Skip to main content

What is CA 19.9 and why should we test this in pancreas cancer?

CA 19.9 is an essential part of the evaluation of pancreatic cancer.

CA stands for Carbohydrate antigen. This CA19.9 is normally produced in two sources in the human body - pancreatic parenchymal cells and the biliary epithelial cells. We still don't know the connection points between the tissue production of CA19.9 and the blood levels.

This protein was discovered in the research for large intestinal cancers, but we have found that it is very useful in pancreatic malignancies. A level of > 1000 has a very high chance (around 99%) of pancreatic cancer. The normal level is around 37 U/L and usually the other cutoffs that pancreatic surgeons remember is 100 U/l and 500 u/L, to assess cancer diagnosis and features of advancing disease.

It is important to check your CA 19.9 levels after the jaundice is relieved by ERCP and stenting. High levels in the presence of jaundice or cholangitis (infection of the bile ducts) is not useful to assess advanced disease.

At PCRRC, we keep 500 u/L as our limit to define borderline resectable disease (it means there is a high chance of missing microscopic disease). We use a lot of local protocols to control the disease in these patients and so far we are very happy with our patient results.

NCCN recommends this tumour marker testing in every pancreatic cancer after decreasing the jaundice. So after the CT scan, we always do the jaundice reduction and check CA 19.9 levels.

Labels:

Comments

Post a Comment

Popular posts from this blog

Is pancreas cancer curable?

Pancreas cancer is NOT curable at present. It is CONTROLLABLE. The treatment options that make this possible are available in Chennai itself. Better surgery techniques, better medical treatments and better radiation methods have added many years to patients suffering from pancreatic cancer. Pancreatic cancer at the root of the blood vessels - CAN be successfully removed. Pancreas cancer with spread to liver - CAN be removed Every pancreas cancer patient should have hope and persist in improving the outcome by using the option of better surgery, better radiation and better medical treatments.
Post a Comment
Read more

Do we have an answer for encasement of arteries in pancreatic cancer?

Pancreas cancer can encase the nearby key arteries. The three arteries that can be involved are hepatic artery (The one that takes blood to the liver), the celiac axis (The artery to the stomach and nearby organs) and the superior mesenteric artery (the artery to the small intestine). Till recently, the approximation of the tumour mass to any of these vessels was considered incurable and not suitable for surgery. These patients were provided palliative chemotherapy and radiation therapy along with pain control measures. These lesions were considered too advanced. NCCN guidelines call these lesions as locally advanced pancreatic cancer. The diagnosis of locally advanced pancreatic cancer is no longer made on the surgical table. With standardised imaging   (1)  being available in most places, pancreatic surgeons make this diagnosis after imaging evaluation. The obvious next step in evaluation is to look for disease in other major organs like liver, lungs and bone. A diagnosis of...
Post a Comment
Read more