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AFP Tumor
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AFP Tumor

I recently had labs drawn and received the results today.  I have an AFP Tumor maarker at 286.0 noted as High.  What does this mean?
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179856_tn?1333550962
I don't want you to think that anyone is ignoring you this is something I honestly don't know about and would take one of the smarties like MikeSimon and Willing......it's just way over my head!!!!
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Avatar_m_tn
I will assume that you are HCV positive but I think that, regardless of your HCV status, you should follow up with a hepatologist (liver specialist).
Patients with Hep C often have elevated AFP but yours is rather high.

I found this at: http://www.medscape.com/viewarticle/452731_4

"...The authors conclude that an AFP greater than 200 ng/mL can be used to confirm HCC in patients with HCV-associated cirrhosis and a liver mass; however, only a few patients will meet this criterion. These results clearly indicate the need for a more sensitive and specific marker for HCC...."

HCC stands for Hepatocellular Carcinoma or liver cancer.
I understand that excerpt to say that an AFP marker >200 ng/ml is not definitively diagnostic for HCC unless there is also cirrhosis and a liver mass present. But, I also think that you should definitely have follow up tests.
HCC when detected early can often be treated so the earlier you catch it the better your odds.

I wish I could be more helpful but all I can advise is for you to find a hepatologist and make an appointment ASAP.

Good luck,
Mike

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446474_tn?1404424777
Lainey,
If you have cirrhosis, AFP is one of the factors your doctor should be monitoring on an ongoing basis. It is usually performed in conjunction with liver imaging which is done 2x yearly to look for signs of HCC (liver cancer).

From MedicineNet.com

"Hepatitis C virus (HCV) infection is also associated with the development of liver cancer. In fact, in Japan, hepatitis C virus is present in up to 75% of cases of liver cancer. As with hepatitis B virus, the majority of hepatitis C virus patients with liver cancer have associated cirrhosis (liver scarring). In several retrospective-prospective studies (looking backward and forward in time) of the natural history of hepatitis C, the average time to develop liver cancer after exposure to hepatitis C virus was about 28 years. The liver cancer occurred about eight to 10 years after the development of cirrhosis in these patients with hepatitis C. Several prospective European studies report that the annual incidence (occurrence over time) of liver cancer in cirrhotic hepatitis C virus patients ranges from 1.4 to 2.5% per year.

In hepatitis C virus patients, the risk factors for developing liver cancer include the presence of cirrhosis, older age, male gender, elevated baseline alpha-fetoprotein level (a blood tumor marker), alcohol use, and co-infection with hepatitis B virus.
------------------------------------------------------------------------------------------------------------------
There is no reliable or accurate screening blood test for liver cancer. The most widely used biochemical blood test is alpha-fetoprotein  (AFP), which is a protein normally made by the immature liver cells in the fetus…

In adults, high blood levels (over 500 nanograms/milliliter) of AFP are seen in only three situations:

    * Liver cancer
    * Germ cell tumors (cancer of the testes and ovaries)
    * Metastatic cancer in the liver (originating in other organs)

Several assays (tests) for measuring AFP are available. Generally, normal levels of AFP are below 10 ng/ml. Moderate levels of AFP (even almost up to 500 ng/ml) can be seen in patients with chronic hepatitis. Moreover, many patients with various types of acute and chronic liver diseases without documentable liver cancer can have mild or even moderate elevations of AFP.

The sensitivity of AFP for liver cancer is about 60%. In other words, an elevated AFP blood test is seen in about 60% of liver cancer patients. That leaves 40% of patients with liver cancer who have normal AFP levels. Therefore, a normal AFP does not exclude liver cancer. Also, as noted above, an abnormal AFP does not mean that a patient has liver cancer. It is important to note, however, that patients with cirrhosis and an abnormal AFP, despite having no documentable liver cancer, still are at very high risk of developing liver cancer. Thus, any patient with cirrhosis and an elevated AFP, particularly with steadily rising blood levels, will either most likely develop liver cancer or actually already have an undiscovered liver cancer.

How is liver cancer diagnosed?

Blood tests

Liver cancer is not diagnosed by routine blood tests, including a standard panel of liver tests. This is why the diagnosis of liver cancer depends so much on the vigilance of the physician screening with a tumor marker (alpha-fetoprotein) in the blood and radiological imaging studies. Since most patients with liver cancer have associated liver disease (cirrhosis), their liver blood tests may not be normal to begin with. If these blood tests become abnormal or worsen due to liver cancer, this usually signifies extensive cancerous involvement of the liver. At that time, any medical or surgical treatment would be too late.

An AFP greater than 500 ng/ml is very suggestive of liver cancer. In fact, the blood level of AFP loosely relates to (correlates with) the size of the liver cancer. Finally, in patients with liver cancer and abnormal AFP levels, the AFP may be used as a marker of response to treatment. For example, an elevated AFP is expected to fall to normal in a patient whose liver cancer is successfully removed surgically (resected).

Imaging studies

Imaging studies play a very important role in the diagnosis of liver cancer. A good study can provide information as to the size of the tumor, the number of tumors, and whether the tumor has involved major blood vessels locally or spread outside of the liver. There are several types of studies, each having its merits and disadvantages. In practice, several studies combined often complement each other...

