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Tumor Markers Post I/O

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  • Tumor Markers Post I/O

    I'm curious of how many people who had slightly elevated tumor markers before the I/O saw a complete normalization post I/O and stayed that way without further treatment. With my first TC experience I had a slight (9) bHCG elevation that did't normalize and led to 3 x BEP. I'm now dealing with a second primary TC and again have a slightly elevated (14) bHCG. My I/O was this past Monday and I don't go back to see my docs until next week.

  • #2
    I'm pretty sure none of the expert TC docs would have gone to 3xBEP with hcg at 9. Did they normalize after chemo?
    Jan, 1975: Right I/O, followed by RPLND
    Dec, 2009: Left I/O, followed by 3xBEP


    • #3
      Thanks for the reply. After my first I/O I had tumor markers drawn and the bHCG level did not normalize, the lowest value was 9 units. Because my markers did not normalize I was staged 1S, which I believe the recommended action is 3xBEP. For what it's worth, my markers were drawn again before my first round of chemo to double check and they had gone up into 30's. My markers normalized after the first round of BEP and stayed that way for the last 9 years up until I was diagnosed with TC a second time last week.

      I haven't updated my signature line but my current situation is:
      Apr 2009 - Found small lump which was confirmed to be tumor via ultra sounds, slightly elevated bHCG
      May 2009 - I/O operation confirmed TC diagnosis - 100% EC (2nd Opinion at UM 95% EC 5% Teratoma) LVI+. Repeated Serum Tests revealed slightly elevated bHCG.
      June/July 2009 - 3xBEP. Tumor markers normalized
      All Clear for 9 years
      August 2018 - Went in for my annual appointment and bHCG was up to 14. US found 2.9cm hypo echoic mass in remaining testicle (Both myself and the NP in the oncology office missed this on the physical exam). Pre I/O CT Scan was clear. Still waiting on pathology report and follow up bloodwork later this week.

      I'm concerned that my markers would not normalize again and I would be forced into chemo regiment without the option for RPLND or even surveillance. I briefly spoke with my oncologist before my surgery and he said BEP would not be an option, but didn't want to get into any prolonged conversations until pathology report was in and I had a new set of tumor markers once enough time had passed for the half life of bHCG.

      It seems like a lot of our 2x warriors on here, including you Dave, have done really well, but in most cases it doesn't appear people received chemo for both occurrences.

      Going back to my original question, I was just trying to get a sense of how often tumor markers normalize post I/O in instance where they are only slightly elevated before surgery.