Expert: Claes-Gustaf Nordquist, M.D. - 6/17/2009

Question
QUESTION: Hi, Doctor.A Ca 19.9 blood test was perform on my sister on may/09 and it was 83.9. Although her Doctor told her it was not something to worry, he order an MRI of the pancreas. She had these tests performed regulary ( she is 62 years old) and all of them were normal, including the last one on Aug- 08. Is the actual one something to get notice of  and if not, what other " thing" could be happening to her ?
Thank you for your response and excuse my English...Sincerely, Marilyn

ANSWER: If her CA 19.9 has been elevated every time but all on around the same level and her MRI scans all have been normal then it is probably nothing to worry about. This is an example of the fact that most of these cancer markers should NOT be used for primary diagnosis - far too many both false positive & false negative results! They are better for monitoring treatment results.



---------- FOLLOW-UP ----------

QUESTION: Thank you very very much, Doctor, but I think that because of my poor English I couldn't explain myself properly. THIS IS THE FIRST TEST THAT IS ABNORMAL.Besides that, what else could be this abnormal result means  And then, what do you suggest could be used for primary diagnosis..?....thank you again, sincerely, Marilyn Pupo

ANSWER: Well in that case we will just have to wait for the MRI scan result. That is all we can do! Please do keep me posted!


---------- FOLLOW-UP ----------

QUESTION: THESE ARE THE RESULTS:
1.- NO EVIDENCE OF FOCAL PANCREATIC MASS OR PSEUDOCYST.
2.- TINY INCIDENTAL RIGHT HEPATIC LOBE AND POSTERIOR SPLENIC FOCI OF FLUID SIGNAL, TOO SMALL TO BE ACCURATELY CHARACTERIZED, LIKELY SIMPLE SYST. THESE MAY BE FOLLOWED AS THEY ARE TOO SMALL FOR SONOGRAPHY AND C.T.

What this mean ?
         Sincerely,
         Marilyn Pupo

Answer
There are no evidence of anything dangerous at all in her pancreas. There are some slight evidence of what is probably small cysts (usually not dangerous) in her liver & spleen. Should be followed with more MRI scans since probably too small for CT or ultrasound scans. No signs so far of any tumor at all!