Tumour Markers (CA-125, CA 19-9, CEA, LDH, β-HCG)
These are routine blood tests sometimes used when an ovarian cyst appears on ultrasound. The name "tumour markers" can sound confronting, but in most cases, they’re used to tick boxes—not because anything concerning is expected. These tests are part of the routine work-up for ovarian cysts—especially if they are large, complex, or in people under 40 or postmenopause. They help rule out rare but important conditions.
When Levels are High
Levels may rise with ovarian or gastrointestinal tumours, but also with common, non-cancerous conditions like periods, endometriosis, infection, inflammation, or even normal variation.
When Levels are Low
Low levels are generally expected and not concerning.
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Understanding trends in the results
Results are interpreted in context—for example, CA-125 may fluctuate with your cycle. Persistent or rising trends may prompt follow-up, but single elevated results are often benign.
💬 Reassurance
If you’ve been asked to do tumour markers, it’s not because something alarming is suspected—it’s part of a cautious, complete approach. Most ovarian cysts are completely normal, and most tumour marker results come back reassuringly normal too.
🔎 Deep Dive: What Each Marker Is Checking
CA-125 i
s a protein made by cells lining the ovaries and abdominal cavity. It’s the most commonly used tumour marker in ovarian cysts. While it can be elevated in ovarian cancer, it’s also frequently raised in non-cancerous conditions like periods, endometriosis, fibroids, and pelvic infections—especially in younger women.
CA 19-9
is more often linked to the digestive system (especially the pancreas and bowel), but it’s sometimes used in ovarian cysts that look mucinous (gel-like) or unclear on scan. It can also rise with gallbladder issues, liver inflammation, or endometriosis.
CEA (Carcinoembryonic Antigen) is a broader tumour marker, often associated with bowel or lung cancers. It’s occasionally included in ovarian cyst follow-up if bowel involvement is suspected based on scan features.
LDH(Lactate Dehydrogenase) is an enzyme released during cell turnover or damage. It’s included mainly for younger patients, especially when a cyst looks solid or fast-growing, to help detect rare ovarian germ cell tumours.
β-HCG(beta-Human Chorionic Gonadotropin) is the hormone produced in pregnancy, but also by some rare ovarian tumours (and endometriosis!). It's always checked in reproductive-age patients—even if pregnancy is unlikely—because some tumours can mimic pregnancy in blood tests.
🌺 CA-125 and Endometriosis
It’s very common for CA-125 to be raised in endometriosis. This doesn’t mean there’s anything dangerous going on—it’s simply a reflection of inflammation in the pelvic area. In fact, mild to moderate endometriosis can push CA-125 above normal levels, especially during your period. That’s why doctors interpret CA-125 with care, especially in younger people or those with known hormonal or inflammatory conditions.
🔎 Deep Dive: What Each Marker Is Checking
CA-125 i s a protein made by cells lining the ovaries and abdominal cavity. It’s the most commonly used tumour marker in ovarian cysts. While it can be elevated in ovarian cancer, it’s also frequently raised in non-cancerous conditions like periods, endometriosis, fibroids, and pelvic infections—especially in younger women.
CA 19-9 is more often linked to the digestive system (especially the pancreas and bowel), but it’s sometimes used in ovarian cysts that look mucinous (gel-like) or unclear on scan. It can also rise with gallbladder issues, liver inflammation, or endometriosis.
CEA (Carcinoembryonic Antigen) is a broader tumour marker, often associated with bowel or lung cancers. It’s occasionally included in ovarian cyst follow-up if bowel involvement is suspected based on scan features.
LDH(Lactate Dehydrogenase) is an enzyme released during cell turnover or damage. It’s included mainly for younger patients, especially when a cyst looks solid or fast-growing, to help detect rare ovarian germ cell tumours.
β-HCG(beta-Human Chorionic Gonadotropin) is the hormone produced in pregnancy, but also by some rare ovarian tumours (and endometriosis!). It's always checked in reproductive-age patients—even if pregnancy is unlikely—because some tumours can mimic pregnancy in blood tests.
🌺 CA-125 and Endometriosis
It’s very common for CA-125 to be raised in endometriosis. This doesn’t mean there’s anything dangerous going on—it’s simply a reflection of inflammation in the pelvic area. In fact, mild to moderate endometriosis can push CA-125 above normal levels, especially during your period. That’s why doctors interpret CA-125 with care, especially in younger people or those with known hormonal or inflammatory conditions.