Computerized axial tomography (CT scan) is a very common study used in the U.S. for the work-up of tumors in the liver. The ideal CT study is a multi-phase, spiral CT scan using oral and intravenous contrast material. Pictures are taken in three phases:

    * Without intravenous contrast
    * With intravenous contrast (enhanced imaging) that highlights the arterial system (arterial phase)
    * When the contrast is in the venous phase

The pictures are taken at very frequent intervals (thin slices) as the body is moved through the CT scanner. Many radiologists use a specific protocol that determines how the contrast is infused in relation to how the pictures are taken. Therefore, CT is much less operator-dependent than is ultrasound. However, CT is considerably more expensive. Furthermore, CT requires the use of contrast material, which has the potential risks of an allergic reaction and adverse effects on kidney function...."

As you can see it is EXTREMELY IMPORTANT to follow up with your hepatologist regarding your AFP level. As with most cancers, if caught early, it can be managed. Be on the safe side and follow-up ASAP.

For further information on HCC go to American Association for the study of Liver Diseases. Here is a link to their practice guideline for managing HCC.
http://www.aasld.org/practiceguidelines/Documents/Bookmarked%20Practice%20Guidelines/hepatocellular%20carenoma.pdf

Hepatocellular Carcinoma
Management of Hepatocellular Carcinoma
Date: 2005 November
Bruix J, Sherman M
HEPATOLOGY
Last Reviewed: N/A
Scheduled Update: In progress

Best of luck,

HectorSF
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Avatar_f_tn
Thank-You all for responding.  
I was diagnosed with Hep C in '94.  I previously had Hep A in 1972 and Hep B in 1979.  I'm scheduled for a CT Scan in 2 weeks and have an appointment with a gastrorinterologist who specializes in HCV on 5/14/10.  I am a little shaken up by the results but will wait until I meet with him to really be concerned.
I tried Interferon for a few weeks but the side effects were so awful that I had to discontinue the meds.  I hear there are a lot of new meds out.  Hopefully, one of them will work.  Have any of you tried any?

Lainey669
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179856_tn?1333550962
Lainey unfortunately the news meds are down right miraculous but all rely on a combination of interferon and ribavirin as well.

Perhaps if you need to try again you could have assistance in dealing with the sides..........it's the only thing that makes it semi-tolerable for anyone and we do know some tricks to help you through if you need them.

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979080_tn?1323437239
How often should one check AFP marker ?
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Avatar_f_tn
You should check (with imaging as well) every six months if you have cirrhosis or late stage 3.
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1180136_tn?1264814491
Hi Laney - I've been having my AFT levels monitored, too.  In Dec it was only 44.  Normal is 0 to 6.  I had new tests done on 4/12 and it has gone up to 120.  That has my dr concerned because there is also a small mass on my liver as well.  So I will be going in very soon to have another biopsy - of just that area - to see what it is.  It is pointless to get too worried until the results come in  Because I have cirrhosis with Ascites, battling now to keep the fluid down, my liver is in pretty bad shape.  Originally, the gastroenterologist didn't want to do a biopsy, because any kind of trauma could affect it negatively, but my dr feels that knowing what the mass is, is more important.  I was surprised that the AFT numbers went up so far that fast, but I don't know what "fast" is.  I do know the 120 is not really that high, but if it is cancer, then the need to know early is important.  Good luck to you.  This whole ordeal is such a roller coaster ride.
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Avatar_m_tn
I have a few questions My nephew who is 12 years old has been diagnosed with HCC he does not have hepatitis. He has tumors on his liver and in his lungs, he is now at St Jude... His AFP numbers were 400,000 when he was diagnosed on June 6th of this year. The docs told my sister there was really no cure for this type of cancer.. But they would go ahead and do the chemo and hope the chemo stops the growth ..the tumor had filled his whole stomach. He has had 2 rounds of chemo and now his AFP numbers are down to 10,000 and the tumor seems to be dieing from the inside. He is in the process of having his third chemo treatment now... my sister is in such a state that she does not ask the difficult questions...So I will... If he does not have hepatitis how in the whole did he get HCC, even St Jude said it was very rare in children... My second question is if there is no cure for this cancer why is the tumor dieing and the AFP numbers falling so fast...should we get our hopes up because of the numbers... Thanks Aunt Lisa
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Avatar_m_tn
(I'm sorry I ment to post this to HectorSF please forgive)


I have a few questions My nephew who is 12 years old has been diagnosed with HCC he does not have hepatitis. He has tumors on his liver and in his lungs, he is now at St Jude... His AFP numbers were 400,000 when he was diagnosed on June 6th of this year. The docs told my sister there was really no cure for this type of cancer.. But they would go ahead and do the chemo and hope the chemo stops the growth ..the tumor had filled his whole stomach. He has had 2 rounds of chemo and now his AFP numbers are down to 10,000 and the tumor seems to be dieing from the inside. He is in the process of having his third chemo treatment now... my sister is in such a state that she does not ask the difficult questions...So I will... If he does not have hepatitis how in the whole did he get HCC, even St Jude said it was very rare in children... My second question is if there is no cure for this cancer why is the tumor dieing and the AFP numbers falling so fast...should we get our hopes up because of the numbers... Thanks Aunt Lisa
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Avatar_m_tn
hi, sorry your nephew is going through this. I can't help but if you want Hector you should start a new thread and title it "Hector". Best of luck and prayers going out to your nephew.
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