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HCG Effect On Tumor Marker Blood Test and Testicular Cancer Monitoring Protocol
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ctastrophe
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Join date: Dec 2011
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Update 8/5/2012 --- Thought I would update this thread to reflect what I have learned:

I am three-and-a-half years out from having a Non-Seminomatous Germ Cell Tumor, Predominately Embryonal Carcinoma, removed via Orchiectomy (uni-ballers unite!). I didn't do Chemo as we thought we caught it quickly, and have been undergoing the monitoring protocol outlined by the Testicular Cancer Research Center. I've included the Protocol here in full as I've talked to a few guys on this Forum who had/have Testicular Cancer and either weren't aware that there IS follow-up tests to be had, or didn't know what tests to talk to their Oncologists about doing:

Year One: Tumor Marker Blood Tests* and Chest X-ray every two months; CT Scan every three months
Year Two: Tumor Marker Blood Tests and Chest X-ray every two months; CT Scans every four months
Years Three through Five: Tumor Marker Blood Tests, Chest X-ray, and CT Scan every six months**
After Year Five: Tumor markers and Chest X-ray once a year

*The three Tumor Marker Tests are:

Alpha-Fetoprotein (AFP)
Lactase Dehydrogenase (LDH)
Beta Human Chorionic Gonadotropin (bhCG)

**Some Oncologists will cut back to once-a-year CT scans after the completion of year three. There is some discussion amongst Oncologists as to which is better. I don't know which is better, but my doctor has me on once-a-year now that I'm in year four. The Pro-more-CT-scans crowd feels that more aggressive testing pays off enough times to be necessary. The Anti-more-CT-scans thinks that cutting out any questionably-unnecessary CT scans saves the patient undue radiation (which CT scans have in spades!).

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The bhCG test is used to indicate a re-emergence of testicular cancer. It is also used in indicating the presence of several other tumors, including: trophoblastic tumors, nonseminomatous testicular tumors, seminomas, melinoma, and carcinomas of the breast, G.I. tract, lungs, and ovaries (which obviously isn't applicable, but I added it for completeness). Elevated bhCG is also indicated in benign conditions including: cirrhosis, duodenal ulcers, and inflammatory bowel disease. Basically

If you have had testicular cancer and are currently in remission, as well as on TRT, you may be wondering if taking hCG to preserve testicular health will cause a "false positive" result from the bhCG blood test. Taking hCG *WILL*, in fact, cause bhCG values to rise, which will make it appear that you have an hCG producing tumor.

The testing range for bhCG is 0.0-3.0IU/L. Anything above this range indicates an hCG producing tumor, cancer, or one of the benign conditions above. Leading up to adding hCG to my protocol, my bhCG test results were always "< 2.0IU/L". After starting hCG, my result was 5.0IU/L.

So, does this mean that someone who is in the monitoring phase post-testicular cancer must abstain from using hCG?

No. As part of the Monitoring Protocol, the patient is getting CT Scans, Chest X-Rays, and two other blood tests in addition to the bhCG test. With the other fail-safes in place it is completely safe for a guy in remission to be using hCG to promote testicular health. As long as you and your doctor both know that the bhCG test will be compromised, and to treat results with this in mind, there is no harm in taking hCG. I will still be getting the bhCG test as part of my Monitoring Protocol, as any change in this value could still indicate all the maladies the test was designed to detect. Consistent use of hCG should give consistent bhCG values, which makes the bhCG still a valuable tool in alerting you and your doctor if something is going wrong.

Another thing to note: Taking hCG won't cause hCG-producing tumors to grow or appear.

Hope this information is helpful.

[ctastrophe]

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VTBalla34
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Join date: Mar 2009
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Following.

I think there will likely be an effect on the test, but I really don't know for sure. I don't know the difference between the hcg you are injecting and the beta subunit of the test--I think one might metabolize into the other, but I cant say for certain.

You could always try it and see. I mean, even if your Beta-HCG test comes back with a change, you can probably rule out cancer return with the other tests and a CT scan. If changed, you could also stop hcg for 4 weeks or so and retest.

The blood tests were useless for me anyway as they were barely in the top 25% of the established range a week before my orchiectomy lol

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ctastrophe
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VTBalla34 wrote:
Following.

I think there will likely be an effect on the test, but I really don't know for sure. I don't know the difference between the hcg you are injecting and the beta subunit of the test--I think one might metabolize into the other, but I cant say for certain.

You could always try it and see. I mean, even if your Beta-HCG test comes back with a change, you can probably rule out cancer return with the other tests and a CT scan. If changed, you could also stop hcg for 4 weeks or so and retest.

The blood tests were useless for me anyway as they were barely in the top 25% of the established range a week before my orchiectomy lol


lol, that's a confidence builder right there!

I think that the bhCG test is important for men is because we produce between 0(undetectable amounts) and 5miU (milli-iU) of hCG, and a cancerous tumor (specifically testicular cancer) would up our levels of it. I'm having a bitch of a time trying to find out if bhCG is just a derivative of hCG, or if it's a precursor, or if it just has a similar name!

