Post surgery blood work - how long to wait?
Sorry for the various questions, but there seem to be so many questions popping up. My 18 year old son had the right side orchiectomy on 8/13. The doctor told us to go for blood work next week to check the tumor marker levels. (only his HCG was elevated to 4 pre-surgery). My question is what day next week should I take him for the blood work? We are trying to get appointments with an oncologist and RPLND surgeon next week so I thought if we could take him for the blood work by Weds. 8/22 maybe they would have the results for the appointments on Friday if I am able to get them. I just wasn't sure how long you have to wait post surgery for the tumor marker to go down if it is going to? Thank you.
hCG of 4 is borderline normal, although slightly on the high side, so while you may see it decrease, it might not be exactly 1/2-ing every 3 days - I will geek out with some examples:
If your son's 'normal' hCG is <1 (let's just call it one for easier math), then 3 days post surgery *if there are no other masses producing hCG* then it should be down to 2.5, then 3 more days down to 1.75, 3 days later to 1.38, etc. So, by the 22nd (and some places vary for how long these tests take, you may want to aim for Tuesday) it should have gone through about 3 half-lives and be lower.
However, if the markers are around 4, or only down to 3 or 2, this is still ok - your son might have a slightly higher normal for a number of normal, physiological systems.
One question - have there been any CT scans? I know I am crossing threads here, but that is important information that will guide therapy options between surveillance, 1-2 rounds of BEP, more chemo or RPLND.
Cancer pharmacologist, caregiver blog here
Wife to Kel, dx 12/30/11 Stage IIIc (poor) embyronal, AFP 13700, 10x11 cm retroperitoneal mass, 1 cm^2 lung met
Left I/O 12/31/10.
4xBEP 1-4/11, AFP=22, 5*7 RP mass, tx failed
1.5 x VeIP 5-6/11; tx failed, AFP/b-hCG rising
Salvage RPLND @Indy 6/29/11, metastatic mixed germ cell tumor with yolk sac, seminoma and teratoma
Remission! AFP steady since 9/2011; 1.5 years ALL CLEAR
Thanks for responding. X-Rays and CT scans were clear. 5% yolk sac 45% embryonal carinoma and 50% teratoma. There is vascular invasion. Just not sure which way to go with this. I am sure it will depend greatly on his post surgery blood work. That's why I was wondering how long to wait in order to get an accurate result. I am guessing that if the HCG levels are still up we are not going to have any choice but to either have chemo or the surgery. Thanks for your response. All of these responses with any information are so appreciated at this point.