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How Concerned Should I be About These Results?

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  • How Concerned Should I be About These Results?

    This is partially for advise, mostly just to get my worries down on paper and off my chest.

    I've talked about it before on here, but my HCG has been slowly rising lately, It was 0 in Jan/Mar, 1.4 in May, now 2.7 in July. I know that those are very low, but I'm really concerned because my tumor markers have never risen before (the highest before was AFP at 6). I have also talked about low T symptoms on here. I did a total T test that came back low normal (300, low for Duke is 175, I'm 24). I'm doing TRT because the symptoms were rough and my Onc agreed that was low for a 24 year old, but I'm not sure I can believe that it would be driving HCG. Don't you need really low T to have HCG increase?

    Also, I'm not really concerned per se, more confused, about my lungs right now. In January my chest Xray showed:

    "There is a small focus of opacity in the medial right middle
    lobe. There is also mild opacity in the posterior costophrenic angle on the
    lateral view."

    This prompted a CT in Feb which showed:

    " There are scattered ground glass opacity seen
    throughout the right lower lobe, some of which are new. There is trace
    residual groundglass in the region of the previously seen subpleural
    consolidative opacity (series 3, image 361), slightly increased in overall
    size compared to prior but markedly decreased in consolidative component.
    Additional area of groundglass opacity in the right middle lobe seen on
    1/4/2018 prior has also nearly resolved in the interim. No pleural
    effusion.Findings are favored to represent
    drug toxicity, versus infectious or inflammatory etiology."

    Now in July I got another X-ray that showed:

    "Interval increased ill-defined basilar opacities projecting
    over the spine on the lateral view." which is prompting another chest CT in august.

    I guess just generally I don't understand what is going on with my lungs (ill defined opacities moving that much doesn't seem like it'd be cancer, but my onc seems concerned)

    I guess the hope is that it's both low grade toxicity AND low T, but nobody seems to know and it's driving me nuts. First time around there were clearly defined moves to make given certain characteristics, but now it just seems so open ended
    *** Serum Markers Never High***
    July 14, 2017: Lump on right testicle
    July 20: US show 3 lesions "highly suspicious for testicular cancer"
    July 26: Pelvic CT shows 1 lymph node @ 2cm, 1 @ 1.4cm
    July 30: Right Radical Orchiectomy
    Aug 2: Pathology report "100% Embryonal Carcinoma"
    Aug 20: Oncologist stages 2A, wants RPLND primary treatment, 2nd CT
    Sept 13: 2nd CT shows nodes now 2.4cm and 1.8cm
    Sept 15: Now Stage 2B, New treatment 3x BEP
    Oct. 2: Begin 3x BEP
    Nov. 28: Finish 3x BEP 2018
    Jan. 04: First all clear CT. Scattered Ground Glass Opacity in lungs common to drug toxicity
    Mar.06: Blood tests negative. STILL ALL CLEAR

  • #2
    Originally posted by SchoolOnHold View Post
    Don't you need really low T to have HCG increase?
    At 300 you HAVE really low t. I don't know why their reference range goes that low, but it's just wrong. At your age you should be twice that or more. Also was that test before or after starting TRT?

    Originally posted by SchoolOnHold View Post
    Also, I'm not really concerned per se, more confused, about my lungs right now.
    The lung results sound unrelated to TC, but they will call out anything they see that is not "normal". I suspect that is what is happening here, but I am not a doc.

    Originally posted by SchoolOnHold View Post
    I guess the hope is that it's both low grade toxicity AND low T, but nobody seems to know and it's driving me nuts. First time around there were clearly defined moves to make given certain characteristics, but now it just seems so open ended
    My advice is to get used to waiting & uncertainty. There will be much of both for a while now.
    Jan, 1975: Right I/O, followed by RPLND
    Dec, 2009: Left I/O, followed by 3xBEP

    Comment


    • #3
      Bleo is known to sometimes mess up lungs and what they are seeing from what I read is these negative effects. It doesn’t seem like cancer rather your lungs being hit with Bleo.

      https://pubs.rsna.org/doi/full/10.1148/radiol.10092129

      I found this. It discusses causes of opacities. Especially related to our situations. A lot can cause them and it doesn’t seem cancer related in your case.
      3/29/17 Diagnosed 100% Embryonal 4/10/17 Left I/O CT scan shows a few suspicious lymph (biggest 1.9 cm) 5/8/17 - 7/3/17 3xBEP 7/20/17 CT Scan Clear, AFP has uptick to 19 8/16/17 AFP Drops in half to 10, ALL CLEAR! 11/16/17 All Clear! AFP continues to drop! 3/19/18 All clear!

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