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Do AFP/HCG results vary from lab to lab? Small increase 1 year post chemo at new lab

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  • Do AFP/HCG results vary from lab to lab? Small increase 1 year post chemo at new lab

    I had embryonal caricinoma 10/26/17; went on surveillance; and relapsed into stage 2A. BEPx3 knocked it out and AFP returned to normal. After being 12 months all clear, I decided to move to a different state and start anew. Chances of relapse I've been told are <1%, with a contralateral TC being 2%. No residuals were present, so we decided against further scans as they were not necessary (talked to Einhorn and he confirmed CT scan optional). Since moving, I got a new oncologist. I just had my new appointment and my AFP was 3.3 (never been over 1.x when no cancer present). Kind of disconcerting, but still in the normal range. She told me to come back in 2 months, rather than our scheduled 4 months.

    Obviously my mind goes wild. Relapse? New TC? It isn't possible. Maybe it's just lab to lab variation?

    Here are all my AFP results before moving:
    10/26/17 1.0 IU/mL (Stage 1B Diagnosis)
    12/11/17 0.9 IU/mL
    2/22/18 4.9 IU/mL (Stage 2A Diagnosis)
    3/5/18 5.9 IU/mL (Day 1 of Chemo Begins)
    3/26/18 1.8 IU/mL
    4/16/18 1.9 IU/mL
    5/30/18 1.4 IU/mL
    8/1/18 1.2 IU/mL
    10/1/18 1.2 IU/mL
    12/3/18 1.6 IU/mL
    2/27/19 1.4 IU/mL
    5/29/19 1.9 IU/mL (12 Months All Clear)
    My HcG Tumor Marker during this entire duration has always been <1

    .................................................. .


    Fast forward 11/12/2019, 5 months later, at my new oncologist in a new state:
    AFP-Tumor Marker 3.3 ng/mL Standard:<6.1 ng/mL
    hCG Quant Pregnancy <2 mIU/mL Standard: <5 mIU/mL
    ..................................................

    A few things to note. AFP is up from 1.9 to 3.3; but the unit of measurements has changed from IU/mL to ng/mL (I don't know if that converts differently). hCG is up to <2 as opposed to <1 (never been that way). hCG looks to be run as a pregnancy marker as opposed to a tumor marker as it was previously (I don't know if that makes a difference).

    I'm not too worried, but obviously cancer puts you in your head. I think I might splurge on a flight and booking too my old oncologist to see what there lab says. Don't know if I can wait two months.

  • #2
    Yes, they definitely can be slightly different lab to lab. Different labs even use slightly different normal ranges as well (perhaps to account for this).
    6/5/15: bHCG 27,AFP 8.66, LDH 361, 5.6cm lymph node - Stage IIC
    6/16/15: Left I/O 85% EC, 10% chorio, 5% yolk sac opinion 2 (mayo) 90% EC, 10% yolk sac
    7/7/15: bHCG 56, AFP 42, LDH 322
    7/13/15: begin 4xEP, end 9/18/15
    10/1/15: bloodwork normal, ct scan shows 2 lymph nodes 1.0cm
    10/26/15: 2nd opinion on CT results - lymph nodes normal. Surveillance!
    4/6/16: 1.7cm X 1.5cm lymph node found with markers normal.
    4/20/16: RPLND @ IU - teratoma only!
    10/22/19: all clears up to this date!

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    • #3
      Everything looks completely normal.
      45yo, left I/O 07/30/2018, T1 pure seminoma, surveillance...
      Waiting...

      Comment


      • #4
        The unit change explains part of it:

        http://unitslab.com/node/99

        Also, each lab has their own "normal range" as long as you are within that range, you shouldn't be concerned by a single test, only an upward trend over time would be worrisome. Also note that cancer cannot be assumed until the AFP level is over 25ng/ml.
        Jan, 1975: Right I/O, followed by RPLND
        Dec, 2009: Left I/O, followed by 3xBEP

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        • #5
          Originally posted by Davepet View Post
          The unit change explains part of it:

          http://unitslab.com/node/99

          Also, each lab has their own "normal range" as long as you are within that range, you shouldn't be concerned by a single test, only an upward trend over time would be worrisome. Also note that cancer cannot be assumed until the AFP level is over 25ng/ml.

          True, I suppose I'm on edge because I had an AFP of just 4.9 with two enlarged lymph nodes and stage 2A going into chemo, so any jump makes me worried. The unit conversion website shows an AFP of 3.3ng/mL = 2.72IU/mL. I know there's a 99% it's nothing.

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