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  • Still Stressin'

    Okay, my pathology report on my testicular cancer was seminoma. Is there a possibility that the reason my afp has risen, is because there is nonseminoma in my lymph nodes? Does that happen? There's no way of telling, until you take them out.

    I'm sorry guys, I'm just a little stressed because I thought I was doing well, until last week. My afp has gone from 2 to 8 in about 2 months. I know that's not real high, but it's driving me crazy. My liver function is normal. I don't have liver disease. I haven't had a beer, since I started chemo. Is there a chance that my afp levels will go down on the next lab?
    Jan 2000 Left I/O
    Surveillance
    Dec 2011 cancer diagnosed in right testicle, and lymph node, followed by I/O
    Pathology report 100% pure seminoma
    March 5 2012 started chemo 4xEP
    May 11, 2012 Finished Chemo.
    October 29, 2012 All Clear.

  • #2
    As far as I know Doctor Einhorn is not concerned until it reachs 25, so it might be a normal fluctuation. Maybe you should check it again in a couple of weeks to see if it keep on rising.
    - early Apr/11: something is "wrong" in my righty
    - 16/Apr/11: ultrasound find a mass in it
    - 27/Apr/11: right I/O
    - 29/Apr/11: stadiation CT scan shows "all clear"
    - May/11: pathology: 1 cm Seminoma (90% necrotic), no RT/LV invasion
    - Surveillance....
    - March/13: relapse - para aortic node 1.7 cm, waiting for treatment...

    Comment


    • #3
      My friend, look at my experience... before I had the surgery, my Afp level was of 1.9. I had the orchiectomy, it was diagnosed and confirmed as seminoma at first stadium, everything seemed to be ok, but, at the second Afp test, it increased to 4.4. So I'm in your same situation. Anyway, you have to consider that you are still in the range and some fluctuations can be normal. It also depends on the fact that the results change from lab to lab tests. My suggestion is to take your blood always in the same medical center, and don't worry if your Afp increases even out of range. According to what the doctors told me, there is nothing to worry about if the level goes until 30 units. If you are worried about some other issues, I suggest to you (even if I'm not a doctor) to take also tests of the CEA marker, and of the serum creatinine. If they are all ok, you don't have to worry about any complication.

      Have a nice day!

      Comment


      • #4
        Originally posted by frank1980 View Post
        My friend, look at my experience... before I had the surgery, my Afp level was of 1.9. I had the orchiectomy, it was diagnosed and confirmed as seminoma at first stadium, everything seemed to be ok, but, at the second Afp test, it increased to 4.4. So I'm in your same situation. Anyway, you have to consider that you are still in the range and some fluctuations can be normal. It also depends on the fact that the results change from lab to lab tests. My suggestion is to take your blood always in the same medical center, and don't worry if your Afp increases even out of range. According to what the doctors told me, there is nothing to worry about if the level goes until 30 units. If you are worried about some other issues, I suggest to you (even if I'm not a doctor) to take also tests of the CEA marker, and of the serum creatinine. If they are all ok, you don't have to worry about any complication.

        Have a nice day!
        Thanks Frank. You've told me alot.I have a feeling everything will be fine.
        Jan 2000 Left I/O
        Surveillance
        Dec 2011 cancer diagnosed in right testicle, and lymph node, followed by I/O
        Pathology report 100% pure seminoma
        March 5 2012 started chemo 4xEP
        May 11, 2012 Finished Chemo.
        October 29, 2012 All Clear.

        Comment


        • #5
          Forgot to say also my AFP increased from the pre I/0 to the 1st check up (I had seminoma). Also my oncologist wasnt concerned.
          - early Apr/11: something is "wrong" in my righty
          - 16/Apr/11: ultrasound find a mass in it
          - 27/Apr/11: right I/O
          - 29/Apr/11: stadiation CT scan shows "all clear"
          - May/11: pathology: 1 cm Seminoma (90% necrotic), no RT/LV invasion
          - Surveillance....
          - March/13: relapse - para aortic node 1.7 cm, waiting for treatment...

          Comment


          • #6
            Originally posted by Rush67 View Post
            Thanks Frank. You've told me alot.I have a feeling everything will be fine.
            You are welcome my friend. If I can report you a thing that my oncologist said, if your Afp is in the range or goes out for a little bit you have not to worry. In these cases, it's recommended to take always a look, if you don't want to take tests of CEA and serum creatinine, at your LDH level. If also this is ok, you are fully protected. And I'm sure that everything will be ok! Stay strong!

            Comment


            • #7
              Rush67,

              As the others have mentioned your AFP is still low/in the normal range, but any steady increase is of course worrisome.

              Some things to note - the overall trend really is the important part. If you see a steadily increasing # that continues to rise past the normal (>10, or per Dr. E, >20-25 ng/mL) than more/other treatment is warranted. And while your liver function tests are good and you aren't drinking, you are on chemo, which will lead to stressing the liver and can be responsible for modest fluctuations.

              Nothing to jump on yet with the RPLND, definitely get that second pathology opinion, but also note that what is in the primary removed tumor and what is in the metastasis may not be the same type (my DH had 100% EC in his primary mass and RPLND showed seminoma, teratoma and yolk sac in his RP nodes).

