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Forum Name: Pancreatic Cancer

Question: CA 19-9 way way down but numerous new tumors found?


 chattmary - Sat Feb 19, 2005 8:51 am

First CA 19-9 reading after 6 rounds of gemzar show significant reduction from 7900 to 3300. Primary tumor in tail of pancreas shrunk from 6.1 x 4.7 to 5.5 x 3.7. Two tumors in liver slightly shrunk. Patient, (my mom) feeling well, eating better and in no pain. HOWEVER CT scan showed "numerous smaller lessions on liver". How can CT go down that much and new things appear on liver? Is gemzar working or not? First CT was in early december without IV contrast - this CT was with CT contrast. Perhaps they were always there. Perhaps they are iron deposits or something else. Is CA 19-9 more reliable than CT scans in monitorin spread of pancreatic cancer? HOw can CA 19-9 drop that much but new lesions appear on liver! Thanks

Dave
 chattmary - Tue Feb 22, 2005 8:47 pm

Update- Saw oncologist yesterday- he said there were only 3 additional very small spots showing on liver and wasn't convinced it was cancer. Basically was convinced all is good news and the CA 19-9 is most important. So CA 19-9 way down and primary tumor shrunk. This is good. I still think this all could be cystadenocarinoma and not adenocarcinoma- but what do I know!
 Dr. Jeffrey Gordon - Sun Mar 06, 2005 7:41 pm

I have read through your prior posts. Thanks for using The Lounge. I hope that your Mother is doing well with the chemotherapy without much side effects.

CA 19-9 in pancreas cancer or other blood tumor markers in other diseases, are not always a reliable way to monitor the effectiveness of a cancer treatment. For the most part, one tends to see a decline in CA 19-9 levels if the pancreas cancer is responding to the chemotherapy. However, some of the cancer may be so poorly differentiated that it lacks the ability to make CA 19-9. Sometimes the cancer may not shrink back from the chemotherapy, but is quieted down by the treatment and thus the CA 19-9 level can fall. Sometimes in pancreas cancer the tumor may not look like any shrinkage has occurred, but in fact such has happened. Pancreas cancer can cause a desmoplastic reaction to occur around it and it can be tough to discern the difference between it and the desmoplastic reaction on CAT scans.

Regarding one of your posts abou the pathology of the tumor, it sounds like what you describe that the tumor is a pancreatic adenocarcinoma, which is the most common type.

Jeffrey A. Gordon, M.D.

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