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As I mentioned before, my last ultrasound on Feb 4 found a fibroid and chocolate cysts (endometrioma) on my ovaries other than my Adenomyosis. My doctor ordered me to get my blood tested, she ordered 5 different tumor marker tests. I felt nervous just to read the word “tumor” on the paper >_<
Tumor Marker? What is That?
According to University of Iowa Hospitals and Clinics:
Tumor markers are substances that can be detected in higher than normal amounts in the blood, urine, or body tissues of some people with certain types of cancer. A tumor marker may be produced by the tumor itself, or by the body in response to a cancer presence.
Tumor markers may be proteins, antigens, or hormones. Tumor marker tests are not used alone in diagnosis because most markers can be found in elevated levels in people who have benign conditions, and because no tumor marker is specific to a particular cancer.
There are 16 tumor markers, you can read the complete list here.
My doctor ordered 5 markers to be tested:
Primary Cancer Site: Liver, germ cell cancer of ovaries or testis
Secondary Cancer Site (>50%): Stomach
False Positives: Pregnancy
Other Benign Diseases Detected: Cirrhosis, hepatitis, toxic liver injury, inflammatory bowel disease, ataxia telangiectasia, Wiscott-Aldrich Syndrome
Normal Values: 0-6.4 IU/ml in men and nonpregnant women
Alpha-fetoprotein (AFP) is a protein produced primarily by the liver in a developing baby (fetus) and the portion of a developing embryo that is similar to the yolk cavity in bird eggs (yolk sac tissues). AFP levels are typically elevated when a baby is born and then decline rapidly. Liver damage and certain cancers can increase AFP concentrations significantly. This test measures the level of AFP in the blood.
AFP is produced whenever liver cells are regenerating. With chronic liver diseases, such as hepatitis and cirrhosis, AFP may be chronicallyelevated. Very high concentrations of AFP may be produced by certain tumors. This characteristic makes the AFP test useful as a tumor marker. Increased amounts of AFP are found in many people with a type of liver cancer called hepatocellular carcinoma and in a liver cancer occurring in infants called hepatoblastoma. They are also found in some people with cancers of the testicles or ovaries.
AFP exists in several different variants. The standard AFP test is for a total AFP, one that measures all of the AFP variants together. This is the primary AFP test used in the United States.
One of the AFP variants is called L3 because of its ability, in the laboratory, to bind to a particular protein called Lens culinaris agglutinin. The AFP-L3% test is a relatively new test that compares the amount of AFP-L3 to the total amount of AFP. An increase in the percentage of L3 is associated with increased risk of developing hepatocellular carcinoma in the near future and of having a poorer prognosis, as the L3-related cancers tend to be more aggressive.
Among patients with low total AFP, AFP-L3 can be higher in those with hepatocellular carcinoma than patients with benign liver diseases. Tumor markers including total AFP and AFP-L3 are used in addition to ultrasound for surveillance of hepatocellular carcinoma in Japan. This practice is different from that in the U.S. and Europe, but the two tests are occasionally ordered by healthcare practitioners in the U.S.
CA-153 (Carbohydrate Antigen 153 / Cancer Antigen 153)
Primary Cancer Site: Breast
Secondary Cancer Site (>50%): Often not elevated in early stages of breast cancer
False Positives: –
Other Benign Diseases Detected: benign breast & liver cancer
Normal Values: < 31 U/ml
Cancer antigen 15-3 (CA 15-3) is a protein that is produced by normal breast cells. In many people with cancerous breast tumors, there is an increased production of CA 15-3 and the related cancer antigen 27.29. CA 15-3 does not cause cancer; rather, it is shed by the tumor cells and enters the blood. This test measures CA 15-3 in the blood.
Since CA 15-3 can be measured in the blood, it is useful as a tumor marker to follow the course of the cancer. CA 15-3 is elevated in fewer than 50% of women with early localized, breast cancer or with a small tumor, but is elevated in about 80% of those with breast cancer that has spread (metastatic). Because not all women with invasive breast cancer will have elevated CA 15-3, the test is not useful in all cases.
CA 15-3 is not recommended as a screening test to detect breast cancer in women because it is non-specific. It may also be elevated in healthy people and in individuals with other cancers such as colon, lung, pancreas, ovarian, or prostate malignancies or certain conditions such as cirrhosis, hepatitis, and benign breast disease.
CA-125 (Cancer Antigen 125)
Primary Cancer Site: Ovarian
Secondary Cancer Site (>50%): Breast, colorectal, uterus, cervix, pancreas, liver, lung
False Positives: Pregnancy, Menstruation
Other Benign Diseases Detected: Endometriosis, ovarian cysts, fibroids, cirrhosis, peritonitis, pancreatitis, pleural effusion, pelvic inflammatory disease
Normal Values: 0-35 U/ml
Cancer Antigen 125 (CA-125) is a protein that is present on the surface of most, but not all, ovarian cancer cells. This makes the test useful as a tumor marker in specific circumstances. The CA-125 test measures the amount of CA-125 in the blood.
Significantly elevated concentrations of CA-125 may be present in the blood of a woman who has ovarian cancer. Thus the test may be used to monitor the effectiveness of treatment and/or for recurrence of the cancer. However, not all women with ovarian cancer will have elevated CA-125 so the test may not be useful in all cases.
Ovarian cancer is the fifth most common cause of cancer death in women. According to the American Cancer Society (ACS), the lifetime risk of a woman developing ovarian cancer is about 1 in 75 and the lifetime risk of death is 1 in 100. ACS estimates that about 22,000 new cases are diagnosed each year in the U.S. and about 14,000 women die of it.
