moderately high ca 125

[maestrack]

Hi,
I'm new to this site and have a few questions I'd like opinions on.  I have a history of complex ovarian cysts and fibroids.  Had a benign cyst removed in  1990 and CA 125 was in the single digits.  Continue with cysts and fibroids which have been monitored with TV ultrasound - they remained stable so no concern.  CA 125 in 2003 was 7.  Now about a month ago I had lumpectomy for stage 1 breast cancer - no node involvement.  Plan to start radiation soon.  Had my cysts checked and new CA125 is 56!  Is there a good chance I now have ovarian cancer?
Thanks for any info/opinion.

[Annekathryn Goodman, M.D.]

Hi There

CA 125 is a protein that is secreted by many tissues and in many situations:

inflammation
liver disease
infection
heart failure
menstruation
pregnancy
fibroids
endometriosis
some cancers

CA 125 is not a diagnostic test and it is not a screening test.
because there is no effective screening test for ovarian cancer, this blood test - the CA 125 test- has been used.
It has also been used to decide whether ovarian cysts should be surgically removed but in most cases of a mildly elevated CA 125, the cysts turn out to be benign

But no study has shown it to help identify ovarian cancer

If you have experienced breast cancer,you may be at higher risk for ovarian cancer than the general population (1 in 70 lifetime risk)
You should talk with your doctor about genetic screening for BRCA 1 and 2 mutations. About 10% of women with breast cancer have this mutation. That would be an indication for the prophylactic removal of your ovaries and fallopian tubes

or if you have 2 or more family members with ovarian cancer even with negative BRCA testing, that is an indication for prophylactic surgery

finally if you have estrogen receptor positive breast cancer, removing the ovaries substantially reduces your risk of recurrent breast cancer.

it may be that if you have had lifelong problems with ovarian cysts, this is a good time to consider removing them.

I know this must be very stressful
please let us know what you decide to do
take care

[maestrack]

Thank you for the info.  I plan to talk with my gynecologist and oncologist this week to help me with my decision.  I feel I should have my ovaries out to remove the risk of cancer there. (Hopefully the currently elevated CA 125 is either a fluke or caused by a benign condition.) Probably should do my scheduled radiation before having them, though.  It's so much to think about at once, having just recoved from breast surgery.
I'll keep you posted and thanks again.