Scanxiety and CA19-9

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LPL
Posts: 651
Joined: Fri Apr 22, 2016 12:49 am
Location: Europe

Scanxiety and CA19-9

Postby LPL » Mon Jul 02, 2018 4:40 pm

Please - I would love some positive vibes for my DH tomorrow. Thank You!
Hubby had an appointment for a checkup CT-scan on June 21st. When we arrived at the hospital we learned that the scanner had broken down :( and July 3rd is the new date for the CT-scan. Sigh... another Scanxiety will happen :cry: We did have an appointment with the Onc though and she said she was pleased with the blood tests taken recently. But of course I know that the CT is what really matters.

About CA19-9.
My husband’s CEA has never been elevated so probably not a Good indicator for him.. (before surgery his CEA was 2.5 and after it has been around 1.5 - never been above 2) but CA19-9 has reacted. Before surgery it was 78. Then it went down to 48 and then 29 and after that it has been around 28-35. His CA19-9 test results has been, from Nov 30 2016 to June 18 2018 “36, 35, 36, 33, 33, 28, 37, 28, 28, 35, 31.”. (Our Lab’s ref value now is <31). Can someone please share knowledge if this 28-35’ish’ could be OK for a man with a kidney function problem? I have read that kidney function can make a difference.
rp1954 has written about CA19-9 and that a much lower(!) value is what you want to see! I do want to see that but I wonder if this kidney problem my husband has means that his CA19-9 will never go down to that optimal level?
This is what I have read. for example:
Serial monitoring of CA 19.9 levels is useful to follow up patients after surgery and those who are receiving chemotherapy for advanced disease [81]. In the literature, there are discordant data regarding CA 19.9 during renal disease. Filella et al. and Zeferos et al. did not notice differences in patients with chronic renal failure compared to normal subjects [62, 63] while Xiaofang et al. [65] and Arik et al. found increased levels of CA 19.9 in chronic kidney disease patients. Therefore, the use of this marker is not recommended in patients with impaired renal function [17].
From (2014) https://www.hindawi.com/journals/bmri/2014/647541/
DH @ 65 DX 4/11/16 CC recto-sigmoid junction
Adenocarcenoma 35x15x9mm G3(biopsi) G1(surgical)
Mets 3 Liver resectable
T4aN1bM1a IVa 2/9 LN
MSS, KRAS-mut G13D
CEA & CA19-9: 5/18 2.5 78 8/17 1.4 48 2/14/17 1.8 29
4 Folfox 6/15-7/30 (b4 liver surgery) 8 after
CT: 8/8 no change 3/27/17 NED->Jan-19 mets to lung NED again Oct-19 :)
:!: Steroid induced hyperglycemia dx after 3chemo
Surgeries 2016: 3/18 Emergency colostomy
5/23 Primary+gallbl+stoma reversal+port 9/1 Liver mets
RFA 2019: Feb & Oct lung mets

rp1954
Posts: 1853
Joined: Mon Jun 13, 2011 1:13 am

Re: Scanxiety and CA19-9

Postby rp1954 » Tue Jul 03, 2018 2:50 am

Different papers have different opinions.

Looks to me like a decent CA199 performance. You have a substantial difference between pre-surgery and post surgery values, which suggests that CA199 is a useful marker. For simple statistics, you have a standard deviation of about 2 units, not bad even grinding in the spikey parts of the post-op CA199 measures. A probable shift in the minimum value due to a "benign disease" process may be disappointing but is a common factor in CA199 series in the 20s. I would be eyeing those 28s as a possible baseline and looking for correlations in the noisey, higher CA199s, with hsCRP, HgbA1C, etc.

The current CA199 data, fairly stable, with a likely benign cause don't provide much basis for cancer process based on CA199. For your situation that would mean either a more constant trend up for 3-4 points, or even going exponential, with doubling times. Also a low CEA, somewhat high CA199 pre-surgery is considered substantially less risky than both elevated then.
watchful, active researcher and caregiver for stage IVb/c CC. surgeries 4/10 sigmoid etc & 5/11 para-aortic LN cluster; 8 yrs immuno-Chemo for mCRC; now no chemo
most of 2010 Life Extension recommendations and possibilities + more, some (much) higher, peaking ~2011-12, taper chemo to almost nothing mid 2018, IV C-->2021. Now supplements

mpbser
Posts: 953
Joined: Wed Apr 19, 2017 11:52 am

Re: Scanxiety and CA19-9

Postby mpbser » Tue Jul 03, 2018 7:24 am

I know nothing about CA19-9 but I am sending positive vibes across the Atlantic to you!
Wife 4/17 Dx age 45
5/17 LAR
Adenocarcinoma
low grade
1st primary T3 N2b M1a
Stage IVA
8/17 Sub-total colectomy
2nd primary 5.5 cm T1 N0
9 of 96 nodes
CEA: < 2.9
MSS
Lynch no; KRAS wild
Immunohistochemsistry Normal
Fall 2017 FOLFOX shrank the 1 met in liver
1/18 Liver left hepatectomy seg 4
5/18 CT clear
12/18 MRI 1 liver met
3/7/19 Resection & HAI
4/1/19 Folfiri & FUDR
5/13/19 HAI pump catheter dislodge, nearly bled to death
6-7 '19 5FU 4 cycles
NED

