CA 19-9/ GGT/ ? FISH

[Guest guest]

For those of you who have had the FISH staining, how high were your

cancer markers?

My son's CA 19-9 is climbing every 6 months and is now 384. His GGT is

289.

He will schedule an MRI and then he will speak with his Dr.

If his Dr. doesn't bring up the need for the FISH staining, should we?

Also, since the high dose urso bit, he has dropped his urso for the

first time from 1800 mg /day to 1500mg day and his

numbers there are climbing too.

ALP 311 to 455

AST 64 to 88

ALT 65 to 77

bili .9 to 1.6 high for the first time since diagnosis.

His albumin also went low to 2.9

We are of course very concerned.

Thanks ,

Lee

[Guest guest]

Dear Lee;

I'm sorry to hear about Bill's rising ALP, bilirubin and CA-19-9.

It's possible that this could be due to a dominant bile duct

stricture:

Z Gastroenterol. 2005 Jun;43(6):587-90.

Impact of dominant stenoses on the serum level of the tumor marker

CA19-9 in patients with primary sclerosing cholangitis.

sen-Benz C, Stiehl A

Abteilung für Gastroenterologie, Medizinische Klinik IV,

Universitätskliniken Köln, Germany. .Benz@...

BACKGROUND/AIMS: Patients with primary sclerosing cholangitis (PSC)

have an increased risk of developing hepatobiliary tumors. The tumor

marker CA19-9 was claimed to indicate the occurrence of bile duct

carcinoma. This study aimed to assess whether increased serum levels

of CA19-9 in PSC patients with dominant stenoses indicate bile duct

carcinoma. METHODS: The study cohort comprised 106 patients treated

over a median time of 5.0 years (range 0.5 - 13 years). All patients

were treated with ursodeoxycholic acid (UDCA) and whenever they

developed dominant stenoses by endoscopic dilatation of these

stenoses. In endoscopically treated patients, CA19-9 levels were

measured before and 3, 6, 12 and 24 months after endoscopic

dilatation. RESULTS: Of the 106 patients, 22 carcinoma-free patients

and 3 patients with bile duct carcinoma had elevated CA 19-9 levels.

In 14 out of 25 patients with elevated CA19-9 levels, dominant

stenoses were diagnosed and treated by endoscopic dilatation. In 71.4

% of the endoscopically treated patients, CA19-9 levels decreased

following the endoscopic intervention. CONCLUSIONS: In PSC patients,

increased serum levels of CA19-9 are rarely due to the development of

bile duct carcinoma. In patients with dominant stenoses, the relief

of biliary obstruction by endoscopic dilatation may lead to a

decrease of the serum levels of CA19-9. PMID: 15986288.

Perhaps an MRCP might be able to detect if a dominant stricture

(stenosis) exists, and if so, then an ERCP and balloon dilatation

might then relieve this blockage. If the CA19-9 then declines to

normal (as indiccated in the above paper), then this would alleviate

your concerns about cholangiocarcinoma. If they do an ERCP, then at

the same time they could take brushings for cytological examination

and FISH. But, I'll keep my fingers crossed that it may be a

stricture.

Best regards,

Dave R.

[Guest guest]

Bria,

Rising CA 19-9 is of course a major source

of concern. I would like to tell you though that a few years ago I had the same

problem with CA 19-9 and my LFTs. My hepatologist decided to perform an ERCP to

check for strictures and take biopsies. While performing the ERCP it was

decided to insert a stent to open a stricture. The LFTs after the stent

placement were normal, as was the CA 19-9. Therefore I agree with

post that it can be a stricture.

In addition, even though 384 is high for

CA 19-9, it is not that high. I remember someone (I am not using names on

purpose) on this forum who did get CCA who had values of 18000. In my humble

opinion it is just a blockage at this level. I, of course, am not a doctor in

any shape or form. I am just telling you my experience.

Regards,

Chaim Boermeester, Israel.

From:

[mailto: ] On

Behalf Of Bria Lee

Sent: Monday, January 12, 2009

02:18

To:

Subject: CA 19-9/

GGT/ ? FISH

For those

of you who have had the FISH staining, how high were your

cancer markers?

My son's CA 19-9 is climbing every 6 months and is now 384. His GGT is

289.

He will schedule an MRI and then he will speak with his Dr.

If his Dr. doesn't bring up the need for the FISH staining, should we?

Also, since the high dose urso bit, he has dropped his urso for the

first time from 1800 mg /day to 1500mg day and his

numbers there are climbing too.

ALP 311 to 455

AST 64 to 88

ALT 65 to 77

bili .9 to 1.6 high for the first time since diagnosis.

His albumin also went low to 2.9

We are of course very concerned.

Thanks ,

Lee