Elevated CA 19-9

kim2005

Just got my tumor markers back and the CA 19-9 is elevated to 47.....below 35 is considered normal.  My oncologist is on vacation so I won't hear from him until next week.  The nurse said not to worry (basically) that she sees numbers much higher than this.  What do you think??  I've had nausea but no diarrhea.

mymountain

Hi Kim,

Why did you have a ca 19 9 drawn?  It is mainly used as a marker for pancreatic or biliary cancers, not usually something in the "normal" tumor marker lab test.   A value of 47 is just over the normal range and can also be elevated in gall stones or cirrhosis.  My father in law passed recently from bile duct cancer and his was consistently in the 3000-4000 range, so I 'm hoping that it's just a fluke from your gallbladder acting up( that would make sense of the nausea symptom)

MM

mymountain

Hi Kim,

Why did you have a ca 19 9 drawn?  It is mainly used as a marker for pancreatic or biliary cancers, not usually something in the "normal" tumor marker lab test.   A value of 47 is just over the normal range and can also be elevated in gall stones or cirrhosis.  My father in law passed recently from bile duct cancer and his was consistently in the 3000-4000 range, so I 'm hoping that it's just a fluke from your gallbladder acting up( that would make sense of the nausea symptom)

MM

oops sorry I hit the submit button twice

kim2005

Thank you so much for your reply....I've been having nausea for 3 weeks straight and a strong, persistent abdominal discomfort.  I asked my oncologist during a routine visit to draw blood for the tumor markers.  These are the results that just came back and he's on vacation so I can't ask his opinion.  The nurse didn't offer much information.  I did have an endoscopy last week but biopsy is not back from that yet.  Do you know what kind of test would detect gallstones or cirrhosis?  My oncologist said (before he knew the lab results) that he'd be happy to order a CT scan to check more into the discomfort. 

kim2005

I'm so glad you feel better Sherri!  Yes, it's the not-knowing stage that can strike fear which I hate because I'm normally a pretty calm person.  But I think those of us who've been through cancer understand that it's hard to deal with these mysterious medical issues.  Today I'm having an MRI and MRCP to look further at the gallbladder, bile ducts and pancreas.  I'm going to ask my doctor about the HIDA scan as I'm not aware of that.  Did they remove your gallbladder?  It's wonderful that you feel great now!

mymountain

Hi Kim,

Just  thinking of you and hope you get your nausea under control. 

I had done so much research on the CA 19-9 when my FIL was ill I really wanted to reassure you that a slight elevation was more than likely a problem with your gallbladder.  I am surprised that you would even have this blood test done in that it is not used as a diagnostic tool, but rather an indicator of treatment response in known pancreatic, and bile duct cancers.

  Here is the mayo clinic's page on the HIDA scan, also called a gallbladder scan.  If it doesn't fully load you can go to their website for all the info.

Good luck

MM 

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Definition

By Mayo Clinic staff

HIDA scan is an imaging procedure that helps your doctor track the production and flow of bile from your liver to your small intestine. Bile is a fluid produced by your liver that helps your digestive system break down fats in the foods you eat.

A HIDA scan, which stands for hepatobiliary iminodiacetic acid scan, creates pictures of your liver, gallbladder, biliary tract and small intestine. A HIDA scan can also be called cholescintigraphy, hepatobiliary scintigraphy or hepatobiliary scan.

A HIDA scan is a type of imaging study called a nuclear medicine scan. This means the HIDA scan uses a radioactive chemical or tracer that helps highlight certain organs on the scan.

Why it's done

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References

1. Society of Nuclear Medicine procedure guideline for hepatobiliary scintigraphy. Reston, Va.: Society of Nuclear Medicine. http://interactive.snm.org/docs/pg_ch11_0703.pdf. Accessed Oct. 3, 2008.
2. General nuclear medicine. RadiologyInfo. http://www.radiologyinfo.org/en/info.cfm?pg=gennuclear&bhcp=1. Accessed Oct. 7, 2008.
3. Practice guideline for the performance of adult and pediatric hepatobiliary scintigraphy. Reston, Va.: American College of Radiology. http://www.acr.org/SecondaryMainMenuCategories/quality_safety/guidelines/nuc_med/hepatobiliary_scintigraphy.aspx. Accessed Oct. 3, 2008.
4. Segerman D, et al. Radionuclide imaging: General principles. In: Adams A, et al. Grainger & Allison's Diagnostic Radiology. 5th ed. Philadelphia, Pa.: Elsevier Churchill Livingstone; 2008. http://www.mdconsult.com/das/book/body/106899019-4/0/1611/0.html. Accessed Oct. 8, 2008.
5. Mettler FA. Essentials of Radiology. 2nd ed. Philadelphia, Pa.: Elsevier Saunders; 2005. http://www.mdconsult.com/das/book/body/106899019-4/0/1276/0.html. Accessed Oct. 8, 2008.

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Nov. 22, 2008

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kim2005

Thanks for the information MM.  Good news in that the MRI and MRCP and biopsy came back 'fine'.  The GI doc just called and said the MRI did show some fluid in my lungs and she wants to order a CT of lungs and gallbladder.  It's certainly a mystery to me but I'm keep plugging along to find answers!

mymountain

Kim,

Did you have the Hida scan?

Any answers?

Thinking of you

kim2005

Hi MM,

I haven't been on the boards lately and I appreciate your concern.  The CT scan came back fine from my chest.  The GI doctor thought maybe we should try a parasite medication in case I picked up a bug from my travels.  I finished the meds and feel better now but I'm going to go back and have the CA 19-9 done again soon.  Even though 47 is not terribly high,  I still would like to understand why it would be high and out of range.  It makes me somewhat nervous even though the scans show nothing at this point.

 Hope all is very well with you!