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Do tumor marker initially rise after starting chemo?

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  • Do tumor marker initially rise after starting chemo?

    The treating onc says that they do because the drugs "blast dead tumor cells round the body" (or something like that) which are picked up by the test. To be fair, he did tell me this
    before I had my markers done. If I am correct my AFP went from 410 (day 1) to 390 (day 14) so it is possible they shot up somewhere between these dates and are now on the
    descent. He says if they are rising after the next blood work he will be "scared".

    I am just wondering if what the onc says about initially rising markers gels with anyone's personal experience.

    Also, is it really the case that one should not get CT scan until weeks after chemo has finished (due the risks of radiation) on the compromised immune system? It seem
    infuriating that one has to rely solely on TMs, which as we know from this forum, seem to have a dubious correlation with abdominal node size.

  • #2
    There is a paper by Bosl at MSKCC that tried to predict outcomes based on rate of decay of tumor markers after starting chemo therapy.

    It said in the paper that they measure markers before starting and at day 7 or 10, I can't remember which , because there is almost always an increase in markers due to cell death. I'm on the bus now , but I'll try to find the paper later and post it. Also remember AFP half life is 5 to 7 days so it could take some time for it to leave your body
    Dx March 21 2016
    Right Orchiectomy march 25 2016
    60% embryonal 35% yolk sac 5% seminoma
    positive node on CT 1.4X1.3cm stage 2a markers rising, HCG 2300 AFP 25
    Started 4xEP april 2016
    Finished chemo July 2016, markers normal, complete radiographic remission
    RPLND MSKCC Aug 2016, removed something like 60 nodes all negative but one with teratoma


    • #3

      Yes, it is a known phenomenon for markers to spike because of cell death. It is referred to as tumour lysis.

      Embryonal Carcinoma; Seminoma. Marker negative.
      August 2001: Right I/O .
      August - December 2001: Surveillance .
      December 2001: Relapse - Stage III. Mets in lymph nodes and lung.
      December 2001 - March 2002: 3xBEP .
      Complications: Neutropaenic sepsis during cycles 1 & 3. I/V antibiotics and isolation.

      March 2012 - Ten years since finishing chemo.

      Survivorship Blog is here