Post-Mortem Diagnosis

I wrote a post about a week ago entitled comfort care. Interestingly enough, we made a post-mortem non-autopsy diagnosis. In a purely academic exercise, I sent off tumor markers on blood that had already been drawn. I figured that this did not put the patient in more discomfort and could be somewhat useful for the family. Of course, tumor markers should not be used to screen for or diagnose cancer. But his CA19-9, a marker classically for pancreatic cancer but also seen in other GI cancers was sky high; normal is <36, his was over a million. I think his presentation with painless jaundice in conjunction with this lab value convinces me that he had pancreatic cancer. Putting him on comfort care was the right thing to do; there was nothing we could have done.