Enlarged Lymph Nodes and No Tumor Markers

[Jacob]

Hi Everyone,

I just went for my 4-year scans and they showed 2 enlarged lymph nodes.
1 iliac that was previously enlarged now grew larger and a new one on the back wall of the stomach. However, the tumor markers are clear.

How likely is it that it can be a recurrence? How concerned should I be?

I am going for a biopsy tomorrow and I need to wait 3-5 days for the results.

Thank you for your help!

Jacob

Diagnosed 5/30/2013
Left R I/O on 6/8/2013
pure seminoma
All scans and bloodwork clear
6/20/17 iliac node enlarged - node back stomach wall enlarged. No elevated tumor markers

[Davepet]

Afraid tumor markers are only useful when positive, pretty much useless when negative, unless they just dropped from positive to negative recently.

Why did they allow an enlarged node to go untreated? Seems odd, to be honest

[Jacob]

Since it wasn't growing they said we can just watch it.

I have another enlarge node in my lung that has been there prior to my I/O but it stayed the same size year after year.

[jmz]

Out of curiosity, how often do you get scans? Every year? To me it would seem weird that it would all of a sudden appear there after that many years gone by. I know Seminoma grows slow but that slow? I'm not sure if I'd be too concerned just yet. I know easier said than done. I've been on edge myself too. Hang in there man and see what the results are. Keep us posted.

[biwi]

What size are they?

[Jacob]

I get scans once a year. My doctor was suprised to see them after 4 years as well. I am having a needle biopsy today at 1pm and should have the results in 3-5 days. Will let you know what happens.

[Jacob]

I don't recall the size. I will certainly ask today.

[Jacob]

One more thing, I see ppl mention LDH as a tumor marker. I have never been tested for that.
The only markers they tested for were HCG and AFP.
AFP was never elevated and HCG was 2.5 pre io and normal 2 weeks later.

Should I ask for LDH marker tests?

[singa76]

As Davepet has written, tumor markers are useless when negative. Since yours have never been elevated (and you had a 100% Seminoma), it is likely that your markers will never be elevated also in the occasion of recurrence. I was in the same situation, my markers were not elevated at the time of first diagnosis (orchitectomy) nor at the time of relapse. It happens more frequently in the case of pure seminoma (in my case it was 95% seminoma).

[Jacob]

Thanks for all the responses.

I am getting more concerned with each answer though

Was hoping it was a one and done deal

[Trekga]

Wishing you the best. I hope someone can chime in about LDH, I'm not even certain if they use that during follow-ups for TC. Please let us know what the biopsy shows.

[jmz]

I just got diagnosed with classic seminoma as well my brother. Both of us had negative markers and his had spread to his lymphnodes really bad. From my understanding it really depends on the type of cancer. From what I've seen and read so far Seminoma doesn't often raise tumor markers.

With that being said, I am going in for a follow up scan here in two weeks and doing more blood work. My doctor ordered the following blood tests.

Alpha Fetoprotein, Serum

HCG, Beta Quantitive

Lactate Dehydrogenase, Serum

I'm not sure if these blood tests will be uses for all follow ups or what but this is what my dr ordered so far in regards to my recent diagnoses of Seminoma.

[Jacob]

I just got diagnosed with classic seminoma as well my brother. Both of us had negative markers and his had spread to his lymphnodes really bad. From my understanding it really depends on the type of cancer. From what I've seen and read so far Seminoma doesn't often raise tumor markers.

With that being said, I am going in for a follow up scan here in two weeks and doing more blood work. My doctor ordered the following blood tests.

Alpha Fetoprotein, Serum

HCG, Beta Quantitive

Lactate Dehydrogenase, Serum

I'm not sure if these blood tests will be uses for all follow ups or what but this is what my dr ordered so far in regards to my recent diagnoses of Seminoma.

I am so sorry to hear that.

You need to deal with yours and a loved one with tc. That sounds like a tough one.

I hope you have an "easy" time of it.
Good luck!

[jmz]

I am so sorry to hear that.

You need to deal with yours and a loved one with tc. That sounds like a tough one.

I hope you have an "easy" time of it.
Good luck!

Thanks, Jacob. Though I posted that to show that I guess the DR may still think the blood tests could show elevated tumor markers even with Seminoma. Even though mine were never there or my brothers. I hope this helps I know it's a rough feeling of uncertainty. Either way, the future outlook appears to be good from everything my doctors say to everybody on this forum. Good luck to you! I really hope it's nothing and you can go on about your life.

[Nish115]

LDH isn't the best marker. For stage 1 patients there are some doctors who never check it, especially in America, so I wouldn't be worried about it. It can be risen by a lot of things as it's to do with cell degeneration and repair etc. Also test ranges vary hugely from country to country, if not hospitals.