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AFP Rising - when is a rise significant?

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  • AFP Rising - when is a rise significant?

    Hi, Some of you might remember, I was diagonsed with TC in April 09' and since then had left i/o and been under surveillance since then. These have been my AFP results to date -

    20 (diagnosed)
    12 (1 week post-op)
    9 (2 week post op)
    7 (3 week post op)
    7 (4 week post op)
    8 (5 week post op)
    8 (Latest marker 6/6
    8 (august09 - April 10)
    10 April 10

    BUT, my AFP has now rise to 10 and I'm very concerned, in fact correct that - scared!

    I've had a slight nipping sensation under my rib rage/stomach (rightside) for a couple of weeks now too, so not sure if that is connected. It almost feels like a stitch under my ribcage.

    8 is considered my normal AFP and has been consisted through the months so far.

    I'm due a CT-Scan in the next couple of weeks. Seeing consultant on Monday and my local hospital has agreed to retake blood on Monday morning so I can get some more results. My LDH was supposed to be tested too but the blood clotted so that screwed up. My HDG was below 4, so that was OK.

    Any advice/opinion would be appreciated.

    I was hoping to become less reliant on the forums, but I hope I'm not back for long :-(
    Last edited by wtcf90; 04-30-10, 01:39 PM.

  • #2
    seems like a normal fluctuation actually. since it was 20 when you were diagnosed, doctors expect it to cut at least by a half (in your case, 10) after the surgery. so the fact that it is rising and dropping from 10 and below is a normal rise and fall.

    unfortunately for me, mine was 12 before surgery, then 15 afterward. that is considered abnormal, since they expected to drop to at least 6. This lets the doctors know that the tumor on the testicle was indeed the reason why the numbers rose in the first place.

    post the ct scans when you get them!
    Diagnosed March 8th 2010 (my mother's birthday :\)
    Left I/O March 9th 2010
    AFP: 17, other markers: Normal, CT Scan: Clear.
    Stage 1-S Non-seminoma: 80% Embyonal, 20% Yolk Sac
    4xEP: April 19th - July 2nd
    August 20th 2010: AFP: 5.5, all markers: Normal. CT Scan: Scheduled.

    All Clear.


    • #3
      Thanks for your reply Lithium.

      For me, the combination of a 2 point increase to 10 combined with the almost stitch sensation under my ribcage on right-hand side makes me concerned.

      The nurse who gave the result and has been with me since day one said that my consultant will probably want to revert to weekly blood-works to make sure things stay in check. My next quarterly CT Scan is now due, so that might be sped up too.

      Does anyone know if my area of discomfort is in line with where a relapse could occur. my consultant gave me the impression a relapse would most likely occur in abdomen.

      Is it worth mentioning that I've had aching in my other testicle on and off for weeks?


      • #4
        The increase is likely within the margin of error. Cancer is typically not assumed until the level is above 25.
        "Life moves pretty fast; if you don't stop and look around once in a while, you could miss it." -Ferris Bueller
        11.22.06 -Dx the day before Thanksgiving
        12.09.06 -Rt I/O; 100% seminoma, multifocal; Stage I-A; Surveillance; Six years out! I consider myself cured.


        • #5
          The frequent bloods and stepped up CT seem to be prudent measures to me.

          The slight increase is bound to put you and your docs on alert - rightly so - but given that the rise is small, and the fact that your AFP is normally high anyway, I doubt this is anything sinister. My own bloods show similar variation, albeit that my normal levels are lower.

          Given the position of your nipping sensation, it's unlikely to be evidence of a relapse. Also, any relapse at this stage (i.e. soon after a clear CT) would be low volume and would not be likely to cause pain.

          I'd bet your AFP will return to normal when it is tested.

          Embryonal Carcinoma; Seminoma. Marker negative.
          August 2001: Right I/O .
          August - December 2001: Surveillance .
          December 2001: Relapse - Stage III. Mets in lymph nodes and lung.
          December 2001 - March 2002: 3xBEP .
          Complications: Neutropaenic sepsis during cycles 1 & 3. I/V antibiotics and isolation.

          March 2012 - Ten years since finishing chemo.

