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  • HCG levels elevated

    I went in for my 6 month check up. Everything was normal, except for my HCG. It was elevated to 15. Normally it's less than 1. I feel fine. They're going to do another test in about a month, and a CT scan before that. Could it be it's a false positive? Has anyone else ever dealt with this?
    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
    Here's what the Testicular Cancer Resource Center dictionary has to say about hcg (red textis by me):

    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.
    I wouldn't be concerned at this point, stick to the plan & see what you find out. You might request a testosterone test, and of course if you use marijuana stop for a while before the next test.

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

    Comment


    • #3
      Okay, Thanks Dave. It could be low testosterone, although I do take testosterone replacement. I have no testicles, so I don't know why I would still have seminoma, other than it being hidden in a lymph node all these years. I guess I'll feel better, once I have the CT scan.
      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


      • #4
        I had a bHCG do that one time. Ended up being a false positive. My value was about the same as yours....low teens.

        I had a blood test 2 weeks after and another a few weeks after that to prove that it was indeed a false positive.

        That was two years ago.

        Wait for the next blood test or try to get one sooner. I would not do any scans unless subsequent tests show the number continuing to rise.

        - 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 !

        Comment


        • #5
          Originally posted by Rush67 View Post
          Okay, Thanks Dave. It could be low testosterone, although I do take testosterone replacement. I have no testicles, so I don't know why I would still have seminoma, other than it being hidden in a lymph node all these years. I guess I'll feel better, once I have the CT scan.
          Since you are on TRT, you should be getting regular testosterone testing, however many docs are not good about that, so get it checked. Mine goes up & down from test to test & my doc seems to prefer low normal over high normal and seems unconcerned if it dips below normal, which I find unacceptable.

          How are you feeling? I looked back at some of your older posts & see you've had some issues keeping the level up where it needs to be. I'd try to schedule a T test on the same day as the marker test. That way there is no guessing.

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

          Comment


          • #6
            I would certainly re-check the labs. Were you scheduled to have a regular CT scan? If so, then having one is of no issue. If not, then I may get the labs verified before I had an added CT exam. beta-hCG labs can be falsely elevated due to cross reactivity to high LH levels due to low testosterone. If the level is still mildly elevated and the CT is clear then you could ask your doctor about giving you a depotestosterone challenge and see if the levels drop. I am not sure how/if it works with people on testosterone but I think it is worth asking before undergoing treatments if nothing in confirmed on imaging and the level is relatively low as it is.

            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


            • #7
              Originally posted by Davepet View Post

              Since you are on TRT, you should be getting regular testosterone testing, however many docs are not good about that, so get it checked. Mine goes up & down from test to test & my doc seems to prefer low normal over high normal and seems unconcerned if it dips below normal, which I find unacceptable.

              How are you feeling? I looked back at some of your older posts & see you've had some issues keeping the level up where it needs to be. I'd try to schedule a T test on the same day as the marker test. That way there is no guessing.

              Dave
              I see an Endocrinologist, who prescribes my testosterone. My free testosterone levels were at 643, back in May. I'll be checked again in a couple months, when I see him.
              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


              • #8
                Originally posted by Mike View Post
                I would certainly re-check the labs. Were you scheduled to have a regular CT scan? If so, then having one is of no issue. If not, then I may get the labs verified before I had an added CT exam. beta-hCG labs can be falsely elevated due to cross reactivity to high LH levels due to low testosterone. If the level is still mildly elevated and the CT is clear then you could ask your doctor about giving you a depotestosterone challenge and see if the levels drop. I am not sure how/if it works with people on testosterone but I think it is worth asking before undergoing treatments if nothing in confirmed on imaging and the level is relatively low as it is.

                Mike

                I'm due for a CT scan anyway, so he wants to do the scan first, before my labs, which are in a month. I've been doing this for 7 years, and it's always been at normal levels. This time, everything else was fine, except the HCG. I'm just finding it hard to believe that it would go 0-15, in 6 months, especially when there are no other tumor markers.
                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
                  Originally posted by JeskiM69 View Post
                  I had a bHCG do that one time. Ended up being a false positive. My value was about the same as yours....low teens.

                  I had a blood test 2 weeks after and another a few weeks after that to prove that it was indeed a false positive.

                  That was two years ago.

                  Wait for the next blood test or try to get one sooner. I would not do any scans unless subsequent tests show the number continuing to rise.

                  - Matt
                  Thanks Matt. That's good to know!
                  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
                    Hoping it's a false positive here. It's highly unlikely that a pure seminoma would last through 4xEP.
                    Young Adult Cancer Survivorship by Steve Pake
                    April is Testicular Cancer Awareness Month!
                    www.stevepake.com
                    Feb 2011, Stage IIB, 4xEP, RPLND, PTSD
                    My Survivorship Thread | All of my Blogs
                    C
                    ONTACT ME ANYTIME!

                    Comment


                    • #11
                      hoping it was a false positive too
                      Son Grant
                      dx 12/21/16 at age 17

                      BEP x3
                      Post Chemo CT Scan on 3/28/17 still showed a few nodes over 2 cm
                      2nd Post Chemo CT Scan on 4/27/17 showed all nodes still over 2cm
                      Post Chemo RPLND 5/8/17: Periaortic Teratoma, Intraaorticaval Teratoma, and Paracaval Teratoma found.

                      Comment


                      • #12
                        My free testosterone levels were at 643, back in May. I'll be checked again in a couple months, when I see him.
                        What units are they using? That sounds extremely high for free T, more like total T


                        I will again suggest not waiting for your endo, ask for a T test at the same time of your next marker test. If markers are up & T is down, you have useful information, if markers are down, & T is up, not so much. Keep in mind, that despite TRT, on any given day your level will be different.

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

                        Comment


                        • #13
                          Originally posted by Davepet View Post
                          What units are they using? That sounds extremely high for free T, more like total T


                          I will again suggest not waiting for your endo, ask for a T test at the same time of your next marker test. If markers are up & T is down, you have useful information, if markers are down, & T is up, not so much. Keep in mind, that despite TRT, on any given day your level will be different.

                          Dave

                          I'm sorry, my mistake. The total testosterone was 643 ng/dl , the free testosterone was 104 pg/ml.
                          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

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