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Elevated AFP (TUMOR MARKERS)
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Elevated AFP (TUMOR MARKERS)

I just got my liver bio back.. inflammation grade 2; fibrosis stage 4
I did have an endoscopy to check for varices and there were none.  I have elevated AFP of 61 (TUMOR MARKERS).  MRI shows no cancer!  Platelets are a bit low.  Bilirubin is ok.  AST & ALT are 2x above normal. My Genotype is 1.
I get very tired a lot and my joints hurt.  Memory is shot anymore... Can't work!!  Do I qualify for SSD oSSI??  I did not start treatment yet and from what I hear its no walk in the park.

My main concern now is the elevated AFP!  How common is this??  I have an appointment with a new Hep doc on the 28th to set up treatment.  Any and all comments will be helpful.
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Your results are very common for one who has cirrhosis. What are the exact number for AST/ALT? Is AST larger then ALT?
What do you mean by “Memory is shot anymore”? Do you have memory problems, lack of concentration, disorientation, poor coordination skills?

Since you have progressed to cirrhosis you are increased risk of getting HCC. You need to be tested every 6 months so that if you should develop HCC it can be caught early and treated. AFP is never used by itself to diagnose HCC. AFP is used in conjunction with imagining such as ultrasound and CT scans to find HCC (liver cancer). It is not used by itself as it is only 60% predictive of HCC.
HCV with a constantly elevated AFP is a risk factor for HCC. But it does not indicate that one has HCC. An AFP over 200 or constantly increasing and a lesion larger than 2 cm is most likely HCC.

Yes, HCV treatment is no walk in the park but what is much more challenging is dealing with advanced cirrhosis and the need for a liver transplant. There is a huge shortage of livers so you could wait for years of constantly worsening of your health until you qualify for one. Therefore you should treat soon, before you develop decompensated cirrhosis at which point you will be unable to treat your hepatitis c and will need a liver transplant.

You should be working with a hepatologist, preferably at a transplant center. They are the most qualified for helping you manage your cirrhosis and if need be they can refer you to the transplant program. In order to receive SSDI you will need a doctor to be aware of your condition and the limitations it puts on your ability to work. You will also need tests to prove that you have HCV and cirrhosis. Look in the Social Security Blue Book for the requirements needed to be considered “disabled” by Social Security. It is a bureaucratic paper work nightmare but the sooner you start the better. It takes about 6 months to review your request for disability and 2 years of being disabled before you can receive Medicare.

Good luck.
Hectorsf
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I don’t believe AFP at 61 ng/mL is necessarily diagnostic of liver cancer. It is often elevated in HCV patients, though. I was told if it increases to say, 500 ng/mL, then something is ‘going on’.

Additionally, as a cirrhotic, it’s good to continue with surveillance for HCC (hepatocellular carcinoma) regardless of viral status; even if the virus is eradicated, the increased risk continues for life. Ultrasound or other imaging coupled with periodic AFP testing will be a way of life from now on.

Someone in here that is helping her husband deal with HCC currently told me that a percentage of HCC tumors don’t emit AFP; so it’s not always a reliable marker, apparently.

Good luck with therapy; yes, I’d apply for SSDI and get the clock started; it’s a bit of a haul to receive entitlement and another stretch for Medicare to kick in. Welcome to the discussion group, by the way--

Bill
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446474_tn?1385271190
Your results are very common for one who has cirrhosis. What are the exact number for AST/ALT? Is AST larger then ALT?
What do you mean by “Memory is shot anymore”? Do you have memory problems, lack of concentration, disorientation, poor coordination skills?

Since you have progressed to cirrhosis you are increased risk of getting HCC. You need to be tested every 6 months so that if you should develop HCC it can be caught early and treated. AFP is never used by itself to diagnose HCC. AFP is used in conjunction with imagining such as ultrasound and CT scans to find HCC (liver cancer). It is not used by itself as it is only 60% predictive of HCC.
HCV with a constantly elevated AFP is a risk factor for HCC. But it does not indicate that one has HCC. An AFP over 200 or constantly increasing and a lesion larger than 2 cm is most likely HCC.

Yes, HCV treatment is no walk in the park but what is much more challenging is dealing with advanced cirrhosis and the need for a liver transplant. There is a huge shortage of livers so you could wait for years of constantly worsening of your health until you qualify for one. Therefore you should treat soon, before you develop decompensated cirrhosis at which point you will be unable to treat your hepatitis c and will need a liver transplant.

You should be working with a hepatologist, preferably at a transplant center. They are the most qualified for helping you manage your cirrhosis and if need be they can refer you to the transplant program. In order to receive SSDI you will need a doctor to be aware of your condition and the limitations it puts on your ability to work. You will also need tests to prove that you have HCV and cirrhosis. Look in the Social Security Blue Book for the requirements needed to be considered “disabled” by Social Security. It is a bureaucratic paper work nightmare but the sooner you start the better. It takes about 6 months to review your request for disability and 2 years of being disabled before you can receive Medicare.

Good luck.
Hectorsf
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