CA 19-9 levels are decreasing, what's next?

Mrs B. · New User Joined: 11 Mar 2008 Posts: 7

My dad has pancreatic cancer. He was diagnosed last october.
His cancer is inoperable since he has metastasis on the perinoteum. Lymph nodes, liver, lungs are clear.

After 5 cycles of chemotherapy (10 weeks) his CA 19-9 level dropped from 12,500 to 800. He's still on chemo.
What does this mean? Is it 'just' some precious extra time he's got? Or could his cancer (and of course the metastasis) be removed with surgery or radiation therapy? The doctor can't give us a clear answer so I hope there's someone here who can.

Eve

brainman

Eve, I am very sorry about your husband's Pancreatic Cancer. Pancreatic Cancer is such a terrible cancer and that it has metastasized only makes his situation worse. Even with aggressive treatment his prognosis is not good Sad

. I cannot begin to imagine how hard this is for you and your family.

It sometimes is possible that after chemotherapy the doctors will revisit other options like surgery or radiation therapy. However, it is more likely that your husband will be on some form of chemotherapy until even chemotherapy stops working. Depending on a lot of other factors including his general health and mental attitude, that could be 2+ years form diagnosis.

You and your husband are in my thoughts and prayers.
_________________
Jim
Site Administrator and long-term cancer survivor
1992 Astrocytoma grade 2, left motor strip
2005 Recurrence this time said to be an Oligodendoglioma grade 3, same location.
My Story Part 1: http://cancerforums.net/viewtopic.php?p=7350
My Story Part 2: http://cancerforums.net/viewtopic.php?t=8029
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Queensland Girl · Regular Joined: 17 Oct 2007 Posts: 38 Location: Australia

Hello,

My Dad was also diagnosed after the cancer had metastised. He had chemo for about two months - three weeks on, one week off. For a while the tumors were shrinking and everything appeared to be going well, then in October, the doctors found that the chemo has stopped working. They stopped the treatment and only intervened when Dad started to suffer from ascites. He has a small operation at the beginning of November to put a shunt in an artery to help with the fluid build-up, but surgery for the cancer was out of the question.

Tragically for our family, my Dad died on January 7. He was a very strong man, very outdoorsy and active, so as Brainman has said, this disease is very aggressive and unfortunately very difficult to cure.

Your Dad and your family will have difficult days ahead, and I can only recommend that you take each day as it comes, and respect your Dad's wishes even if you don't understand them.

Every fight is different, my Dad was diagnosed in July so we only had six months until the end. Hopefully your Dad will respond well to treatment and have much more time.

You are in my thoughts,

Queensland Girl

suoiruc · Regular Joined: 12 Mar 2008 Posts: 15

I have not heard of this kind of responce to chemo. Glad it is working for your father. I would suggest if you see those numbers start to climb, you would consider discontinuing the chemo if the treatments were making him ill. I think that just compounds the problem. There might be some other alternatives and if you want, you can consider the reply I submitted to audib ( two entries- the last one today). Again, I am still learning myself and would like to know if you can tell me which chemo drugs are they using to treat your father?

audib · Regular Joined: 29 Jun 2007 Posts: 14

My father in laws CA-19 numbers were in the thousands too and dropped to in the hundreds after several rounds of chemo and radiation. He is still unable to have surgery because of the tumor's location-no mets but it is too close to the hepatic artery for the surgeon to remove. While I am not a doctor, what I think may be happening is the CA-19 is a measure of tumor activity and perhaps the chemo has slowed down the tumor. It does not unfortunately, mean that they are able to do surgery or change the prognosis.

Mrs B. · New User Joined: 11 Mar 2008 Posts: 7

suoiric: My father was treated with Irinotecan, Mitomycin and Taxotere.

The CA19.9 levels slowly stopped dropping and then started climbing again. So no more chemo for my father. The scans showed some decrease in tumorsize. Still no new metastasis.
Right now my father is om immunotherapy. He's getting weekly PegIntron shots and daily low dose Interleukin-2 shots. And once a month he gets a low dose local Interleukin-2 injection (intra-tumourally).

He's doing pretty well. He is extremely tired from the chemo, but still walks three times a day. He never stopped eating, even when he was feeling really really bad.

Eve

suoiruc · Regular Joined: 12 Mar 2008 Posts: 15

Thank you Eve, for giving me the information on chemo drugs. That was actually good timing since my mother and I are to see her substitute oncologist on Thursday to discuss starting her on Fluoroucil to control future bleeding caused by metastasis to her liver. This approach doesn't make alot of sense to me for various reasons, mainly because my mother has not done well with past chemo treatments. I will ask the doctor about the drugs that seemed to work in your fathers case. I would like you to know about a diet I believe may benefit your father. It's called the Budwig Diet and there is plenty of information out there about it. My mother has alot of difficulty in eating the mixture because of her Whipple operation so she cannot consume as much as required for best results. You are in a better situation for the diet since your father has not had the whipple. Good luck and keep up the fight.
Suoiruc

Mrs B. · New User Joined: 11 Mar 2008 Posts: 7

My dad wasn't doing well the last few weeks. He had lost a lot of weight, and was is pain. I was affraid he entered the last stage of his illness. He gave up hope and didn't want to live like that anymore.

He went to see another doctor for a second opinion. We don't know the doctor's opinion yet since we're waiting for some test results, but the good doctor prescribed him some pain medication and pancreatic enzymes. And those enzymes are wonderful. No more pain, he can eat meat again and best of all, his taste returned after 4 months!
We were afraid that the metatstasis in his abdomen blocked his guts, but now it seems it was 'just' food that his body couldn't absorb anymore.

I really hope that I can share more good news when the test resuts get back.

Eve

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