CA19-9
15
MENTIONS
5
EPISODES
4
PODCASTS
Search complete. 15 mentions across 5 episodes found for "CA19-9".
Oct 20, 2026
Yasmin G. Hernandez-BarcoGUEST
His complement levels and eosinophils were normal.
Yasmin G. Hernandez-BarcoGUEST
His CA-19-9 was also elevated and his creatinine was 2.3 with the urinary sediment was bland.
Yasmin G. Hernandez-BarcoGUEST
And he had elevations in his liver function test and on the biopsy sample, there were greater than 40 IgG4 positive cells per high powered field, and also an elevated IgG4 to IgG ratio.
Yasmin G. Hernandez-BarcoGUEST
So in this patient, because he had multi-organ involvement, steroids prednisone was initiated to really rapidly control the disease.
LiuHOST
If it's normal, it doesn't mean you don't have cancer.
LiuHOST
CA-19-9 is associated with pancreatic cancer, but it can also rise if you have pancreatitis, bowel duct obstruction, cholangitis, liver disease, and other gastrointestinal cancers.
LiuHOST
Some people do not even produce CA-19-9 even though they have pancreatic cancer.
LiuHOST
So again, it is not a clean screening test.
LiuHOST
CA can rise in colon cancer, but it's also found in smokers, inflammation, liver disease, as well as other cancers.
Alec ZeckHOST
Oh, my gosh.
Nathan SilesGUEST
So I started, you know, sub- subtly figuring this out when I moved to Far North Queensland and r- increasing the structured water and the hydration and capturing the light, and that's when my LDH and my alpha-fetoprotein and all these cancer markers which I was managing, CA 19, CA 13, all these ones, they all went flat to zero, completely zero in my body, and to me, such a relief, you know? And then that's when Dr.
Nathan SilesGUEST
Jack Kruse invited me to come over to, uh, to Mexico to an ophthalmology conference 'cause he wanted to use me as an example on stage in front of 150 ophthalmologists and-
Alec ZeckHOST
Who are telling you to avoid UV light at all costs.
VivekHOST
So where does that leave us for our patient and clinic? How do you actually decide what to do?
RonakHOST
So I think that based on our conversation here today, we can say that for clearly resectable patients with favorable features, that it's normal or near normal CA 19-9, small tumor, good performance status, a conversation about upfront surgery followed by adjuvant modified FOLFIRINOX remains a completely defensible approach, and that is also what we're seeing in our data to really support this.
RonakHOST
In high volume centers, we favor a neoadjuvant approach even for resectable disease when there are high risk features suggesting occult metastatic disease, so things like elevated CA 19-9, which is still gonna be high after biliary drainage.
RonakHOST
Remember that it can be artificially high when the bilirubin is very high.
RonakHOST
So elevated CA 19-9 after decompression, a large primary, bulky, or suspicious area of lymph nodes, significant weight loss or pain suggesting more extensive disease.
RonakHOST
So the argument is really you're trying to downgrade the degree of their disease with this neoadjuvant approach before taking them to the OR.
RonakHOST
Our patient has a CA 19-9 of 180 after decompression, a small tumor, and good performance status, so he would be this kind of patient where it may be reasonable to take up front to surgery.
RonakHOST
However, perhaps, you know, a multidisciplinary tumor board discussion would be important for somebody like this, also considering his age amongst other characteristics.
VivekHOST
Just something I wanted to mention there.
VivekHOST
So what about CA 19-9? What do you guys think about that? How do we actually use it for pancreas cancer?
DanHOST
That is something that we're drawing on practically all patients that are coming in with pancreatic adenocarcinoma.
DanHOST
It's something that we consider a useful tumor marker in monitoring response to therapy or for doing surveillance after somebody's had that tumor resected.
DanHOST
But it is not a useful screening test or diagnostic test all on its own.
DanHOST
And there's a few reasons for that.
DanHOST
One of the biggest caveats with this testing is that it's basically CA 19-9, its another name is the sialylated Lewis antigen, and about five to ten percent of patients are Lewis antigen negative, so they don't make CA 19-9 at all.
DanHOST
So in this population of patients that are Lewis antigen negative, we essentially don't have a tumor marker to follow.