Increased HCG levels

[Swissguy]

I was diagnosed with a non-seminoma tumor in my right testicle and had an orchiectomy on May 27, 2015. Because the tumor markers were 0 both before and after the orchiectomy, I was placed on a surveillance program with blood tests for tumor markers every 3 months and CT scans every 6. Last Monday I went for my first three month checkup and had blood drawn for the tumor marker tests. Otherwise the checkup was good. My urologist's office called me on Wednesday last week and told me that my blood tumor markers are elevated and that my doctor wants me to have a CT scan with contrast ASAP. I asked which marker was elevated and she told me that my HCG level is 18 and that it should be less than five. I know there is a possibility of a false/positive result if your testosterone level is very low, but my testosterone level at the same visit was 585 (I am on 2 pumps of Androgel per day) so this pretty much knocks out the false/positive possibility.

I am very scared and worried now. I have my CT scan this Thursday and a consultation with my doctor next Monday and I do not know what to expect. If anybody else has experienced this or has any knowledge of this happening I would appreciate your help. I thought that after the surgery with the tumor markers being 0 that except for the surveillance visits that this was over for me and now I am in a tail spin. Going from an HCG level of 0 to 18 in three months does not seem like a good thing...

Scared in Virginia

[Talis]

Hi there.

18 is elevated, but not ridiculously so. It *could* be a false alarm, but your doctor is right in getting additional scans asap. If the CT finds an enlarged lymph node then unfortunately you'll be put straight on 3xBEP chemo (or 4xEP). If there's no sign of any enlarged nodes, then a potentially even more stressful waiting game will probably ensue, with additional blood tests - probably weekly or even more regularly - and with additional scans, possibly including a PET scan. If the blood markers drop then you'll go back to your usual surveillance regime. If they rise and continue to rise then ultimately you'll probably have to undergo chemo.

What kind of non-seminoma was it - can you remember the constituents?

In any case, try to keep calm and not let your mind run over-speed with worries. Many others have gone through this successfully.

Good luck with the additional tests - let us know how you get on.
- T

[JeskiM69]

Tails is absolutely correct in what he says. I would say that considering BHCG is up then there's likely to be some Choriocarcinoma in there. That value us still very low so it's likely that if it is a recurrence then you caught it very early and it should be easily cured with chemo.

- Matt

[dcnovachris]

Swiss Guy - I also live in Virginia. As you mentioned, there is a possibility that the bloodwork could have led to a false positive. There are many factors involving with taking blood that can lead to such results (how phlebotomist draws the blood, how it's handled/stored, how long from draw to analysis, etc). The chances are fairly low with someone who draws blood regularly, but it is possible. Excluding that possibility, your doc is absolutely correct to order a CT scan immediately. This will identify any enlarged nodes and give them a better understanding of what's going on. If the CT is clean, they may change your surveillance schedule to more frequent blood draws and imaging. This is a good thing as it will allow them to trend the tumor markers and identify any recurrences at the earliest stages.

It may be difficult to look at it this way, but rest assured that your doctor's swift response is a GOOD thing. It means they recognize the importance of being proactive and will pay dividends.

Sending thoughts and prayers your way this week! Let us know how the tests go.

PS - I'll also be going in for a CT scan this Thursday. It will be my first scan since having an RPLND four months ago. As a member of this forum, you'll never be going through this experience alone

[Swissguy]

Thanks for the replies. I am as always preparing for the worst and hoping for the best. I will post again after the results come through.

[Bskiballin3]

Virginia crew checking in as well. Must be something in the air down here lmao. Well good luck with you situation. I had an elevated bhcg one time at a zero to an 15. Retest a few days later it was 11. Retest 2 weeks later at a different lab and it was zero again and has been Zero ever since. I have 1 year since seminoma diagnoses coming up so I'm nervous right now.

[Casbes]

We are in Fairfax. Where are you other Virginians located?

[Bskiballin3]

In Roanoke under the care of Lowell inhorn at blue ridge cancer care. He did his residency under dr einhorn at IU way back in the day so I feel like I'm in pretty good hands.

[Swissguy]

In Wytheville VA. I had my CT scan today and see my urologist on Monday. I am sure I will be presented with a plan of action then.

[dcnovachris]

In Alexandria under the local care of Dr. Ivan Aksentijevich.

[JeskiM69]

Whoa....seems like Virginia is a TC epicenter.....I think I'll stay here in TX

- Matt

[Rickandsabri]

Bringing this post back... I was reading about tumor markers when I noticed all the VA folks on this thread. We are in Tidewater (Virginia Beach)