ca19-9 or ca199

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natelaugh
Posts: 92
Joined: Wed Apr 03, 2019 11:40 pm

ca19-9 or ca199

Postby natelaugh » Sat Sep 28, 2019 12:36 pm

Hi,

My dad finished his 12cycles chemo and his CEA increase to 12.1. We decide we need more blood test and did it on our own. We got a ca19-9 and the result came back 950 and normal range is (0-34)U/mL. It is so high that they had to repeat the test to confirm. This is our his first ca19-9 result. His doctor never order a ca19-9 and we order it ourselves.

My questions are, does anyone have a ca19-9 as high or higher than 950 while on chemo? What is the range of ca19-9 while on chemo?

Thanks,
Nate.
Caregiver to 80M
DX:CC,RC,desc
11/2018 rightPain
1/19/19 scopy,path
1/23 CTscan
2/19 surgery
2/26-2/28 NGTube
2/28-3/14 TPN bc ileus
3/2 2nd surgeryCloseOpenWound
3/4-3/28 woundVac
size: 6cm Adenocarcinoma
grade Poorly
Stage IIIC T3N2aMx
PositiveLymph:5of28
BaselineCEA:68
LVI:Y
PNI:N
Surgical margins:clear
MSI:MMR (MLH1, MSH2, MSH6, PMS2) Intact nuclear expression
Lynch status:N
Laparascopic, partial colectomy
CEA:3/28/19 2.8
Chemo:4/16/19-9/17/19 5FU,12cycles,every 14days,leucoverin,zofran,Dexamethasone

rp1954
Posts: 1523
Joined: Mon Jun 13, 2011 1:13 am

Re: ca19-9 or ca199

Postby rp1954 » Sun Sep 29, 2019 12:15 am

A lot of the blood tests will be greatly altered by the cellular and organ damage that Folfox does. Geriatric Folfox treatment can affect a lot.

Basically, the highly affected panels and markers will peak at different times and recede toward new normals over the year that follows 6 months of chemo, if all goes well. CA199 is affected by various irregularities or elevation in other panels, starting with hsCRP. With immunochemo (and IV vitamin C), we were able to use CA199 with rock steady, low noise results for over a year, during my wife's second year of chemo (after her second surgery), and then see likely flares rise and fall after that. In the first year, her most valuable data were a spiking CA199 series then treated back down with more chemo adjustments while her elevated CEA didn't change much more. A few people have been better able to navigate their CRC with CA199 than with (dud) CEA values, for years. Folfox/Folfiri, can greatly distort CA199 cumulatively during treatment; inflammations and infections can substantially distort (e.g. triple) CA199 values further.

We never really saw enough blood data on the board to well range CA199 distortions with the various panel elevations during/after chemo. CA199 is most valuable before the first treatments - before surgery, after surgery and before chemo and used with various blood panels that I mentioned last April. Long after a heavy chemo treatment series, CA199 should become a normal marker again, perhaps shifted. In between, one would be looking for a decline of the distorted CA199 values with the other affected panels constant or in decline toward normal too, but lots of uncertainties.
Last edited by rp1954 on Sun Sep 29, 2019 8:20 pm, edited 2 times in total.
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 to almost nothing mid 2018, mostly IV C

Rock_Robster
Posts: 392
Joined: Thu Oct 25, 2018 5:27 am
Location: Melbourne, Australia

Re: ca19-9 or ca199

Postby Rock_Robster » Sun Sep 29, 2019 2:32 am

I can’t add anything to this discussion sorry but would like to say it’s good to hear from you rp1954 :) . Hope all’s well.
Male 37; Melbourne, Australia
10/2018 Dx 3.5cm RC adenocarcinoma, 12cm from AV
Mod diff, EMVI+ LVI+ PNI-
3 LN; 4 liver mets
pT3pN1aM1a; Stage IVa. MSS, NRAS (G13R)
CEA: Oct-18= 12; Nov-18= 14, Mar-19= 2.4, Aug-19 <2.0
11/18 - FOLFOX x 6
3/19 - Liver resection
4-5/19 - 25 x pelvic radiation; complete met. response
07/19 - ULAR (robot), temp ileo, 1/27 LN
08/19 - Missed liver spot
08-11/19 - FOLFOX x 1, FOLFOXIRI x 1, FOLFIRI x 5
12/19 - Planned liver resection #2 & (01/20) stoma reversal

User avatar
CRguy
Posts: 10035
Joined: Sun Feb 10, 2008 6:00 pm

Re: ca19-9 or ca199

Postby CRguy » Mon Sep 30, 2019 12:32 am

natelaugh wrote: We got a ca19-9 and the result came back 950 and normal range is (0-34)U/mL. It is so high that they had to repeat the test to confirm. This is our his first ca19-9 result. His doctor never order a ca19-9 and we order it ourselves.
My questions are, does anyone have a ca19-9 as high or higher than 950 while on chemo? What is the range of ca19-9 while on chemo?

Hi Nate
I have CA19-9 done for monitoring since CEA is NOT a marker for me. We started after resections and chemo, so I had no PRE-cancer Tx baseline.
CA19-9 is non specific ... BUTT may be used in monitoring a number of abdominal cancers, particularly pancreatic ....
CA19-9 can be elevated in many types of gastrointestinal cancer, such as colorectal cancer, esophageal cancer and hepatocellular carcinoma. Apart from cancer, elevated levels may occur in pancreatitis, cirrhosis, and diseases of the bile ducts. It can also be elevated in people with obstruction of the bile ducts.

AND
A higher than normal level of CA19-9 can be found in healthy people and can also be found in people with non-cancerous and cancerous conditions.
Non-cancerous conditions include:
liver diseases, such as cirrhosis or hepatitis
inflammation of the gallbladder (cholecystitis) or gallstones
inflammation of the pancreas (pancreatitis)
cystic fibrosis
some disorders of the lung, kidney or gastrointestinal tract

Types of cancer include:
some types of pancreatic cancer
colorectal
stomach
liver
bile duct
lung
breast
uterine
ovarian


SO ......
You would need to check that the lab is testing and quoting the SAME test validation ranges
i.e. your quoted reference range is in fact THAT of the testing lab ... don't assume !
AND that the testing methodologies are comparable.
(( we had MANY discussions here when a number of CEA protocols / Labs changed their methods and results ))

We will do our best to help you here
BUTT ... keep pushing the Doctors and the Labs with your questions until
You Get an Answer !!!!

Best wishes
CRguy
Caregiver x 4
Stage IV A rectal cancer/lung met
12 Year survivor
my life is an ongoing totally randomized UNcontrolled experiment with N=1 !
Review of my Journey so far


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