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  • Enlarged Lymph Nodes and No Tumor Markers

    Hi Everyone,

    I just went for my 4-year scans and they showed 2 enlarged lymph nodes.
    1 iliac that was previously enlarged now grew larger and a new one on the back wall of the stomach. However, the tumor markers are clear.

    How likely is it that it can be a recurrence? How concerned should I be?

    I am going for a biopsy tomorrow and I need to wait 3-5 days for the results.

    Thank you for your help!

    Jacob

    Diagnosed 5/30/2013
    Left R I/O on 6/8/2013
    pure seminoma
    All scans and bloodwork clear
    6/20/17 iliac node enlarged - node back stomach wall enlarged. No elevated tumor markers

  • #2
    Afraid tumor markers are only useful when positive, pretty much useless when negative, unless they just dropped from positive to negative recently.

    Why did they allow an enlarged node to go untreated? Seems odd, to be honest
    Jan, 1975: Right I/O, followed by RPLND
    Dec, 2009: Left I/O, followed by 3xBEP

    Comment


    • #3
      Since it wasn't growing they said we can just watch it.

      I have another enlarge node in my lung that has been there prior to my I/O but it stayed the same size year after year.
      Last edited by Jacob; 06-23-17, 08:31 AM.

      Comment


      • #4
        Out of curiosity, how often do you get scans? Every year? To me it would seem weird that it would all of a sudden appear there after that many years gone by. I know Seminoma grows slow but that slow? I'm not sure if I'd be too concerned just yet. I know easier said than done. I've been on edge myself too. Hang in there man and see what the results are. Keep us posted.
        April 2017 - Scheduled physical with DR for testicular pain / ultrasound scheduled
        May 2017 - US shows 3 solid masses 1.2 x 0.7 x 0.7 cm/0.8 x 0.5 x 0.8 cm/ 0.4 x 0.3 x 0.4 cm
        June 2017 - Left orchiectomy & diagnosed with Seminoma
        As of October 2017 - All clear!

        Comment


        • #5
          What size are they?
          6/5/15: bHCG 27,AFP 8.66, LDH 361, 5.6cm lymph node - Stage IIC
          6/16/15: Left I/O 85% EC, 10% chorio, 5% yolk sac opinion 2 (mayo) 90% EC, 10% yolk sac
          7/7/15: bHCG 56, AFP 42, LDH 322
          7/13/15 - 9/18/15: 4xEP
          10/1/15: bloodwork normal, ct scan shows 2 lymph nodes 1.0cm
          10/26/15: 2nd opinion on CT results - lymph nodes normal. Surveillance!
          4/6/16: 1.7cm X 1.5cm lymph node found with markers normal.
          4/20/16: RPLND @ IU - teratoma only!
          9/18/2017 all clears up to this date!

          Comment


          • #6
            I get scans once a year. My doctor was suprised to see them after 4 years as well. I am having a needle biopsy today at 1pm and should have the results in 3-5 days. Will let you know what happens.

            Comment


            • #7
              I don't recall the size. I will certainly ask today.

              Comment


              • #8
                One more thing, I see ppl mention LDH as a tumor marker. I have never been tested for that.
                The only markers they tested for were HCG and AFP.
                AFP was never elevated and HCG was 2.5 pre io and normal 2 weeks later.

                Should I ask for LDH marker tests?

                Comment


                • #9
                  As Davepet has written, tumor markers are useless when negative. Since yours have never been elevated (and you had a 100% Seminoma), it is likely that your markers will never be elevated also in the occasion of recurrence. I was in the same situation, my markers were not elevated at the time of first diagnosis (orchitectomy) nor at the time of relapse. It happens more frequently in the case of pure seminoma (in my case it was 95% seminoma).

                  Comment


                  • #10
                    Thanks for all the responses.

                    I am getting more concerned with each answer though

                    Was hoping it was a one and done deal

                    Comment


                    • #11
                      Wishing you the best. I hope someone can chime in about LDH, I'm not even certain if they use that during follow-ups for TC. Please let us know what the biopsy shows.
                      17 year old son Grant dx 12/21/16
                      pre/o markers 12/21/16- HCG:1065.15,AFP:298.8,LDH:1119
                      pre/o CT Scan 12/22/16 normal
                      r/o 12/22/16
                      Post r/o Elevated Markers with INCREASE 4 weeks post r/o;
                      PATHLOGY: mixed maligent germ cell 8.6 x 6.2 x 5.9 cm

                      -80% Embryonal, 10% Yolk Sac, 5% Teratoma, 5% Choriocarcinoma w/LVI within Spermatic Cord and invasion into Rete Testis
                      2nd CT scan on 1/24/17 3 nodes 2 over 2.5, one over 3.5
                      BEP x 3 1/27/17
                      Post Chemo CT Scan on 3/28/17 still showed a few nodes over 2 cm
                      2nd Post Chemo CT Scan on 4/27/17 showed all nodes still over 2cm
                      Post Chemo RPLND 5/8/17: Periaortic Teratoma, Intraaorticaval Teratoma, and Paracaval Teratoma found.