              Hang in there, keep watching the AFP, and a post-chemo RPLND done by a center of excellence (I definitely suggest contacting IU or MSKCC) is manageable.

              T
              Tracy
              Cancer pharmacologist, caregiver blog here

              Wife to Kel, dx 12/30/11 Stage IIIc (poor) embyronal, AFP 13700, 10x11 cm retroperitoneal mass, 1 cm^2 lung met
              Left I/O 12/31/10.
              4xBEP 1-4/11, AFP=22, 5*7 RP mass, tx failed
              1.5 x VeIP 5-6/11; tx failed, AFP/b-hCG rising
              Salvage RPLND @Indy 6/29/11, metastatic mixed germ cell tumor with yolk sac, seminoma and teratoma
              Remission! AFP steady since 9/2011; 2+ years ALL CLEAR

              Comment


              • #8
                Originally posted by CancerSux View Post
                Rush67,

                As the others have mentioned your AFP is still low/in the normal range, but any steady increase is of course worrisome.

                Some things to note - the overall trend really is the important part. If you see a steadily increasing # that continues to rise past the normal (>10, or per Dr. E, >20-25 ng/mL) than more/other treatment is warranted. And while your liver function tests are good and you aren't drinking, you are on chemo, which will lead to stressing the liver and can be responsible for modest fluctuations.

                Nothing to jump on yet with the RPLND, definitely get that second pathology opinion, but also note that what is in the primary removed tumor and what is in the metastasis may not be the same type (my DH had 100% EC in his primary mass and RPLND showed seminoma, teratoma and yolk sac in his RP nodes).

                Hang in there, keep watching the AFP, and a post-chemo RPLND done by a center of excellence (I definitely suggest contacting IU or MSKCC) is manageable.

                T
                Yeah, I've decided to hold off on the RPLND, until we get more information. The PET scan will help determine alot of things. I just can't see my self getting cut up, until I actually know what is down there in my belly. The CT scan is only showing the one node, which is responding to chemo.

                On my next appointment I will ask for a second opinion on the pathology report.
                Jan 2000 Left I/O
                Surveillance
                Dec 2011 cancer diagnosed in right testicle, and lymph node, followed by I/O
                Pathology report 100% pure seminoma
                March 5 2012 started chemo 4xEP
                May 11, 2012 Finished Chemo.
                October 29, 2012 All Clear.

                Comment


                • #9
                  Well, after obsessively coming on this website for about a week, trying to find answers, and learning who Dr. Einhorn is, I contacted the man, and he responded to me within an couple of hours. I was extremely pleasantly surprised, especially on a weekend.

                  He told me that my doctors are wrong, and I have zero reason for concern right now, and to just finsh my chemo, and follow up. I tell you what, it's been awhile since I did the happy dance, but I definately did one today. Talk about tears of joy.

                  This website has been a real Godsend. I've learned more this week about TC, just by coming on this website, and reading everybody's posts, than I have my whole life. It's been like a school. I didn't even know who Dr. Einhorn was until I came on here. Finding out that he's the ultimate authority on TC, and that I would be able to communicate with him, is just beyond amazing.

                  Thank you everybody.
                  Jan 2000 Left I/O
                  Surveillance
                  Dec 2011 cancer diagnosed in right testicle, and lymph node, followed by I/O
                  Pathology report 100% pure seminoma
                  March 5 2012 started chemo 4xEP
                  May 11, 2012 Finished Chemo.
                  October 29, 2012 All Clear.

                  Comment


                  • #10
                    Well, I have great news. I had labs done today, and my AFP numbers went down from around 8 to 4.5. So, after a steady climb, they have gone down. I'm pretty excited about that. The doctors here have caused me alot of anxiety this week. I had an oncologst, and two urologists freaking out over the steady climb, which had me kinda stressed. Dr. Einhorn was the only doctor who told me not worry about the AFP numbers, and of course, he was right.
                    Jan 2000 Left I/O
                    Surveillance
                    Dec 2011 cancer diagnosed in right testicle, and lymph node, followed by I/O
                    Pathology report 100% pure seminoma
                    March 5 2012 started chemo 4xEP
                    May 11, 2012 Finished Chemo.
                    October 29, 2012 All Clear.

                    Comment


                    • #11
                      Good news!

                      That is great news, the reference range of the lab report I have indicates anything less than 8 as normal. Mine is 4.4 and I have pure seminoma.
                      03/16/2012 Ultrasound Diagnosis TC (Tumor 5.5 cm)
                      03/22/2012 Right I/O Pre-IO markers normal
                      03/28/2012 Pathology Classic pure Seminoma, pT1/N?/M0/S0
                      04/05/2012 CT Scan--Clear? (single 1.2 cm node External iliac)
                      05/03/2012 PET Scan CLEAR. All markers Normal.
                      05/04/2012 1 X CARBOPLATIN INFUSION (Chemo Lite)
                      09/02/2012 CT All Clear! (1 cm External Illiac Node)
                      04/04/2013 CT All Clear!

                      Comment

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