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Thread: CA 19-9 increases after finished chemo therapy

  1. #1
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    CA 19-9 increases after finished chemo therapy

    My husband was diagnosed with pancreatic cancer last summer 2018, 51 years old. He had total pancreatectomy surgery in July. He was discharged as early stage of cancer, no lymph node involved. He started chemo therapy, gemzar for 6 months from August 2018 and done Jan 2019. The CA 19-9 from 355 down to 35 then went up at cycle 4 and after he finished the chemo at the end of Jan 2019, his CA19-9 went up to 258 and now is 1400. Dr. Sent him to do ct scan, PET scan, MRI but the results are normal. After chemo, he doesnít feel well , uncomfortable around his abdominal, he feels something is rolling, pinching, tingling, back pain, and losing weight. The dr wants to send him to have a minor surgery to put a microscope to look inside the abdominal if there is cancer. I disagree with that because i think the surgery will knock him out. All the images scan and test results made our emotions unsecured, i want to tell the dr to give my husband a break to take rest and recover from everything. Back in my country, we dont do any tumor blood test within 3 or 6 months after the chemo or radiation. Only 907 blood test, not the CA19-9. Iím wondering if anyone ever has cancer comes back after finishing the chemo? Is it dangerous if we take 3 month rest, if there is cancer cells in his body now, can it spreads to other part within 3 months?
    Please give me some advice
    Thanks in advance!
    Yen
    Last edited by Baoyenle; 02-23-2019 at 05:20 PM.

  2. #2
    Super Moderator Top User ddessert's Avatar
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    Baoyenle,
    Yes, most of us have a recurrence after surgery. Chemotherapy after the surgery delays a recurrence for most patients and probably prevents a recurrence for some.

    It is good that there was no lymph node involvement but I find that inconsistent with a total pancreas removal. No lymph node involvement usually means it was caught early and it would not need a total pancreatectomy.

    The rising CA19-9 numbers are troubling, but not definitive for a recurrence.
    BRCA2 3398del5
    Dec 2010 - back/abd pain
    May 2011 - Unresectable stage III, 2.5cm tumor
    Jun-Aug 2011 - Gem/Cis, 9 rounds
    Oct-Nov 2011 - Radiation+Xeloda, 25 days in 5 weeks
    Oct 2011-Sep 2012 - shrinking tumor
    Feb 2012 - National Familial Pancreatic Study
    Aug 2012 - Downgraded to stage IIA, PGP
    Sep 2012 - Whipple, T3N0M0, 0.5cm tumor, 0/16 lymph nodes
    Dec 2012 - Quebec PanCan Study
    Sep 2012-May 2018 - NED
    Mar 2013-present - NCT01088789
    @pancanology

  3. #3
    Thanks, David.
    I might have asked elsewhere, but do you know of cases where recurrence after surgery occurred, and still long-term survival was attained?
    February 2016- diagnosed with PC
    March 2016- inoperable due to arteries, also liver mets suspected
    March 2016-January 2017 -Gemzar/Abraxane
    February 2017 surgery-PC tumour and liver mets removed at same time
    July 2018 Back on Gemzar/Abraxane due to rising CA 19-9. Scans were clear.

  4. #4
    Super Moderator Top User ddessert's Avatar
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    Steven Lewis is a pretty famous example. Had the Whipple, then a recurrence, another surgical resection, and is now in his 9th year of survival. He and I have just been on a Facebook group discussing a recurrence in the ureter for a woman's brother in Boston.

    https://anticancerclub.com/news-and-...ncer-survivor/
    BRCA2 3398del5
    Dec 2010 - back/abd pain
    May 2011 - Unresectable stage III, 2.5cm tumor
    Jun-Aug 2011 - Gem/Cis, 9 rounds
    Oct-Nov 2011 - Radiation+Xeloda, 25 days in 5 weeks
    Oct 2011-Sep 2012 - shrinking tumor
    Feb 2012 - National Familial Pancreatic Study
    Aug 2012 - Downgraded to stage IIA, PGP
    Sep 2012 - Whipple, T3N0M0, 0.5cm tumor, 0/16 lymph nodes
    Dec 2012 - Quebec PanCan Study
    Sep 2012-May 2018 - NED
    Mar 2013-present - NCT01088789
    @pancanology

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    Thanks, i read that some has recurrence after the surgery but do you know anyone has recurrence after the chemotherapy?

  6. #6
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    Maybe thatís the reason why my husbandís doctor wants to do total pancreatectomy instead of whipple procedure. When my husband was diagnosed, the dr said Bao may need the Whipple procedure or less but then after he tested the pancreas, he made the decision to remove totally. His surgery went from 4-6 hours to 9 hours, then itís followed by the chemo after a month. Btw, we went to Baylor St Luke Medical Center for the surgery and his surgeon doctor is Barakat Omar.
    Last edited by Baoyenle; 02-23-2019 at 05:28 PM.

  7. #7
    Super Moderator Top User ddessert's Avatar
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    Quote Originally Posted by Baoyenle View Post
    Thanks, i read that some has recurrence after the surgery but do you know anyone has recurrence after the chemotherapy?
    Yes, that is about 75% of patients. Less if all the lymph nodes are clear, like for your husband. But most don't have a total pancreatectomy, and I suppose that also helps lower the recurrence rate.

    But the chemotherapy after the surgery mostly ends up delaying the recurrence, not get rid of the chance completely.
    BRCA2 3398del5
    Dec 2010 - back/abd pain
    May 2011 - Unresectable stage III, 2.5cm tumor
    Jun-Aug 2011 - Gem/Cis, 9 rounds
    Oct-Nov 2011 - Radiation+Xeloda, 25 days in 5 weeks
    Oct 2011-Sep 2012 - shrinking tumor
    Feb 2012 - National Familial Pancreatic Study
    Aug 2012 - Downgraded to stage IIA, PGP
    Sep 2012 - Whipple, T3N0M0, 0.5cm tumor, 0/16 lymph nodes
    Dec 2012 - Quebec PanCan Study
    Sep 2012-May 2018 - NED
    Mar 2013-present - NCT01088789
    @pancanology

  8. #8
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    Thanks Jackie501

  9. #9
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    Thanks for the information about the survivor Steven Lewis, i love the link. I will read it and show it to my husband.

  10. #10
    Thanks, David!
    February 2016- diagnosed with PC
    March 2016- inoperable due to arteries, also liver mets suspected
    March 2016-January 2017 -Gemzar/Abraxane
    February 2017 surgery-PC tumour and liver mets removed at same time
    July 2018 Back on Gemzar/Abraxane due to rising CA 19-9. Scans were clear.

 

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