Not likely a vaccine side-effect
DEAR DR. ROACH: I have a history of cancer with an elevated CA-125 level. Recently I had a shingles shot and soon thereafter, my CA-125 level was high. An extensive workup showed up nothing significant, and a repeat CA-125 level was back down to normal. Could the shingles shot have elevated my CA-125 level?
ANSWER: CA-125 is a tumor marker most commonly used for ovarian cancer. Although not all ovarian cancers have a high CA-125 level, the measure of this marker can be useful in following women with ovarian cancer and in evaluating women with a possible ovarian mass.
CA-125 is not specific for ovarian cancer. Many other conditions can increase the level. I could not find any reports of a vaccine causing a temporary increase in CA125. One of the most common reasons for the CA-125 level to increase temporarily is menstruation, but there are others, including urine infection, diverticulitis and pneumonia. It’s possible it was the vaccine, but it also might have been some other condition that resolved on its own.
Because the CA-125 level is neither sensitive nor specific, it is not recommended for screening for ovarian cancer in average-risk women.
DEAR DR. ROACH: My son lost his spleen in an accident several years ago, and I understand his immune system is therefore compromised.
I have never heard of, and can find no evidence of, transplanting a spleen. He is very conscientious in doing what he can to avoid exposure at this dangerous time, but I am wondering what he and others with his condition can do to further protect themselves.
ANSWER: The spleen is an organ that removes damaged blood cells, but it is also an important part of the immune system, and acts as a kind of super lymph node — a place where white blood cells congregate and become activated. People without spleens are at risk due to the immune system effects, as the liver takes over the job of removing worn-out blood cells.
Spleen transplants have been tried, but are not likely to be successful as a single organ transplant. However, in people who are undergoing a multiple organ transplant (stomach, intestine, pancreas, with or without liver), spleen transplants have been done successfully at the same time. You haven’t heard much about these kinds of transplants as they are quite uncommon compared with kidney, liver or heart transplants.
People without spleens are particularly at risk from infections from bacteria with capsules, such as streptococcus pneumoniae and salmonella species. Whenever possible, people are immunized for encapsulated organisms before the spleen is