Currently, less than 20% of ovarian cancers are found in the early stages before they have spread outside the ovary. The primary reason they go undetected is that the symptoms of ovarian cancer are fairly non-specific.
The need for a reliable method for early detection of ovarian cancer among asymptomatic women continues to drive ongoing research. In the meantime, regular physicals, pelvic exams, and an awareness of family history and symptoms are important.
CA-125 is not recommended as a screening test for asymptomatic women because it is non-specific. Small quantities of CA-125 are produced by normal tissues throughout the body and by some other cancers. Levels in the blood may be moderately elevated with a variety of non-cancerous conditions, including menstruation, pregnancy, and pelvic inflammatory disease.
CA-19-9 (Cancer Antigen 19-9)
Primary Cancer Site: Pancreas, colorectal
Secondary Cancer Site (>50%): –
False Positives: –
Other Benign Diseases Detected: pancreatitis, ulcerative colitis, inflammatory bowel disease
Normal Values: < 33 U/ml
Cancer antigen 19-9 (CA 19-9) is a protein that exists on the surface of certain cancer cells. CA 19-9 does not cause cancer; rather, it is shed by the tumor cells and can be detected by laboratory tests in blood and sometimes other body fluids. This test measures the level of CA19-9.
Since CA 19-9 can be measured in blood, it is useful as a tumor marker to follow the course of the cancer. CA 19-9 is elevated in about 70% to 95% of people with advanced pancreatic cancer. (Read more on the Test tab of this article and in the Pancreatic Cancer article.)
However, CA 19-9 may also be elevated in other cancers, conditions, and diseases such as: gallbladder and bile duct cancers (cholangiocarcinoma), colorectal cancer, gastric cancers, ovarian cancer, lung cancer, liver cancer, bile duct obstruction (e.g., gallstones), pancreatitis, cystic fibrosis, thyroid disease, and liver disease. Small amounts of CA 19-9 are present in the blood of healthy people. Since CA 19-9 is not specific for pancreatic cancer, it cannot be used by itself for screening or diagnosis.
CEA (Carcinoembryonic Antigen)
Primary Cancer Site: Colon
Secondary Cancer Site (>50%): Kidney, thyroid, liver, lymphoma, lung, stomach, melanoma, bladder, ovary, cervix, breast, pancreas, stomach, bladder
False Positives: Cigarette smoking about 5% of the population has above normal CEA
Other Benign Diseases Detected: pancreatitis, hepatitis, COPD, lung infection, inflammatory bowel disease, biliary obstruction
Normal Values: < 3 ng/ml in non-smokers < 5 ng/ml in smokers
Carcinoembryonic antigen (CEA) is a protein that is present in certain tissues of a developing baby (fetus). By the time a baby is born, it drops to a very low level. In adults, CEA is normally present at very low levels in the blood but may be elevated with certain types of cancer. This test measures the amount of CEA in the blood to help evaluate individuals diagnosed with cancer.
CEA is a tumor marker. Originally, it was thought that CEA was a specific marker for colon cancer, but further study has shown that an increase in CEA may be seen in a wide variety of other cancers. CEA can also be increased in some non-cancer-related conditions, such as inflammation, cirrhosis, peptic ulcer, ulcerative colitis, rectal polyps, emphysema, and benign breast disease, and in smokers. For this reason, it is not useful as a general cancer screening tool, but it does have a role in evaluating response to cancer treatment. When an individual has been diagnosed with cancer, an initial baseline test for CEA may be performed. If this level is elevated, then subsequent serial testing of CEA may be performed to monitor cancer as the individual undergoes treatment.
Here are My Blood Test Results…
As you can see I have two markers that show elevated numbers. My CA-125 score is 679.4 U/ml (normal score is < 35 U/ml) and my CA-19-9 score is 152.6 U/ml (normal score is < 27 U/ml). The first time I saw these numbers at the hospital, I felt hot flush suddenly crawling to my chest and head, the same feeling when I had when I was in a motorcycle accident a few years ago. You know something bad is happening, you know it’s not a dream, and you can’t stop it.
So, an elevated CA-125 could be caused by Endometriosis. I have a Chocolate Cysts (Endometrioma) which is a sub-type of Endometriosis. The sad thing is from what I read on Dr. Andrew Cook’s book, “The Endometriosis Health&Diet Program: Get Your Life Back”
If the patient has an elevated CA-125 reading, it is more likely that she has invasive stage III or stage IV Endometriosis rather than non-invasive stage I or II.
My doctor doesn’t speak English fluently. She never told me that I have invasive stage III or IV Endometriosis. She just told me that she’s concern about how high the CA125 and CA199 test results, and she’s afraid that the cysts will cause problems to my ovaries. She told me that I will have to take another ultrasound and blood test one month from now to see whether the cysts grow bigger and/or the CA125 and CA199 readings is elevating. If they are, she said I will need surgery. But, if the cysts were shrunk, then we will discuss different treatments.
To be honest, I don’t really understand what kind of surgery she was talking about. She couldn’t explain the condition very well in English. It’s frustrating. Maybe I need to go to a different hospital. I know a hospital that some of the doctors are from America or Europe, even the local doctors are fluent in English, but the thing is it’s so expensive. I’m afraid I can’t afford the price. Oh… the dilemma of being a poor ill foreigner in China >_<
I don’t want to get any surgery here. If I was going to get one, I will do it when we move to the USA. Until that time has come, I will do an alternative treatment to shrink the Endometrioma!
I just started Dr. Andrew Cook’s Endo Health and Diet Program today, I will talk more about it in a different post. Meanwhile, I’m wishing you, Adeno and Endo Warriors, pain-free days!