Hello my Dad has stage 4 Pan. Can and is undergoing Gemzar Tarceva treatment has been seeing a significant decline in tumor markers. CT showed disease was stable,, last week his tumor marker was "up" he is feeling terrible and is tolerating the chemo less and less. What does the tumor marker mean exactly??
dear jena the ca 19-9 is a tumor marker specific to pancreatic cancer this number can sometimes be a false positive especially if it is only slightly elevated: but it is often elevated significantly when the tumor has returned or increased in size my husband always wanted a straight answer to his questions so that is what i will do for you. God bless you dear as you and your father go through this hard place sincerely jimandkathy
just to clarify the CA 19-9 tumor marker is elevated in many GI cancers. It can be used to monitor treatment effectiveness and tumor progression. In diagnosis it has limited value except in the situation of extreme elevations (>1000) with the presence of jaundide and a pancreatic mass.
I also have a question about CA19-9. Pre-whipple my Dad's CA19-9 was 333. Now three months post-whipple (had lymph node involvement and positive margins - Stage III) it is 2081! But his last two CT scans did not show any growth or mass in the abdomen. Can the spread occur without showing up on the CT - with the CA19-9 being so high?
the general rule for Ca19-9 in PC is that a series of increases can be indicative of disease progression. Most agree that should be followed up with CT/MRI. Single levels by themselves are not much value. They can be high with no disease progression and low with disease progression. So its good news the scans are clear. The high level could be treatment related. I would see what the next level shows and not worry for now.
You may wish to look up a study done by Dr. Adam Berger and reported at an oncology conference in Philadelphia in June of this year. His results suggest that CA-19 results can be as much as 2-9 months ahead of what scans will show. My Dad had a slight rise in CA-19-9 two weeks ago and they told us that it does fluctuate somewhat so a slight rise should not be a concern. I hope it's a small rise and that things turn around and go back in the right direction for you.
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