Unless I get a straight answer that I shouldn't do it then I will be guinea-pigging it. Livestrong (who, by the way, will send you hell of free bracelets if you tell them you have testicular cancer - think of it as a consolation prize for having a nut removed) says the following:

"Abnormal hCG levels do not necessarily diagnose testicular cancer on their own. There is variability in normal levels, and you should consult with your physician to decide what your lab results really mean. For men recovering from testicular cancer, periodic checks of serum hCG levels may be a component of preventative care that you can discuss with your physician as well." http://www.livestrong.com/...level-in-males/

So even if this one test is out of whack, I'll still have two other blood markers as well as X-Rays and CT Scans for diagnostic tools. The only thing I hope I won't come to find out is that raising your hCG levels increases your chances of having another bout with testicular cancer. I don't see how that would be the case; Taking hCG would probably just give a false-positive. But just thinking about having to lose another testicle makes me a little cautious about screwing with my labs.



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ctastrophe
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Okay, so I found this:

"There are two common types of hCG tests. A qualitative hCG test detects if hCG is present in the blood. A quantitative hCG test (or beta hCG) measures the amount of hCG actually present in the blood." http://www.americanpregnancy.o...

Assuming this is correct: It looks like the bhCG test is equivalent to a Total Testosterone test, and a regular hCG test being akin to a Steroid Test, meaning it only gives a positive or negative without any other data. With this in mind I'm guessing that taking hCG will definitely give you a false positive as I'm sure an hCG user's bhCG level will be much higher than 5miU, given that they would be taking 250iU EOD.

It looks like a regular hCG test is a pregnancy test - Piss on the strip and if you have hCG in your stream then you're likely pregnant. Whereas the bhCG test tells you exactly how much hCG there is which, according to some other sites I've seen, can tell you approximately how long you've been pregnant. The longer that kid has been in you the higher the hCG.

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VTBalla34
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I just went back and looked at my bloodwork. Looks like I was lying when I said the hcg was barely in the upper 25% of the range. It was actually in the lower half lol.

HCG: 2 (0-5)
AFP: 2 (0-6.1)
LDH: 206 (100-220)

I don't even know what they were when I got my one year follow-up done. He just said they were in range, so that's all I needed to know.

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ctastrophe
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VTBalla34 wrote:
I just went back and looked at my bloodwork. Looks like I was lying when I said the hcg was barely in the upper 25% of the range. It was actually in the lower half lol.

HCG: 2 (0-5)
AFP: 2 (0-6.1)
LDH: 206 (100-220)

I don't even know what they were when I got my one year follow-up done. He just said they were in range, so that's all I needed to know.


Yeah, the only time I listen to the doc when told I'm "in range" is my oncology labs, and I never even take a look at the numbers.

I had to do some digging to find any of my cancer labs. Here's what I found:
After Cancer (September 2009):
bhCG <2 (<5)
AFP 3ng/dL (0-15)
LDH 150U/L (120-230)

Surgery in March 2009

Before Cancer (February 2009):
bhCG <2 (<5)
AFP 3.7ng/dL (0-15)
LDH 154U/L (120-230)
Benzodiazepines DETECTED (UNDETECTED)...oops.

All of a sudden I don't stake too much in the tumor markers doing much of anything.

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VTBalla34
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All of a sudden I don't stake too much in the tumor markers doing much of anything.


haha yeah...I wonder why neither of us seemed to have shit wrong with us based on that. Just goes to show you can't always rely on bloodwork.

ctastrophe wrote:

Benzodiazepines DETECTED (UNDETECTED)...oops.


Dont know this one. What is it?

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ctastrophe
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VTBalla34 wrote:

ctastrophe wrote:

Benzodiazepines DETECTED (UNDETECTED)...oops.


Dont know this one. What is it?


At the time it was either Xanax or Valium.

Or Ativan.

Benzos are anxiety drugs.

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bartonmlee
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ctastrophe, why did you have a drug panel done? they usually tell you and in most cases it's a urine test.

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ctastrophe
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bartonmlee wrote:
ctastrophe, why did you have a drug panel done? they usually tell you and in most cases it's a urine test.


At the time I wasn't sure what was going on, and I had seen my doctor because I felt a lump. He did the tumor markers as well as other tests like CBC, etc. For some reason he included a drug panel. So I tested positive for benzos (which I had a script for Valium but I was taking some Xanax that a friend gave me...luckily it doesn't say which benzo), and alcohol, but tested negative for Meth, Coke, Marijuana, and a few other things I can't recall. I guess he was just trying to cover all bases maybe? I honestly don't remember that time too much because I felt like I was going insane. That could be why the drug test was done.

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bartonmlee
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your doc is required to tell about drug testing and it's illegal to test without your approval. you dont
add a drug panel with a hormonal panel unless you're taking specific narcs, such as percoset, or vicodin
which can affect testosterone levels quite dramatically. and you weren't on any. should ask him why he did
this.xanax and valium are benzos.....

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