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Slightly Elevated LDH at 5 Year Mark

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  • Slightly Elevated LDH at 5 Year Mark

    Slight LDH elevation of 228 on 5 year mark post chemo.

    Hi all. Wow crazy to think I’m back, is been five years since I posted here. So, a quick recap, on April 2018 testicular cancer suspected with physical checkup, all tumor markers elevated AFP ~70, HCG ~6, and LDH ~240.

    I had Orchiectomy on May 2018. Got diagnosed with Stage 1A non seminoma. All tumor markers were good after surgery with no signs of cancer on scans. I chose to do adjuvant chemo on August 2018 with 1xBEP. It was completed in September 2018.

    All scans and markers have been good these past years until now on my five year mark post chemo and it potentially being the final?! blood test. Well now LDH has shown slightly elevated at 228. Now, I know this is only a slight elevation (my lab shows 87-225 as normal range), but during these past five years the LDH has moved only from 130 to 170, never up to 200 or beyond, and the only time it was in the 200s was when I had cancer, so it makes me worried. HCG shows < 1 which is good. Now AFP shows 4, which is also fine but during these past five years, it has only range from 2 to 3.3, never reached 4 until now, but still within range (My lab shows 0 to 8.3 as normal) so not worry about the AFP but kinda like an ‘hmm’ kind of thing.

    Anyhow, any thoughts on potential recurrence? I see my Oncologyst next week (I always look for the results before seeing him - I’m too impatient to wait until those appointments) and wonder what he will recommend. I know I need as well as definitely want to take another blood test soon but not sure how soon is it recommended, would it be 2 weeks, 1 month, etc? Was really looking forward to celebrating the five year mark and potentially hearing the ‘cure’ word (although the medical definition of it …) but not quite done with it yet. Still super grateful though since results could’ve been worse, but just hope this bump isn’t cancer related, I guess we should see soon.

  • #2
    I see nothing here that would worry me the slightest.

    LDH often is not very useful as a tumor marker during follow up, even for Seminoma (and you mention non-Seminoma diagnosis, which means it's even less useful). Lots of false positives. Strenous exercise can raise LDH, for example.

    Read more here on markers during follow-up:

    Also ignore AFP. Normal variation.

    I would keep an eye on HCG because that's the most reliable traditional, non MRNA marker. And check your remaining testicle.

    And congrats on the five-year mark!