          Survivorship Blog is here


          • #6
            No need to worry about 10. That's just a normal fluctuation.
   <---full story here
            Diag. 12/07, stage 3 non/sem mix lg tumors in abd. lymph nodes, sm mets in R lung. 01/08-R Orch 02/08-4xBEP, 08/08-RPLND remove tertoma. 08/08-Rlpsd, sm tumors in liver, 09/08-2xHDC/stem cell 12/08-complete remission, 06/09-rlpsd tumor in abdmnl node, 07/09-2nd RPLND, 08/09-all clear, rmssn, 10/09-rlpse, mult mets in liver, lungs, and abdmn. 10/09 -Tax/Gemzar begun, 02/10-Tax/Gem failed 03/2010 - ARQ-197 in NY. 05/10 - Oxalitplatin begun


            • #7
              A further thank you to Nick, Sean & Fred for your supportive comments.

              It's very encouraging to here that you think this is more likely to be a blip/within margin of error and nothing sinister. If anything, it's a further wake-up call to continue healthy living - I'm guilty of a few too many drinks sometimes! Drinking plenty of water and relaxing this weekend.

              I'm having my AFP & LDH re-done on Monday morning (before consultant appointment) - apparently I can normally get the results within a couple of hours if drawn at hospital rather than GP.


              • #8
                Hi all, just back from consultation and results in

                Blood drawn this morning at hospital -

                AFP - Still at 10 (no change from last Thursday result)
                LDH - Perfectly normal (forgot result, but all good)
                HCG - below 4 (normal)

                My consultant did the usual lymth node & teste examination and could not feel any nodes that were inflamed or any swelling in other teste. He agreed that I acted correctly in getting another blood test to show complete results.

                Unfortunately the latest AFP result wasn't available at time of consultation today. The consultant agreed that if the AFP result had increased since last week, then my blood should be drawn more frequently (1x2-weeks) However if it remained (as it has) at 10, then just to stick to my CT Scan in the next few weeks and blood as normal in a month. He did say I was welcome to get my blood done every two weeks if I pleased.

                The nurse also made the point that it has been 6wks since my last blood test and that a 2 point increase was not significant at all.

                I just wanted to make sure you guys all agreed with that. Not sure if I should go in two weeks or continue to enjoy life and go in a month. After all my treatment (should I relapse) be no different for a very early stage relapse or a relapse that has metastasized

                Any feedback/comments would be hugely accepted.


                • #9
                  An AFP of 10 isn't really something to be overly concerned with. If it were me I'd get checked in two weeks, the peace of mind would allow me to relax and enjoy myself.
                  Son Jason diagnosed 4/30/04, stage III. Right I/O 4/30/04. Graduated College 5/13/04. 4XEP 6/7/04 - 8/13/04. Full open RPLND 10/13/04. All Clear since.

                  Treated by Dr. Rakowski of Midland Park, NJ. Visited Sloan Kettering for protocol advice. RPLND done at Sloan Kettering.


                  • #10
                    I think this rise is non-cancer related, it could be your normal. If it was cancer I would tend to think the rise would be more than 2 points over that time span. The rib feeling could be arbitrary as well. All you can do is keep an eye on it.

                    As your own advocate you did the right thing sharing everything with your doc and voicing your concerns. The good news is that you are aware of your own body and you keep a close eye on it. Don't let anxiety/ paranoia take over, you are in control now.

                    Stay positive, keep laughing, find the funny.

                    Diagnosed 4/17/08
                    Right orchiectomy 4/18/08
                    Pure choriocarcinoma; HCG 715,000; lungs, lymphnodes, liver, and random other places
                    4X VIP chemo at IU with Dr. Einhorn 4/25/08-7/4/08
                    HCG down to 7.2 10/28/08
                    HCG back up to 198 12/29/08
                    1 X PVB 1/2/09-1/6/09
                    2 X HDC w/ stem cell rescue 2/4/09-3/14/09
                    Follow-up with Dr. Einhorn 4/22/09
                    HCG 1.2
                    3 rounds, 21 days, twice daily, VP-16 50mg 4/24/09-7/10/09



                    • #11
                      Personally, I'd have it checked in two weeks, just to put my mind at rest.

                      It's encouraging that it has stayed stable since the last draw, though. When AFP rises due to cancer activity, it's not likely to plateau, but to keep rising. It sounds like it is nothing to worry about.

                      Embryonal Carcinoma; Seminoma. Marker negative.
                      August 2001: Right I/O .
                      August - December 2001: Surveillance .
                      December 2001: Relapse - Stage III. Mets in lymph nodes and lung.
                      December 2001 - March 2002: 3xBEP .
                      Complications: Neutropaenic sepsis during cycles 1 & 3. I/V antibiotics and isolation.

                      March 2012 - Ten years since finishing chemo.

                      Survivorship Blog is here