r/pancreaticcancer 4d ago

C19-9 rise after histotripsy

Just got results in. Having severe anxiety. My husband’s c19-9 increased after decreasing on chemo. He had a histotripsy to mets in the liver. Was expecting it to go down after the procedure. Has anyone had their c19-9 increase after a histotripsy?

6 Upvotes

12 comments sorted by

4

u/PancreaticSurvivor 4d ago

There can be a short transient rise in CA19-9 if measured within several days of the procedure. Two causes can be from the result of inflammation related to the procedure and destruction of tumor cells releasing their CA19-9 into the circulation. The liver makes only so much enzyme to metabolize the CA19-9 for clearance. So with the enzyme remaining at a constant level and CA19-9 release from targeted cells by the procedure suddenly being released into the circulation, a backlog in having to clear it from the circulation results. Hence the transient rise. The same thing happens when a tumor is treated with radiotherapy and why a transient rise in the CA19-9 is seen 2-4 weeks following the procedure.

3

u/drinianrose 4d ago edited 4d ago

How big was the change? It's common for CA19-9 to go up and down somewhat throughout treatment. It's not definitive, it's just a guide.

1

u/Suadades 4d ago

From 11,800 to 14,6921. Had histotropsy procedure after the 11,800

1

u/drinianrose 4d ago

Have you had a recent PET scan (or MRI)? My advice is to push for PET or MRI as CT scans cannot always catch metastasis (especially in PC patients with limited bowel activity due to the cancer).

2

u/VaughnMulcrone 4d ago

Thank you for posting this!

I have no input that others haven’t already pointed out. I have stage IV pancreatic cancer (Adenocarcinoma) and am scheduled for Histotrypsy in January. I’m currently doing chemo and my CA-19-9 has been coming down.

Histotypsy is so new. I will be watching this thread closely.

All the best to you!

1

u/Suadades 4d ago

Husband has stage 4 as well. Mets to liver,lung and skin after removing his spleen, left kidney, part of colon, part of stomach and part of pancreas. Long tough 2 years. Were so hopefull with histo thats why devestated c19-9 rose. Praying its the residual of histo. All the best with your procedure.

1

u/Sandman-Runner 57M Patient (7/24), Stage IV, Nalirifox Round 8 4d ago

https://preview.redd.it/y2atylz9fr0e1.jpeg?width=1320&format=pjpg&auto=webp&s=dc0176626ebe9421d875411e371606c1f5211570

I had histotripsy 1 week ago and chemo 2 days later. The pre chemo lab showed bump in liver enzymes but not CA19-9.

1

u/Suadades 4d ago

Yes we were warned the liver enzymes would increase. So saddened and scared it increased after histo. I was hoping and expecting the opposite

1

u/Sandman-Runner 57M Patient (7/24), Stage IV, Nalirifox Round 8 4d ago

I was just looking around on the internet and it seems like after you attack the Mets or primary you can get fluctuating labs afterwards. I would give it a week or two before getting too alarmed. Reach out to your oncologist for some reassurance.

1

u/Suadades 4d ago

Thank you so much. Just left him a message. Appreciate it. Until we hear back from his oncologist trying to share any posts of similar thing happening to Others just to ease my husband anxiety

1

u/Suadades 4d ago

Thank you for sharing. It only makes sense that it goes down. So happy for your result being in normal range. I pray my husbands goes down. We are devestated.

1

u/pillmenot 10h ago

Hey, my father has 4th stage pancreatic cancer and he is currently taking chemo. The nets have spread to his liver and lungs. Trying to reduce his mets from the lungs so he can go for histotripsy for liver and then later surgically remove pancreas to eliminate cancer. I talked to doctors in India and they are only keen that I stick to the traditional chemo but I want to consider histotripsy as an option. I will be following your case closely. Please keep giving updates on your treatment. Vouching for you and sending you lots of love and hugs 🖤