Elevation in LDH

[andy26]

Hi Everyone,

So I recently had my 3 month post chemo checkup and just got some of my blood results back. Before surgery and chemo my LDH level was at 195 (standard range for my lab is <250 is considered normal). Three months later (yesterday) my LDH was 255. I'm concerned with this rise. My oncologist said yesterday that my cure rate was very high and that they were moving my check ups to every 6 months as oppose to every 3 months. But I'm still concerned in the elevation of my LDH. Any help would be greatly appreciated.

Thanks,

Andy

[Fed]

LDH is a very non-specific marker, and increases in LDH can indicate a multitude of things. LDH is a hallmark of tissue degradation, and there are many circumstances that can cause that. Given that you had seminoma, you need to rely heavily on scans rather than bloodwork. You are only a bit above the upper limit, and that may well be within the margin of error.

Now, weren't you diagnosed recently? For seminoma surveillance you're not supposed to move to the 6-month schedule until you're three years out (follow-ups are typically every 4 months in years 1-3, and I haven't heard of any newer guidelines).

[smoothee]

Hey bud,

Like Fed said, it seems a little early to be starting a 6 month follow-up schedule. Best of luck with the markers, I'm sure it'll be nothing to worry about.

[NicksGirlfriend]

My LDH went on the rise once, up past 350 and my oncologists weren't worried. It is VERY non-specific, in fact, the oncologists admitted they don't even use it for TC at my hospital.

[andy26]

Thx for the feedback guys...I e-mailed my doctor and he said all my other tumor markers were norman and he said NOT to worry about my LDH. Like NicksGirlfriend said, LDH is very non-specific. As far as my checkup being moved to every 6 months. I looked up the followup guidelines for classic seminoma with 1 round of chemo and it shows blood markers every 4 months and a CT scan once a years. I don't know if I was looking at an old version if anyone has a newer follow up schedule that would be great. Or any feedback would be very helpfull.

Thanks,

Andy

[Paul54]

Andy,
I just checked the latest NCCN guidelines.

Surveillance and post-carboplatin:
Tumor markers and CT of abdomen and pelvis- 3-4 months for three years
Chest Xray- alternate visits

Post-XRT:
Tumor markers and chest X-ray- 3-4 months for one year, 6 months for year two, annually thereafter
CT of abdomen and pelvis- annually

I recall reading that the most likely area of relapse during surveillance or post-carbo is the abdomen, and for post-XRT is the chest, so the CT and Xray frequencies are set accordingly.

To me, six months doesn't sound like enough.

[andy26]

Thanks Everyone. I will push my oncologist to follow the NCCN guidelines.