the pelvis with cancer cells, only to be found on pathology post removal. ######
Next: From experience I would be asking for an MRI of the abdomen/pelvis ,MRI's are very precise when read by a Radiologist that specializes in GYN/ONC, My wife went to a radiology practice that does all types of MRI's and the Radiologist read her MRI as a fibroid. I then took her to Sloan Kettering in NYC to see a GYN/ONC surgeon Dr Carol Brown who had the MRI repeated by a GYN/ONC Radiologist who called her DX to the tee which was confirmed after surgery.
The best advice you see all over these posts is you have to be your own advocate, be aggresive and stay on top of your phycicians. Get copies of all your tests/results as you are entitled to them. Post with any other questions you have this site has some very knowledgeable people on it. I wish you all the best.
1242509 tn?1279120864
Aspiration of cyst contents is NOT recommended because no tissue is obtained for pathology, evaluation of cyst fluid is not reliable exclusion for malignancy, there is a high rate of recurrence and aspiration does not provide better results than simple observation or cystectomy. If the cyst is malignant, spillage of malignant cells into the peritoneal cavity is highly possible from draining or ruptureing the cyst.
1191484 tn?1289124134
I have been reading your intial reply to alicomeau in response to her elevated CA125. In particular your reference to " an inflamation" may be the cause of the rise.

I have Primary Peritoneal Cancer (not in treatment at the moment) which is treated exactly the same as Ovarian Cancer. I recently went for a check up and was shocked to discover that my CA125 had risen from 71 to 1,280 in 2 months. My onc was a little non plused as my CT scan results showed very little change.

Now my question is "Is it possible for IBS (inflamation of the bowel) to cause this sharp elevation? I have been suffering with this condition quite badly throughout the last 2 - 3 months as I wait to see whether my cancer is going to settle down. With you referring to the rise in CA125 may be down to inflamation made me wonder?

Thanks Tina
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