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Fluctuation in HCG

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  • Fluctuation in HCG

    Hello. My husband has posted about our son who was diagnosed in December stage 3c, pure EC, hCG 1354, AFP 7.3 and LDH 934. After first round of chemo, hCG 41, AFP 3.1 and LDH 334. After 2nd round, hCG and AFP were normal. We visited Dr Einhorn after treatment ended and he reviewed medical records and scans and put our son on surveillance, no RPLND. Just had TM draw, 5 months one week post chemo, and hCG went from

  • #2
    (I can't get my post to post correctly so continuing here.) hCG went from

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    • #3
      What she is saying is, the HCG went from less than 2 to 2. Dr. Einhorn said there is "zero concern". She is still worried about it though.

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      • #4
        My hcg went from unmeasurable for 6 months to a 16, then retest to 11, then retest to unmeasurable again and has been for another 6 months. Hcg can be a tricky thing
        Left R/O on 10-9-14. Ct scans all clear.
        Pure Seminoma stage 1a. no vascular invasion.
        surveillance started, with chest x-ray 12-3 , blood work 1-22-14.

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        • #5
          Whoa. I would be a crazy mom through that!!! Dr. Einhorn wrote again and explained he was pretty experienced with TC and that I should trust his judgement. I'm going with it.

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          • #6
            I would completely trust Dr. Einhorn's opinion on this and a small rise is really insignificant. There is nothing to worry about in your son's case.

            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.

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            • #7
              If it's not constantly going up with each test then it's nothing to worry about.

              - Matt
              March 4th 2014: [AFP = 2.5; bHCG = 6; LDH = 618]
              March 13th: Left IO 100% Classic Seminoma
              6.3 x 5.1 x 3.8 cm, no invasion of anything
              LDH never fully normalized
              Stage: IS
              Watchful Waiting
              May 1st: promoted to Stage IIB with two PET active tumors in the para-aortic lymph nodes 2.5 & 2.4 cm
              May 12th: started 3xBEP
              Neupogen during Cycle 2 and 3
              July 8th: Last Bleo shot of Cycle 3 -- chemo completed !
              August 4th: Post Chemo CT/PET scan
              September 4th: Port removed
              July 10th 2018: 4 YEARS ALL CLEAR !

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              • #8
                I can only second everyone else's recommendation that you trust fully in Dr. Einhorn's assessment. I was treated at Indiana University and the entire urology staff was incredible. As far as bHCG, the normal range is 0-5 and fluctuations within that range are not uncommon. Something to keep an eye on is the trend over time. If it's rising slowly, but steadily, you may ask if there are reasons why. If it's up-down-up-down within normal range, there may not be reason for concern.
                3/16/15: Urologist visit for suspicious lump. Tumor markers negative. Ultrasound showed solid mass.
                3/18: Radical left I/O.
                3/24/15: Pathology: 100% EC w/ LVI present. Chest CT clear, Abdo CT shows 3 enlarged nodes (1.0, 1.1, 1.6cm). Clinical Stage IIA.
                5/4/15: Primary (open) RPLND w/ Dr. Foster at IU. 34 nodes removed, only 2 had presence of EC. Pathological Stage IIA.
                June 2015: First ALL CLEAR!
                August 2015: ALL CLEAR!
                September 2015: Post-RPLND baseline CT scan ALL CLEAR! Lymphocele measuring 9x5x5cm was noted, surgeon said it was harmless and should resorb within a year.
                November 2015: Bloodwork and chest x-ray clear
                February 2016: Bloodwork, chest x-ray, CT scan clear
                July 2016: Bloodwork, chest x-ray clear (CT scan in September)

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                • #9
                  Originally posted by Casbes View Post
                  Dr. Einhorn wrote again and explained he was pretty experienced with TC and that I should trust his judgement. t.
                  Well, that is the understatement of the century! Dr E discovered the 3xBEP chemo that has changed TC from 90+% fatal to 90+ % cured (not remission, CURED).You can certainly feel comfortable when he tells you to not worry.

                  Here is what the Testicular Cancer Research Center Dictionary has to say about hcg:
                  Human Chorionic Gonadotropin (hCG), beta subunit - In adults, significant elevation of levels of beta HCG occurs only during pregnancy and in patients with trophoblastic neoplasms or nonseminomatous germ cell tumors. As a result, it is used as a tumor marker. Essentially, 100 per cent of patients with trophoblastic tumors and 40-60 per cent of patients with nonseminomatous germ cell tumors, including all patients with choriocarcinoma, 80% of patients with embryonal carcinoma, and 10-25% of patients with pure seminoma are diagnosed with elevated levels of beta HCG. The serum half life of beta hCG is 24 to 36 hours, which implies that elevated concentrations should return to normal within 5 to 7.5 days after surgery if all tumor is removed. Please note that the normal HCG level is usually less than 5 miu/ml. Also note that the HCG level can become elevated (falsely positive) due to abnormally low levels of testosterone or because of marijuana use
                  You son is within the normal range, nothing to worry about unless it starts climbing.

