CA 19-9 (Pancreatic tumour marker)
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Cancer antigen 19-9 (CA 19-9) is a protein that exists on the surface of certain cancer cells. CA 19-9 does not cause cancer; rather, it is shed by the tumour cells and can be detected by laboratory tests in blood and sometimes other body fluids. This test measures the level of CA19-9.
Since CA 19-9 can be measured in blood, it is useful as a tumour marker to follow the course of cancer. CA 19-9 is elevated in about 70% to 95% of people with advanced pancreatic cancer. However, CA 19-9 may also be elevated in other cancers, conditions, and diseases such as: gallbladder and bile duct cancers (cholangiocarcinoma), colorectal cancer, gastric cancers, ovarian cancer, lung cancer, liver cancer, bile duct obstruction (e.g., gallstones), pancreatitis, cystic fibrosis, thyroid disease, and liver disease. Small amounts of CA 19-9 are present in the blood of healthy people. Since CA 19-9 is not specific for pancreatic cancer, it cannot be used by itself for screening or diagnosis.
CA 19-9 (cancer or carbohydrate antigen 19-9) blood test is used to monitor the progress of pre-existing cancer or to assess the effectiveness of cancer treatment. Levels of the tumour marker go up as cancer spread or down it the tumour shrinks. Most commonly it is used for pancreatic cancer but it can be used for bile duct cancer, colon cancer and stomach cancer.
The test is not normally used to diagnose pancreatic cancer as levels are often low in people with very early stages of the disease and high levels can indicate conditions other than cancer such as cirrhosis, cystic fibrosis and gallstones.
- Abdominal and/or back pain
- Loss of appetite
- Unexplained weight loss
If CA 19-9 is initially elevated in pancreatic cancer, then a series of CA 19-9 tests may be ordered during cancer treatment to monitor response and on a regular basis following treatment to help detect recurrence.
CA 19-9 may sometimes be ordered when a healthcare practitioner suspects bile duct cancer in a person with a bile duct obstruction. Non-cancerous causes of bile duct obstruction can cause very high CA 19-9 levels, which fall when the blockage is cleared. In these cases, it is a good idea to wait at least a week or two after the blockage is relieved (by placing a tube, or stent, in the bile ducts) to re-check CA 19-9 levels.
Low amounts of CA 19-9 can be detected in healthy people, and many conditions that affect the liver or pancreas can cause temporary elevations.
Moderate to high levels may be seen in people with pancreatic cancer, other cancers, and in several other diseases and conditions. The highest levels of CA 19-9 are seen in cancer of the exocrine pancreas. This cancer arises in the tissues that produce food-digesting enzymes and in the ducts that carry those enzymes into the small intestine. About 95% of pancreatic cancers are of this type.
Levels of CA 19-9 that are initially high and then fall over time may indicate that the treatment is working and/or that the cancer was removed successfully during surgery. Levels that remain high or rise over time may indicate that treatment is not working and/or that the cancer is recurring.
The laboratory test results are NOT to be interpreted as results of a "stand-alone" test. The test results have to be interpreted after correlating with suitable clinical findings and additional supplemental tests/information. Your healthcare providers will explain the meaning of your tests results, based on the overall clinical scenario. Certain medications that you may be currently taking may influence the outcome of the test. Hence, it is important to inform your healthcare provider of the complete list of medications (including any herbal supplements) you are currently taking. This will help the healthcare provider interpret your test results more accurately and avoid unnecessary chances of a misdiagnosis.
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