                      Comment


                      • #12
                        I just got diagnosed with classic seminoma as well my brother. Both of us had negative markers and his had spread to his lymphnodes really bad. From my understanding it really depends on the type of cancer. From what I've seen and read so far Seminoma doesn't often raise tumor markers.

                        With that being said, I am going in for a follow up scan here in two weeks and doing more blood work. My doctor ordered the following blood tests.

                        Alpha Fetoprotein, Serum

                        HCG, Beta Quantitive

                        Lactate Dehydrogenase, Serum

                        I'm not sure if these blood tests will be uses for all follow ups or what but this is what my dr ordered so far in regards to my recent diagnoses of Seminoma.
                        April 2017 - Scheduled physical with DR for testicular pain / ultrasound scheduled
                        May 2017 - US shows 3 solid masses 1.2 x 0.7 x 0.7 cm/0.8 x 0.5 x 0.8 cm/ 0.4 x 0.3 x 0.4 cm
                        June 2017 - Left orchiectomy & diagnosed with Seminoma
                        As of October 2017 - All clear!

                        Comment


                        • #13
                          Originally posted by jmz View Post
                          I just got diagnosed with classic seminoma as well my brother. Both of us had negative markers and his had spread to his lymphnodes really bad. From my understanding it really depends on the type of cancer. From what I've seen and read so far Seminoma doesn't often raise tumor markers.

                          With that being said, I am going in for a follow up scan here in two weeks and doing more blood work. My doctor ordered the following blood tests.

                          Alpha Fetoprotein, Serum

                          HCG, Beta Quantitive

                          Lactate Dehydrogenase, Serum

                          I'm not sure if these blood tests will be uses for all follow ups or what but this is what my dr ordered so far in regards to my recent diagnoses of Seminoma.
                          I am so sorry to hear that.

                          You need to deal with yours and a loved one with tc. That sounds like a tough one.

                          I hope you have an "easy" time of it.
                          Good luck!

                          Comment


                          • #14
                            Originally posted by Jacob View Post

                            I am so sorry to hear that.

                            You need to deal with yours and a loved one with tc. That sounds like a tough one.

                            I hope you have an "easy" time of it.
                            Good luck!

                            Thanks, Jacob. Though I posted that to show that I guess the DR may still think the blood tests could show elevated tumor markers even with Seminoma. Even though mine were never there or my brothers. I hope this helps I know it's a rough feeling of uncertainty. Either way, the future outlook appears to be good from everything my doctors say to everybody on this forum. Good luck to you! I really hope it's nothing and you can go on about your life.
                            April 2017 - Scheduled physical with DR for testicular pain / ultrasound scheduled
                            May 2017 - US shows 3 solid masses 1.2 x 0.7 x 0.7 cm/0.8 x 0.5 x 0.8 cm/ 0.4 x 0.3 x 0.4 cm
                            June 2017 - Left orchiectomy & diagnosed with Seminoma
                            As of October 2017 - All clear!

                            Comment


                            • #15
                              LDH isn't the best marker. For stage 1 patients there are some doctors who never check it, especially in America, so I wouldn't be worried about it. It can be risen by a lot of things as it's to do with cell degeneration and repair etc. Also test ranges vary hugely from country to country, if not hospitals.
                              24 year old diagnosed 6/11/16
                              Pre/o markers 9/11/16 - HCG 15, AFP 210, LDH 539
                              Pre/o CT Clear
                              Non-seminoma (80% embryonal carcinoma, 10% yolk sac tumour, 5% chorea carcinoma, 5% seminoma)
                              Post-op markers - 14/12/16 - HCG 35, AFP 1050, LDH 430
                              Post-op CT with one enlarged lymph node - 1.5x1cm
                              Borderline stage 2B/3B
                              BEPx3 started 15/12/16 (Borderline BEPx4 - Advise of Dr. E to only do 3 rounds)
                              CT and markers clear - in remission - 28/2/16

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