                  Dave
                  Jan, 1975: Right I/O, followed by RPLND
                  Dec, 2009: Left I/O, followed by 3xBEP

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                  • #10
                    Yeah, I know. Totally cracked me up when I read it. What a great doctor. We have been in touch with Dr Einhorn since before D started treatment. He and Jackie have been very helpful and reassuring.

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                    • #11
                      Hello all, I had embryonal carcinoma in right testicle. Removed in May 2015, pathology results - vascular and lymphatic invasion. CT scan was clear day after I/O (max size was inguinal nodes 18x8mm). Suggested 2 cycles of BEP, but I choose the survelliance. First check in July - blood markers - LDH 5.4, B-HCG 0.1, AFP 1.55. 2nd CT in September 2015 - the same results as in May (also the inguinal nodes 18x8mm the same size, all parameters same as the 1st scan). Oncology visit in October - doctors said letīs see according the markers (beacuse of the inguinal nodes 18x8mm). The results, B-HCG 1.27, LDH 5.5, AFP 1.58 Tumor markers LDH and AFP exactly the same as in July, but B-HCG was 0.1 and now is 1.27. From the oncology "view" they are negative, but I have worries, whether this B-HCG does have the rising tendency or not. Next check of markers is planned in Dec 2015, and praying for the same results...
                      04/24/2015 – pain in the right testicle – USG confirmed mass, blood results B-HCG = 12 U/l, AFP = 6.14 ug/l, LDH = 9,
                      05/05/2015 – I/O (100% Embryonal carcinoma, LVI presented)
                      05/06/2015 – post-operative CT scan negative, 2xBEP suggested
                      6/2015 - surveillance (my decision)
                      7/2015, 9/2015 - markers negative
                      9/2015 - 2nd CT negative, 6 months later CT re-checked and found one node which measured 16x12mm
                      10/2015, 1/2016, 2/2016 - markers negative
                      2/2016 - 3rd CT scan - 2 nodes (border) - 12x8mm, 13x9mm
                      3/2016, 5/2016, 8/2016, 11/2016, 2/2017 - markers negative
                      2/2017 - 4th CT scan - 11x7mm (was 12x8mm) and 8x5mm (was 16x12mm)
                      7/2017 - markers negative

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                      • #12
                        Hello all, I had embryonal carcinoma in right testicle. Removed in May 2015, pathology results - vascular and lymphatic invasion. CT scan was clear day after I/O (max size was inguinal nodes 18x8mm). Suggested 2 cycles of BEP, but I choose the survelliance. First check in July - blood markers - LDH 5.4, B-HCG 0.1, AFP 1.55. 2nd CT in September 2015 - the same results as in May (also the inguinal nodes 18x8mm the same size, all parameters same as the 1st scan). Oncology visit in October - doctors said letīs see according the markers (beacuse of the inguinal nodes 18x8mm). The results, B-HCG 1.27, LDH 5.5, AFP 1.58 Tumor markers LDH and AFP exactly the same as in July, but B-HCG was 0.1 and now is 1.27. From the oncology "view" they are negative, but I have worries, whether this B-HCG does have the rising tendency or not. Next check of markers is planned in Dec 2015, and praying for the same results...
                        04/24/2015 – pain in the right testicle – USG confirmed mass, blood results B-HCG = 12 U/l, AFP = 6.14 ug/l, LDH = 9,
                        05/05/2015 – I/O (100% Embryonal carcinoma, LVI presented)
                        05/06/2015 – post-operative CT scan negative, 2xBEP suggested
                        6/2015 - surveillance (my decision)
                        7/2015, 9/2015 - markers negative
                        9/2015 - 2nd CT negative, 6 months later CT re-checked and found one node which measured 16x12mm
                        10/2015, 1/2016, 2/2016 - markers negative
                        2/2016 - 3rd CT scan - 2 nodes (border) - 12x8mm, 13x9mm
                        3/2016, 5/2016, 8/2016, 11/2016, 2/2017 - markers negative
                        2/2017 - 4th CT scan - 11x7mm (was 12x8mm) and 8x5mm (was 16x12mm)
                        7/2017 - markers negative

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