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Started 2nd BEP - Need Advice on Markers

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  • Started 2nd BEP - Need Advice on Markers

    Hi, glad to have found such a great community where you can ask advice and share your story. I'm 31yrs old, white male from Europe.

    - So, in late November, 2011 I was diagnosed with TC.

    - Original CT scan found one increased lymph node in retroperitoneal, 20mm/2cm = 0.787 inches

    - On December 2, 2011 I got my I/O on the right testicle

    - Histology showed it's a non-seminoma: 98% embryonal carcinoma, 2% yolk sac tumor

    - Clinically staged IIA

    - Markers have been increasing since I learned the news: originally within normal range, then going up, the highest mark was like 52 for AFP and 40 for HCG

    - The most recent check before I started 2nd cycle of BEP got AFP = 6, hCG = under 3, oncologist seems to be happy

    - Follow up scan showed that the lymph node decreased by approx. 50% after the first cycle of BEP

    NOW HERE'S MY QUESTION: I read that neither embryonal carcinoma, nor yolk sac tumor secrete hCG, why could my blood test show increased hCG earlier?

    From what I understand this mix of tumors is not the worst combination, am I right?

    Thanks!

  • #2
    Hi Arty - Here's some info on HCG levels in different types. best to you, embee

    Raised bHCG level are rarely elevated in seminoma. The figures below provide the chances of having an elevated b HCG level in different types of testicular cancers -

    100% - Chorio carcinoma

    60% - Embryonal carcinoma

    55% - Teratocarcinoma

    25% - Yolk Cell Tumor

    7% - Seminomas
    Nephew Will (19 years old)

    2-14-11 Left I/O; 50% EC, 40% teratoma; 10% yolk sac
    3-14-11: BEPx3
    4-18-11: Markers normalize
    6-13-11: IU pathology: 60% teratoma, 35% EC, 5% yolk sac
    7-7-11: left modified template nerve sparing RPLND at IU; 2/19 nodes with teratoma (2%), rest necrotic
    10-01-11: 1st post-RPLND TM ALL CLEAR
    12-01-11: 1st post-RPLND CT ALL CLEAR

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    • #3
      Hi Arty,

      hCG can be markedly elevated with embroynal cell. It can also be falsely elevated with hypogonadism, heterophilic antibodies and marijuana use.

      Thanks,
      Mike
      Oct. 2005 felt lump but waited over 7 months.
      06.15.06 "You have Cancer"
      06.26.06 Left I/O
      06.29.06 Personal Cancer Diagnosis Date: Got my own pathology report from medical records.
      06.30.06 It's Official - Stage I Seminoma
      Surveillance...
      Founded the Testicular Cancer Society
      6.29.13 Summited Mt. Kilimanjaro for 7th Cancerversary

      For some reason I do not get notices of private messages on here so please feel free to email me directly at mike@tc-cancer.com if you would like to chat privately so as to avoid any delays.

      Comment


      • #4
        embee, Mike, thanks for your input.

        My male hormone levels when last checked were within acceptable ranges, free testosterone even went up after the I/O.

        After the chemo hCG seems to be back on track so I'll just keep an eye on it. Maybe it's embryonal carcinoma that produces it. I don't know what heterophile antibodies but I probably smoke pot two times in a lifetime with no response from the nervous system. )

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        • #5
          Arty I had 70% EC/30% Seminoma and both my AFP and Hcg were elevated. 77 and 209 respectively just before chemo and were normal after Rd. 1 of BEP.

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          • #6
            Got it, similar to my case, thanks for sharing!

            Comment


            • #7
              Originally posted by arty View Post
              embee, Mike, thanks for your input.

              My male hormone levels when last checked were within acceptable ranges, free testosterone even went up after the I/O.

              After the chemo hCG seems to be back on track so I'll just keep an eye on it. Maybe it's embryonal carcinoma that produces it. I don't know what heterophile antibodies but I probably smoke pot two times in a lifetime with no response from the nervous system. )
              Just an FYI, heterophilic antibodies are kind of hard to explain but they are basically antibodies that can react with a bunch of different entities and can thus interfere with the hCG test itself.

              I wouldn't worry too much about them. Especially, since your hCG is decreased.
              Oct. 2005 felt lump but waited over 7 months.
              06.15.06 "You have Cancer"
              06.26.06 Left I/O
              06.29.06 Personal Cancer Diagnosis Date: Got my own pathology report from medical records.
              06.30.06 It's Official - Stage I Seminoma
              Surveillance...
              Founded the Testicular Cancer Society
              6.29.13 Summited Mt. Kilimanjaro for 7th Cancerversary

              For some reason I do not get notices of private messages on here so please feel free to email me directly at mike@tc-cancer.com if you would like to chat privately so as to avoid any delays.

              Comment

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