User avatar
LPL
Posts: 651
Joined: Fri Apr 22, 2016 12:49 am
Location: Europe

Re: Scanxiety and CA19-9

Postby LPL » Tue Jul 03, 2018 3:20 pm

Good News :D
It was a brand new scanner at our hospital this time.
Husband’s oncologist gave us the result - she said:
Everything looks fine! If OK again next time (in 6month) we can remove the port.

mpbser,
So kind of you to send positiv vibes - it worked :wink:

rp1954,
Thank you so much for explaining and giving advice!
You mention HbA1c and CRP.
Husband’s HbA1c after his latest surgery (the liver mets) has been OK, 6.5(June-17) and 5.9(April-18). Actually this 5.9 is the best result he has had since being diagnosed with diabetes type2 in Dec-13.
Regarding CRP. I mentioned the kidney problem, that happened in 2012 and CRP was at that time elevated, around 15-20.
Then in 2016, after his 1st CRC emergency surgery it was 18. The day after his 2nd surgery (removing the primary etc.. see my signature) it jumped up to 120(!). Then it was around 10-15 during the 4 chemo before surgery NR3 (the liver mets). Right before that 3rd surgery it went up to 23 and the days after surgery it was 35 and 66. After that, when tested, it has been normal, aka below 5. Unit mg/L.
So looking at hubby's latest 4 bloodtests (period July-17 to July-18), the CRPs were all normal and tested at the same time as CA19-9. So, No I can not see any high(er) CRP in correlations to the 4 latest CA199s that were 28, 28, 35, 31.
DH @ 65 DX 4/11/16 CC recto-sigmoid junction
Adenocarcenoma 35x15x9mm G3(biopsi) G1(surgical)
Mets 3 Liver resectable
T4aN1bM1a IVa 2/9 LN
MSS, KRAS-mut G13D
CEA & CA19-9: 5/18 2.5 78 8/17 1.4 48 2/14/17 1.8 29
4 Folfox 6/15-7/30 (b4 liver surgery) 8 after
CT: 8/8 no change 3/27/17 NED->Jan-19 mets to lung NED again Oct-19 :)
:!: Steroid induced hyperglycemia dx after 3chemo
Surgeries 2016: 3/18 Emergency colostomy
5/23 Primary+gallbl+stoma reversal+port 9/1 Liver mets
RFA 2019: Feb & Oct lung mets

SteveNZ
Posts: 147
Joined: Tue Apr 24, 2018 4:21 pm
Location: New Zealnd

Re: Scanxiety and CA19-9

Postby SteveNZ » Tue Jul 03, 2018 4:53 pm

Great news. :D
Aged 56 - I feel really young...
Colo-Rectal Cancer T2 N1 M0
March 2018 - Diagnosis
April-May 2018 Radiation+Chemo then a TIA (Minor Stroke). - Stopped Chemo.
August 27th-November 2018 - Surgery and long, long recovery
*Decided to live to 100 as I will get a telegram from Her Majesty the Queen when 100yrs old. I so, so want one.
Am a Salvation Army chap so I complete 'knee drill' (prayer) to the Commander in Chief often. For myself personally this helps me through.

User avatar
LPL
Posts: 651
Joined: Fri Apr 22, 2016 12:49 am
Location: Europe

Re: Scanxiety and CA19-9

Postby LPL » Wed Jul 04, 2018 5:24 pm

SteveNZ wrote:Great news. :D

Thank you Steve.
I’m sending positive thoughts for your upcoming tests!
DH @ 65 DX 4/11/16 CC recto-sigmoid junction
Adenocarcenoma 35x15x9mm G3(biopsi) G1(surgical)
Mets 3 Liver resectable
T4aN1bM1a IVa 2/9 LN
MSS, KRAS-mut G13D
CEA & CA19-9: 5/18 2.5 78 8/17 1.4 48 2/14/17 1.8 29
4 Folfox 6/15-7/30 (b4 liver surgery) 8 after
CT: 8/8 no change 3/27/17 NED->Jan-19 mets to lung NED again Oct-19 :)
:!: Steroid induced hyperglycemia dx after 3chemo
Surgeries 2016: 3/18 Emergency colostomy
5/23 Primary+gallbl+stoma reversal+port 9/1 Liver mets
RFA 2019: Feb & Oct lung mets

Lee
Posts: 6207
Joined: Sun Apr 16, 2006 4:09 pm

Re: Scanxiety and CA19-9

Postby Lee » Wed Jul 04, 2018 6:30 pm

Congratulations to you and your DH

All the best,

Lee
rectal cancer - April 2004
46 yrs old at diagnoses
stage III C - 6/13 lymph positive
radiation - 6 weeks
surgery - August 2004/hernia repair 2014
permanent colostomy
chemo - FOLFOX
NED - 16 years and counting!


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