CA-125 Test Price in Pakistan: Rs 3,360 at Marham Lab

CA-125 measures a protein called cancer antigen 125 in your blood. MedlinePlus explains that it is a type of tumour marker, meaning a substance often made by cancer cells or by normal cells in response to cancer. It adds that organs in the female reproductive system may make CA-125 when they are inflamed, including in response to normal bodily functions such as a menstrual period. At Marham Lab a CA-125 test costs Rs 3,360, reduced from Rs 4,800.

This needs saying before anything else, because it is the commonest reason people book this test for themselves and the commonest reason it causes needless fear.

MedlinePlus states it directly: your provider cannot use a CA-125 to screen for ovarian cancer if you are not at high risk. The reason it gives is that other conditions which are not cancer also cause high CA-125 levels. It lists them.

• Endometriosis
• Pelvic inflammatory disease (PID)
• Uterine fibroids
• Liver disease

MedlinePlus adds that natural bodily functions including your menstrual period and pregnancy can also raise CA-125.

Uterine fibroids and endometriosis are common. A woman with either, or one who happens to be menstruating, can have a raised CA-125 and no cancer at all. That is precisely why the test is not used as a general check, and why booking it without a doctor's instruction tends to produce anxiety rather than information.

MedlinePlus lists three legitimate uses, and notes which is the main one.

So this is largely a monitoring test for women already diagnosed, and a supporting test where something has already been found. MedlinePlus is clear on the limit of what it can do: only a biopsy can diagnose ovarian cancer.

MedlinePlus lists the factors that make ovarian cancer more likely, which is the group in whom testing may be suggested.

• Having a mother or sister, or two or more other relatives, who have had ovarian cancer
• Having family members who have had breast cancer or colorectal cancer
• Having inherited certain gene changes, including changes in the BRCA1 or BRCA2 genes, or Lynch syndrome, an inherited disorder that raises the risk of many cancers
• Having had breast, uterine or colorectal cancer yourself

MedlinePlus closes that section with sensible advice: if you are concerned about getting ovarian cancer, talk with your provider about your risk. That conversation, rather than a test booked alone, is the right first step.

This is the part worth reading slowly, because the test is unreliable in both directions.

MedlinePlus states that while high CA-125 levels do not always mean ovarian cancer, a normal CA-125 result does not rule it out. It gives two reasons: levels may be low in the early stages of cancer, and not everyone with ovarian cancer makes high levels of CA-125.

So a reassuring number is not a clearance, and an alarming number is not a diagnosis. Both need a doctor.

For women already under treatment, MedlinePlus explains how the trend is read.

Notice that each of these depends on several measurements over time rather than one. A single CA-125 in isolation tells an oncologist very little.

Persistent bloating, a swollen abdomen, pelvic or abdominal pain, feeling full quickly, or a change in how often you need to pass urine are symptoms that deserve a gynaecologist's assessment. The right investigation usually begins with an examination and an ultrasound rather than a blood marker, and MedlinePlus notes CA-125 is used alongside imaging when a lump has already been found.

Take symptoms to a doctor. Let the doctor decide whether this test belongs in the plan.