CA 19-9 Test Price in Pakistan: Rs 3,360 at Marham Lab

CA 19-9 measures a protein called cancer antigen 19-9 in your blood. MedlinePlus explains that it is a type of tumour marker, meaning a substance made by cancer cells or by normal cells in response to cancer. At Marham Lab a CA 19-9 test costs Rs 3,360, reduced from Rs 4,800.

This belongs first, because CA 19-9 is often bought privately in the hope that it will rule cancer in or out. It cannot.

MedlinePlus states that because high levels of CA 19-9 can mean different things, providers do not use the results from a CA 19-9 test alone to screen for or diagnose cancer or other diseases. Your provider has to consider it alongside other tests.

Here is the reason. MedlinePlus lists the non cancer conditions that also raise CA 19-9.

• Gallstones, which can block your bile ducts
• Cholangitis, an infection of the bile ducts
• Pancreatitis, inflammation of the pancreas
• Cirrhosis, or scarring, of the liver
• Bile duct disease, including a blockage or infection
• Liver disease
• Cystic fibrosis

MedlinePlus also states plainly that healthy people can have high CA 19-9 levels. Gallstones alone are common enough in Pakistan to make a raised result far from rare.

There is a second limitation that cuts the other way, and it is unusually candid.

MedlinePlus states that some people do not make CA 19-9 even when they have a cancer that usually produces high levels of it. For these people, a CA 19-9 test is not useful.

So a normal figure in someone with worrying symptoms proves nothing. Symptoms need investigating on their own merits.

MedlinePlus lists the real uses, which are mostly about monitoring rather than finding.

The cancers MedlinePlus associates with raised CA 19-9 are those of the pancreas, bile duct, colon and rectum, stomach, ovaries and bladder.

MedlinePlus notes that if your provider is using CA 19-9 to help check for signs of cancer, they will perform additional tests, and names them.

• A physical examination, since some associated cancers have noticeable signs. MedlinePlus gives the example that pancreatic cancer can cause the liver or gallbladder to swell
• Imaging tests such as x-rays, CT scans and MRI
• Cholangiopancreatography, used to look at the pancreatic and bile ducts to see whether they are blocked or narrowed, which could indicate a tumour

If your concern is abdominal symptoms rather than monitoring a known cancer, an examination and imaging are where the answer comes from. A [lipase test](/labs/tests/lipase-test-price) and [liver function tests](/labs/tests/lft-test-price) are the usual first blood tests, not a tumour marker.

This is the most practical thing on the page for anyone being monitored.

MedlinePlus states that laboratories use different methods to measure CA 19-9 and that the test method can affect your results. It advises that if you are having regular tests to monitor cancer, it is important to have them done the same way and usually in the same lab, so your provider can compare results over time. It notes your report usually says which method was used.

Switching labs between tests can create an apparent rise or fall that reflects the method rather than the disease. If you are on a monitoring schedule, stay with one laboratory.

MedlinePlus says your provider may order this test if you have symptoms of the cancers associated with high CA 19-9, and lists them.

• Jaundice, a yellowing of the skin
• Weight loss
• Abdominal pain
• Weakness
• Swollen gallbladder or liver

Jaundice with weight loss and abdominal pain needs a doctor promptly. Those symptoms deserve an examination and a scan, and this blood test is one part of that work rather than a substitute for it.

MedlinePlus explains that if you are being treated for cancer you may be tested several times, and sets out what the pattern means.

If you do not have cancer and your level is high, MedlinePlus notes you may not have a problem needing treatment, though it may indicate a condition such as pancreatitis or gallstones.

MedlinePlus states that usually you do not need any special preparation for a CA 19-9 blood test, though you should ask your provider to be sure. It adds that if you take certain vitamins you may need to stop them before the test.

Tell your doctor about every supplement you take, and about any history of gallstones, pancreatitis or liver disease, since all of them change how the number should be read.