Elevated CA125 Level and Tamoxifen

Stephen C. Rubin, MD
Last Modified: November 1, 2001

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I am a 48-year-old ovarian cancer survivor. It is my fifth year of no recurrences. I have been having elevated CA 125 results. All diagnostic imaging comes back negative. My doctor wants me to start taking Tamoxifen, to lower the CA 125. I am worried that it is too risky and has too many side effects. Please help me. I am feeling to good to go through all of that again.  
Thank you

Stephen C. Rubin, MD, Professor and Chief of the Division of Gynecologic Oncology, University of Pennsylvania Health System, responds:

In your situation, a persistently elevated CA 125, there may be a chance that the cancer has begun to become active, regardless of the results of your diagnostic imaging. Tamoxifen is sometimes used in this setting in patients who are feeling well, as it may possibly delay tumor progression and the onset of symptoms. Other management options could include further observation without treatment, exploratory surgery to assess tumor status, or going back on to chemotherapy. Tamoxifen is generally a very well tolerated drug (especially compared to chemotherapy), and is certainly a reasonable option.

CA-125 blood test, transvaginal ultrasound do not lower risk, have high false-positive rate

May 23, 2011 - The combined use of a CA-125 blood test and transvaginal ultrasound for early detection of ovarian cancer does not appear to reduce the risk of death from the disease in the general population, and harm may result from diagnostic evaluation performed after false-positive tests, according to research to be presented at the annual meeting of the American Society of Clinical Oncology, held from June 3 to 7 in Chicago.

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