Markers increased from 0 before BEP, above normal after 3xBEP? Is it possible?!

[ccomsa]

Hi,

I'm Ciprian and I read about these problems with markers and I have a
similar problem. After surgery (right radical orcheictomy), in august, I
was diagnosed with T1NxMx. The markers were 0!!! I followed 3 cycles of
BEP (september-november). And after this, on the final evaluation, two
weeks ago, I found out that my markers are above normal limits (I don't
know the values yet) and the doctor says to repeat the marker tests on
monday. This situation seems to me pretty strange.
I am from Romania, the doctors here are very good specialists, but I was
intending to come in the States, in NY, to do my phd, starting with
January 8. Now I don't know what to do. I don't know if the medical
insurance which I can do there would help me to do some tests in the
States and some treatment in case it will be needed.
Could some one help me with some advices!?
Thank you,
Ciprian.

[dadmo]

ccomsa:
Welcome to the forum. The Testicular Cancer Resource Center says that, normal AFP is less than 5 ng/mL, but cancer cannot be assumed until it is over 25 ng/mL and that a normal HCG level is less than 5 mIU/mL, though it may also be elevated by abnormally low testosterone or by marijuana use. This site says that for LDH, "Normal values may vary slightly from laboratory to laboratory. A typical range is 105-333 IU/L (international units per liter)." As far as coming to New York that could be great for you, Memorial Sloan-Kettering Cancer Center is one of the world leaders in the treatment of testicular cancer. When you find out what your markers are post them here.

[ccomsa]

Hi,
After the surgery: the anatopato exam showed that it
was a pure seminoma, the markers were close to 0 and
the CT scan showed only 3 lomboaorthic nodes of 8-9mm
(this seemed to be meanless).
After 3 BEP: the markers were: AFP 51ng/ml on a 0-8.5
range and bHCG=0.7 on a normal scale values of 0 to
0.4.
Any ideas, please!?

Ciprian.

[Scott]

If your AFP was really 51 ng/mL, you almost certainly didn't have pure seminoma.

I'm unsure about the lymph nodes. Did your doctors assume they were metastasis? If not, I'm not sure why you would have had 3xBEP.

[danebert]

Scott is correct. If your AFP is elevated, even if concidered pure seminoma, it is treated as though you have nonseminoma. You should contact an expert. Although unlikly, the rise in AFP could be cause by some kind of liver damage, possibly from chemo, or somethingelse such as hepatitis, or cirosis.

[Scott]

Ciprian, do you have any more information yet?

[ccomsa]

Hi,
Just today I received the result to the CT and it is everything normal, except the liver which is homogene but it has increased dimensions: LHD=18cm, LHS=6cm. I'm still waiting for the repeated markers test.
About if it was pure or non-pure seminoma, I have to tell that before BEP, the markers were very close to 0.
They gave me 3BEP just in case, just to be sure everything will be allright - this what they told me.
So, do you think the liver could be the problem? I think the best is to wait for the markers, talk with the proffesor and probably do some test for the liver.
Thanks for your support.

[Scott]

I would definitely want to see the repeat blood marker test results.

On a different note, though, while 3xBEP is the appropriate treatment for metastatic testicular cancer, but it's too much to do "just in case."

[ccomsa]

Clear so far!

Hi!
I just thought it would be nice to come with an update. Since my last post here back in 2005, a couple of things happened.
First, since January 2006 I'm in US, NJ, doing my PhD.
Second, each time I go back home, in Romania, I go to the hospital and do a check-up. So far, so good: I'm clear and everything looks normal, although the fear that something may happen again still lives in me.
Third, since April 2008, I am the lucky father of a healthy son!
I hope everybody who has this kind of illness, is strong and lucky as I was and I hope to remain.
Best wishes,
Ciprian.

[Scott]

That's fantastic, Ciprian! Congratulations on your "all clear" results, Ph.D. studies, and especially your son!

[ccomsa]

I would definitely want to see the repeat blood marker test results.

On a different note, though, while 3xBEP is the appropriate treatment for metastatic testicular cancer, but it's too much to do "just in case."

Scott,
I repeated the markers back in december 2005: first they told me they are so bad; the whole day I was desperate; but ONLY at the end of the day I noticed that on the file with the results was NOT MY NAME! Second day I've got my results and they were very good. They came good every time since then.

Regarding the 3xBEP "just in case", that's the common practice in Europe. I came to US and talked to a doctor at Saint Barnabas NJ (unfortunately I couldn't go anymore to see him since my insurance is so bad and my scholarship so low) and he knew about this.

Ciprian.

[ccomsa]

That's fantastic, Ciprian! Congratulations on your "all clear" results, Ph.D. studies, and especially your son!

Thank you! I wish you health and luck and thank you for your support!
Ciprian.