Why Do I Need All These Blood Tests?

Blood tests provide insight into the existence of cancer, how it is responding to treatment, and if it is going away, or progressing. If you’ve been diagnosed with ovarian cancer, there are a number of blood tests you will need for the rest of your life.

These blood tests look for something called a “biomarker”. A biomarker is defined as a “measurable substance”. This substance can be a chemical, a hormone, or a non-hormonal protein. Some of the biomarkers may be directly related to ovarian cancer, and others may be related to other cancers or physiologic processes associated with cancer. Your oncologist will explain exactly which blood tests you need, and what to expect. The most common biomarkers for ovarian cancer include:

Blood Test Biomarkers

  • CA-125
  • CA 19-9
  • CEA
  • HE-4
  • AFP
  • HCG
  • Estrogen, Testosterone, Inhibin

CA-125: CA-125 stands for Cancer Antigen #125. It was identified in the 1980s as a biomarker for cancer cells. While it can be found in a number of body tissues, it is found most abundantly in ovarian cancer cells.

It is not used as a regular screening test for ovarian cancer in the general population, because CA-125 may be present when there is no cancer. For example it may show up as a result of fibroids, or related to menstruation. It is most helpful once cancer has already been diagnosed because increases or decreases in the circulating blood, and gives doctors insight into the progression of disease.

Normal CA-125 is less than 35 u/ml. After an ovarian cancer diagnosis, rising levels may mean the cancer is spreading, and falling levels may indicate treatments are working.

CA 19-9: this test may also be called Carbohydrate Antigen 19-9, Cancer Antigen 19-9, or sialylated Lewis (a) antigen. It is a blood biomarker primarily found in pancreatic cancer. For a woman diagnosed with ovarian cancer, this test can show if there is spread to the GI organs.

CEA: Carcinoembryonic antigen is a type of protein found in developing fetuses, in a number of cell types, and is associated with the development of tumors. A number of non-cancerous medical conditions can increase the CEA level. These include inflammation, smoking, liver disease and benign tumors.

Elevated levels of CEA, over 20 ng/ml, are most commonly associated with colon and rectal cancers. However, they can also be found when there is ovarian, pancreatic, thyroid, breast and lung cancer.

HE-4: Human epididymis protein 4 is found all cell types of ovarian cancer. It can show up even when other biomarkers for ovarian cancer are not present, making it helpful to detect the presence of this cancer. HE-4 is primarily used to monitor ovarian cancer after treatment has been completed, to see if the levels are going down or going up. If the levels go up this is a sign that treatment may need to start again. Decreasing levels of HE-4 is a good sign.

AFP: Alfa-fetoprotein is produced by a growing fetus, and is found in the amniotic fluid. It is also used to diagnose individuals with ovarian, testicular and liver cancer. Liver disease can cause this blood test to be high, without the presence of cancer.

AFP may be ordered when cancer is suspected, during treatment to determine if the cancer cells are being reduced, and after treatment to track if the cancer is returning.

HCG: Human chorionic gonadotropin is another hormone produced during pregnancy, that shows up with certain cancerous conditions.

HCG levels will go up if the Germ Cells of the ovary become cancerous. Germ cells are responsible for making the egg. Germ cell tumors can also develop in other parts of the body, such as on an organ or inside the chest wall. Radiologic testing will determine the site of the tumor.

Estrogen, Testosterone, Inhibin: hormones associated with normal reproduction and sexual function are closely monitored as they can indicate abnormalities in how the reproductive organs are functioning.

Get Help

Long term blood testing can be expensive. If you suspect your ovarian cancer was caused by the use of talc based products, such as Johnson & Johnson’s baby powder, contact Dr. Greg Vigna today. Greg Vigna MD, JD is a practicing physician and attorney. He will review your case for free. You may qualify for your medical costs to be covered by the baby powder manufacturer.