Seminoma with AFP question

[jonmac]

I was diagnosed after a right side Orchirectomy of haveing pure Seminoma. I am in the Navy on flight status so the results were verified at a lab in D.C. and then a third time at Portsmouth Naval medical facility in VA. All three said pure seminoma.

My AFP initially was 11.4 but then prior to surgery (4 days later) it was 4.4. The CT scan and chest xray were clean. 7 weeks later, I am now in Portsmouth and the AFP was 10.7. The Doctors are a little cofused with the 4.4 I think. The only thing the 11.4 and 10.7 had in common were that I had consumed alcohol within 3 days or so of the tests. Another factor could be that 6 years ago I was treated with INH and it almost caused liver failure. LFTs were off the charts. (10 times normal) Maybe it could have caused some liver damage or maybe it reacts differently to alcohol now?

The doctors are saying if the next AFP number is still high. (they consider over 10.0 high) they wand to do 2 or 3 cycles of VIP. (BEP can cause lung toxicity and as a "Flyer" it would keep me out of my job much longer) If it is decreasing they will treat as pure seminoma)

Does this train of thought make sense to you guys or should I question this thought process further. I am prepared to do chemo if that is best, but I don't want to do 3 cycles if it is not needed.

Thanks
Jon

[Scott]

Welcome, Jon. You're right that there are other reasons that AFP may be elevated, including liver damage. I think a second opinion from a center of expertise is important.

[Kiwi]

Hi Jon

My levels have never been "normal", this goes back to 2001.

They are above the normal and can vary by about 5 points, but have always been in the same range. The docs have looked at other things to see if there is anything else going on but nothing has ever been detected.

They came to the conclusion that that this is just my "normal", a simple example ...... some people are Tall while others are Short, there is a normal "range" but some people will fall outside of that range.

You should keep monitoring to detect changes and confirm what your "normal" is or if they is something else going on.

Cheers

Kiwi

[Scott]

Note the Testicular Cancer Resource Center glossary's entry for AFP (emphasis mine):

Alpha-fetoprotein - AFP is a protein found in the bloodstream of some men with nonseminomatous testicular cancer (It is NEVER present in seminoma patients). The level rises when the cancer is growing and falls when the cancer is shrinking or has been surgically removed, so a blood test can possibly measure the progress of the disease and success of treatment. Because of this behavior, it is referred to as a tumor marker. Elevated levels of AFP occur in 75 per cent of patients with teratocarcinoma, embryonal cell carcinoma, and yolk sac carcinoma. (However, increased levels of AFP are also found in patients with liver diseases, such as cirrhosis, acute and chronic hepatitis and hepatic necrosis.) The serum half life of AFP is 5 to 7 days, which implies that elevated levels of AFP should fall by one half of the initial level per week and should probably return to normal within 25 to 35 days after surgery if all of the tumor has been removed. The higher the level, though, the longer it will take to return to normal. Please note that AFP is normally less than about 5 ng/ml, but cancer cannot be assumed until it is over 25 ng/ml. Also note that a very small number of people have a naturally high level of this protein in their blood (though less than 25) even though they do not have cancer.

[jonmac]

Thanks

Thanks for the posts and info. I have had 3 friends in the same line of work that have TC and the military Dr's are known for being agressive with the treatments. I just want to make sure it is warranted. I think I will push for another AFP test or two before I commit to something.

[Scott]

I think I will push for another AFP test or two before I commit to something.

I would, too, if I were you, especially with the pathology report saying it's pure seminoma, which doesn't elevate AFP.

[Kiwi]

"Also note that a very small number of people have a naturally high level of this protein in their blood (though less than 25) even though they do not have cancer."

Good? to be in another special group of non normal people!!!....was 100% seminoma both times too...they have checked out Liver and others but these have been ok.

Cheers

Kiwi