The first time I received a CA125 test was after two large cysts were found on my left and right ovary via a pelvic ultrasound. My gynecologist informed me that it was a routine precautionary measure due to the size of the cysts. Unfortunately, I knew very little about this particular test and its purpose– hence, my anxiety attack when my results revealed that my CA125 levels were in the mid 200’s. Therefore, raising the possibility that I had ovarian cancer. However, cancer wasn’t the cause of the increased levels of CA125 in my system. It was later that I learned the role ovarian cysts, endometriosis, and uterine fibroids play in regards to CA125. 

While I wouldn’t wish this experience on anyone, the reality is that endometriosis affects one out every ten women in the U.S., and roughly 20-40% of those women will experience issues with chocolate cysts or endometriomas. It’s because of these statistics that it’s crucial to understand more about tests such as CA125. What purpose do they serve for women’s health, and are they a beneficial diagnostic tool? 

CA125 Test: What Exactly Is It?

I’m going to go on a limb and assume that you’ve never heard of this test before. I know that until I received it, I, for sure, had no knowledge of it. But, it’s a test that measures the amount of protein cancer antigen 125 present in the bloodstream. Additionally, it requires a blood sample to measure these levels. Furthermore, it’s an essential biomarker used by doctors to help diagnose and treat ovarian cancer. For instance, in my situation, the CA125 was administered because of the large cysts I had on my ovaries. Other times when a doctor may find this test appropriate, there’s an abnormal mass in the pelvis, uterus, or abdomen.

Additionally, it’s administered to help monitor the progress of ovarian cancer treatment and determine if cancer has returned.

CA124 Test

Limitations to Make A Note Of

While the CA125 test is beneficial in diagnosing and treating ovarian cancer in most cases, there are a few limitations that make it inappropriate for use as a screening tool. The first reason is that benign noncancerous conditions such as endometriosis, uterine fibroids, liver disease, pelvic inflammatory disease, pregnancy, and menstruation can increase CA125 levels. Consequently, if medical professionals aren’t testing for these specific conditions, it could lead to misdiagnosis and unnecessary testing. Furthermore, using the CA125 as the primary diagnostic tool can lead to failure in actually diagnosing ovarian cancer. The reason for this is because ovarian cancer doesn’t always cause CA125 levels to become elevated. Hence why, if this test is the primary diagnostic tool, it can miss the fact that ovarian cancer is indeed present. 

Due to its limitations as a screening tool, it’s generally not used to screen and diagnose ovarian cancer. Instead, it’s purpose is to be a biomarker combined with other testing modalities such as transvaginal ultrasound, pelvic ultrasound, and obtaining a biopsy. In any case, additional testing may still be necessary. For example, imaging tests such as PET/CT scans and MRI aid in diagnosing ovarian cancer accurately. Whereas, a blood panel helps identify the presence of serum human epididymis protein (HE4)— which is a protein produced by some women with ovarian cancer that may also prove beneficial in diagnosing ovarian cancer. However, none of these tests are standalone diagnostic tools but remain part of a diagnostic process. Ultimately surgery may be necessary so a biopsy can be obtained, and tissue can be tested for cancer.

When A CA125 Is Recommended

Since this test is an imperfect screening tool, it’s not going to be a test you receive during routine check-ups and examinations. Instead, this test is administered under certain conditions. For instance, if you’re similar to me and have an imaging test that reveals the presence of ovarian cysts, your doctor may administer this test as a screening tool for ovarian cancer. Your doctor may recommend this test in addition to other imaging tests as a preventative measure if you are at an increased risk for ovarian cancer. And finally, if you’re receiving treatment for ovarian cancer, your doctor may periodically administer this test to determine if you’re responding well to treatment. 

when is the CA125 recommended

Advocating For Your Health During the Diagnostic Process

I wish that I would’ve been better at speaking up and advocating for myself during my diagnostic journey. Luckily I’ve learned from my mistakes and know for the future and can share some helpful insights with you. 

Know Your Risks & Monitor Symptoms

Having a solid understanding of your risk of ovarian cancer can help your medical team during the diagnostic process. Furthermore, sharing your family history regarding endometriosis and uterine fibroids are also beneficial. Discussing with your doctor when you’re menstruating or if you believe you could be pregnant, could also help determine if the CA125 should be administered since these conditions can cause false positives. Also, keep track of the symptoms that you’re experiencing. Many of the symptoms of ovarian cancer are similar to other conditions, such as endometriosis and fibroids. Keeping track of all the symptoms you have can be beneficial. 

Know When To Seek A Specialist

In many cases, once you’ve taken a CA125 and your levels are significantly above the 46 units per milliliter (46 u/mL), your doctor will refer you to an oncologist for further testing. An oncologist is better at interpreting imaging results and knows the best tests to administer that determine if you have ovarian cancer. This may include surgery to remove the cyst or mass while also obtaining  a biopsy for testing. They will also discuss next step options should results come back positive for ovarian cancer. These options could include additional surgery, chemotherapy, or radiation; it all depends on your specific case. 

You may also find it beneficial to seek the opinion of other specialists if you have a family history of certain conditions such as endometriosis or uterine fibroids. Creating a team that is committed to identifying the root cause of your issue and are open to seeking acceptable solutions is the main priority. If you find that the doctor you’re working with isn’t providing you with excellent care, don’t be afraid to seek a second opinion. Your health takes priority over any doctor’s ego or whatever sense of “loyalty” you feel you owe them. So, don’t be afraid to speak up for yourself when it’s necessary. 

advocate for your health

Future Outlook

Trust me when I say I know firsthand how stressful and upsetting the whole process can be. I’ve been there and done that. But, you can and will get through this. Also, know that because your CA125 test comes back higher than average, it doesn’t mean you have ovarian cancer. So, as hard as it may be, remain positive, and know that it’s not the end. Understand that there are so many benign conditions such as endometriosis and fibroids that can increase those levels. My test results came back as 225 u/mL, which was caused by the chocolate cysts on my ovaries, endometriosis in my pelvis, and a uterine fibroid. So, don’t get too caught up on the results of the CA125, especially if you’re at an increased risk of endometriosis. Ask questions if you’re unsure about something, and don’t be afraid to get a second opinion if you think you’re getting the run-around. 

Most importantly, I hope you’ve learned more about what the CA125 is and its purpose in the diagnostic process for ovarian cancer. Take this knowledge and be encouraged to advocate for your health. 

References

Survivornet, The CA125 Antigen– Why Is It Important for Ovarian Cancer? By Dr. Bobbie Rimel

Mayo Clinic, CA125 Test

 

About the Author 

women's health and wellness blogger

Hi, my name is Kathleen but you can call me Kat. I’m a health and wellness professional turned freelance writer and content creator.  You can find me on  YouTube and Instagram. If you take the opportunity to visit me on my other platforms don’t hesitate to leave a message, I would love to hear from you!

 

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