Aa
AFP Levels all other test fine
Hello,
My husband has had hep c since 1992. He had treatment about 18 years ago. Did not get rid of it but brought levels down. He is now seeing his gastro doc. His Doc said he has elevated AFP, he had an ultrasound it was negative no signs of liver damage, cat scan that came back negative plus a colonoscopy. Everything looks great according to DR. He does not drink when he did it was very little and it was beer. He was never an IV drug user. But a transfusion. Are there more tests or is it present in him from the HEP C itself?
My husband has had hep c since 1992. He had treatment about 18 years ago. Did not get rid of it but brought levels down. He is now seeing his gastro doc. His Doc said he has elevated AFP, he had an ultrasound it was negative no signs of liver damage, cat scan that came back negative plus a colonoscopy. Everything looks great according to DR. He does not drink when he did it was very little and it was beer. He was never an IV drug user. But a transfusion. Are there more tests or is it present in him from the HEP C itself?
Does that mean that anyone who has cirrhosis is at risk of getting liver cancer for the rest of their life - or until one got a healthy liver via transplant?
JimmyMose did a very good job of summing up the relationship between AFP and liver cancer risk. I would just add...
A lot depends on what is meant by "elevated AFP". The exact numbers themselves and the pattern of the numbers is what is important. For example...if your husband let's say has an AFP of 35 ng/mL and it is staying around that number on successive AFP tests than that could just be caused by inflammation of the liver as a result of his hepatitis C. But if we are speaking of numbers that are rising over time and over 100 ng/mL that would be a red flag that needs follow up as it may suggest liver cancer.
Let's keep in mind that the risk of liver cancer in increased only in those folks with cirrhosis.
"ultrasound it was negative no signs of liver damage, cat scan that came back negative"
First we must realize that these tests are not definitive regarding cirrhosis or liver cancer.
1. A person can have cirrhosis and they may not have signs of it such as nodular growths that are seen of these two imaging studies.
So the doctor should look for other indications of cirrhosis... A biopsy would be first thing that should be done to determine the stage of liver disease assuming their are no other obvious signs. A low platelet count would be an indication or any other sign of cirrhosis would mean a higher risk of the occurrence of liver cancer. Of course anyone diagnosed with cirrhosis should already be having surveillance for liver cancer every 6 months with ultrasound and AFP.
2. Not all liver cancer can be seen with ultrasound or a CT scan especially in its early stages. People can develop HCC and the tumor(s) can be too small to visualize at first using either ultrasound or CT with and without contrast but AFP with certain types of liver cancer can be the early warning that cancer is developing.
My main concern is no gastroenterologist is knowledgeable or experienced enough to diagnose liver cancer. Yes they should certainly be able to assess if someone has cirrhosis. So that should be known by know if this doctor has been caring for your husband over time. But liver cancer is not always straight forward in its diagnosis especially in its early stages.
Personally if your husband is possibly cirrhotic I would get a referal to see a hepatologist to assess his liver disease. The danger is that if your husband does have cirrhosis there is the risk of liver cancer. I can tell you from personal experience the it is vitally important that liver cancer is diagnosed as early as possible for the best outcome. The consequences of a missed or late diagnoses is not something that anyone want to happen. I believe erring on the side of caution is the best approach when it comes to liver cancer because the outcome of a missed early diagnoses of liver cancer can be so catastrophic.
So in my opinion I would get the true facts about the tests results that have been done (get copies of the test results) to determine the chances of your husband having cirrhosis and the risk of liver cancer and then take appropriate action. Sooner rather than later. When it comes to cancer time early diagnoses and treatment is critical.
I am hoping the the AFP numbers we are talking about are low and not rising over time and your husband has not developed cirrhosis so he is not at increased risk of developing liver cancer.
Wishing you both the best.
Hector
A lot depends on what is meant by "elevated AFP". The exact numbers themselves and the pattern of the numbers is what is important. For example...if your husband let's say has an AFP of 35 ng/mL and it is staying around that number on successive AFP tests than that could just be caused by inflammation of the liver as a result of his hepatitis C. But if we are speaking of numbers that are rising over time and over 100 ng/mL that would be a red flag that needs follow up as it may suggest liver cancer.
Let's keep in mind that the risk of liver cancer in increased only in those folks with cirrhosis.
"ultrasound it was negative no signs of liver damage, cat scan that came back negative"
First we must realize that these tests are not definitive regarding cirrhosis or liver cancer.
1. A person can have cirrhosis and they may not have signs of it such as nodular growths that are seen of these two imaging studies.
So the doctor should look for other indications of cirrhosis... A biopsy would be first thing that should be done to determine the stage of liver disease assuming their are no other obvious signs. A low platelet count would be an indication or any other sign of cirrhosis would mean a higher risk of the occurrence of liver cancer. Of course anyone diagnosed with cirrhosis should already be having surveillance for liver cancer every 6 months with ultrasound and AFP.
2. Not all liver cancer can be seen with ultrasound or a CT scan especially in its early stages. People can develop HCC and the tumor(s) can be too small to visualize at first using either ultrasound or CT with and without contrast but AFP with certain types of liver cancer can be the early warning that cancer is developing.
My main concern is no gastroenterologist is knowledgeable or experienced enough to diagnose liver cancer. Yes they should certainly be able to assess if someone has cirrhosis. So that should be known by know if this doctor has been caring for your husband over time. But liver cancer is not always straight forward in its diagnosis especially in its early stages.
Personally if your husband is possibly cirrhotic I would get a referal to see a hepatologist to assess his liver disease. The danger is that if your husband does have cirrhosis there is the risk of liver cancer. I can tell you from personal experience the it is vitally important that liver cancer is diagnosed as early as possible for the best outcome. The consequences of a missed or late diagnoses is not something that anyone want to happen. I believe erring on the side of caution is the best approach when it comes to liver cancer because the outcome of a missed early diagnoses of liver cancer can be so catastrophic.
So in my opinion I would get the true facts about the tests results that have been done (get copies of the test results) to determine the chances of your husband having cirrhosis and the risk of liver cancer and then take appropriate action. Sooner rather than later. When it comes to cancer time early diagnoses and treatment is critical.
I am hoping the the AFP numbers we are talking about are low and not rising over time and your husband has not developed cirrhosis so he is not at increased risk of developing liver cancer.
Wishing you both the best.
Hector
The tests he had are good signs. Elevated AFP occurs in some people with chronic Hepatitis C. Normal rage is below 8.3 Have you asked the doctor about this? If the doctor is concerned, will most likely do more tests to try and pinpoint the cause?
Is his doctor a gastroenterologist or hepatologist who specializes in Hepatitis C? He should be evaluated for retreatment with the new drug(s).
Here is a thread and discussion from last fall
http://www.medhelp.org/posts/Hepatitis-C/AFP-tumor-marker/show/2023902
Read Hectors comments. If the levels kept increasing to 100 and over, that would be cause for more concern.
Is his doctor a gastroenterologist or hepatologist who specializes in Hepatitis C? He should be evaluated for retreatment with the new drug(s).
Here is a thread and discussion from last fall
http://www.medhelp.org/posts/Hepatitis-C/AFP-tumor-marker/show/2023902
Read Hectors comments. If the levels kept increasing to 100 and over, that would be cause for more concern.
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