For my 18 year old son - please help interpret blood test results

[PNR]

My 18 year old son has a testicular growth. He had the ultrasound. Now I just got the blood test results. The problem is it is not clear to me what it means:

All Hepatic Function Panels are in normal levels.
All BUN-Creat are in normal levels

Cancer Markers:

hCG, Beta Subunii, Qn (Serial)
HCG, Beta Chain, Quant, S 4 (high) Normal Level: 0-3
AFP, Serum Tumor Marker 6.5 Normal Level: 0.0-8.3
LDH 132 Normal Level: 0-225

Is the fact that the HCG is 1 point higher than normal an indicator for cancer?
Has anyone else ever had this type of result?
Please help if you can....

[a.d.]

This result is somewhat ambiguous because the HCG value is so close to the normal range. In any event, an ultrasound confirmed testicular growth has, I believe, a >90% chance to be cancerous, so you should probably brace for this diagnosis. Keep in mind, though, another statistic: the overall cure rate for testicular cancers is extremely high, inching ever closer to 100% in stage 1 tumors, and remains excellent even for quite advanced disease (which your son probably does not have, considering his almost non-existent tumor markers).

[PNR]

Thank you for the quick response. I have been reading since I posted this and have found information that indicates the normal level for male hcg is between 0 - 5, which would make his 4 normal. I was just wondering what others hcg levels had been on their blood test. This is a horrible enough situation and I was so hoping it would be benign.

[Paul54]

I am so sorry you need to deal with this. Male HCG levels are supposed to be very low, usually much lower than 4, but the results and ranges depend on the lab. High HCG or AFP almost always indicate TC. Each of the five tumor types have characteristic tumor markers, but often the marker levels are not raised at all. That's why markers alone are not used to diagnose TC. My markers were normal.

The ultrasound is the most reliable indicator of a tumor, and the CT scans and Xrays are used for determining spread.

Did they say how big the testicular mass is? Have they arranged for a CT and Xray?

BTW, hepatic (kidney) and BUN-Creatin (liver) tests are usually run to make sure there won't be problems with the contrast used for CT scans.

You have my best wishes and prayers that everything will turn out the best possible from here on.
Paul

[PNR]

Thank you. Everything I read said that there is normal level of HCG for males, it is just that the lab test says normal is 0-3 and other sites I have read say 0-5 so not sure if 4 is elevated or not. From reading on here others HCG's were 25 and up so I figured 4 is still low. The size of the tumor is 1.5 x 1.0 x 1.4 cm. Ultrasound imression was "ill-defined predominantly solid but complex right testicular mass". X-ray and CT Scans tomorrow. Back to the local doctor on Wednesday for results. Then to NY on Friday to see a doc from NY Presbyterian... Thanks again for replying...so desperate for information and answers at this point.

[Davepet]

Generally a solid mass indicates TC, no idea what "predominantly solid means, but I suspect probably the same thing.

Dave

[PNR]

Can't a testicular mass ever be benign? My son's is partially solid and partially fluid which I was hoping would be leaning toward a benign tumor. None of the other markers in his blood test results were elevated...only HCG and only 1 point higher than the normal on the blood test.

[Paul54]

The "rule-of-thumb" stat is that 95% of all testicular solid masses are malignant (cancer). The other 5% are non-TC tumors such as Leydig or Sertoli cell, or other things considered benign because they don't spread. In the majority of those cases, the testicle would need to be removed anyway. And if you're wondering, we hear about 1 or 2 false alarms each year. As heartbreaking as that may sound, the silver lining is that the problem wasn't cancer and that guys have two.

[Fed]

In terms of HCG, levels should be at or near zero in men and non-pregnant females. HCG is also known as "the pregnancy hormone", and that's what pregnancy tests detect. Some events can cause an increase in HCG such as certain hormonal problems or, indirectly, smoking marijuana. Either way, the compelling factor here is the ultrasound report that states unequivocably your son is dealing with a solid mass, and like Paul said above, 95% of the times they are malignant.

[JPM]

Can't a testicular mass ever be benign? My son's is partially solid and partially fluid which I was hoping would be leaning toward a benign tumor. None of the other markers in his blood test results were elevated...only HCG and only 1 point higher than the normal on the blood test.

Seminoma sometimes causes elevated HCG, but it sometimes doesn't result in any elevated tumor markers. For what it's worth, my HCG was 9 prior to surgery. Unfortunately, the only way to know for sure what it is is to remove it.

JPM

[PNR]

Thank you to everyone for responding. We did speak to the doctor in NJ today and he pretty much confirmed the same things that all of you have said. It is indicative that something is going on although it is good that the other markers are not elevated. The main point now is to have it removed quickly. We are now going to see the doctor in NY tomorrow in an effort to try and expedite this. Thanks again.

[Davepet]

Good luck with the surgery & keep us posted on how things work out.

Dave