AFP is a blood marker for liver cancer. HCC. But, it is NOT an accurate predictor of HCC. If you mean will the blood level go down after treatment I don't know. Maybe someone else knows.
If you have HCC, treatment will not cure the cancer. HCC is particuliar fast and fatal illness. If you are a cirrhotic, with Stage 4 liver disease, you should have a scan (CT triple phase is what I have had done) done every 6 months to monitor for HCC.
If you do develop HCC it can move you to the top of the liver transplant list as long as it has not spread outside your liver and as long as the cancer is limited in size and you don't have too many cancerous lesions.
"Alpha-fetoprotein (AFP) Blood Test
The most widely used biochemical blood test for liver cancer - hepatocellular carcinoma (HCC) is alpha-fetoprotein (AFP), which is a protein normally made by the immature liver cells in the fetus. At birth, infants have relatively high levels of AFP, which fall to normal adult levels by the first year of life. Also, pregnant women carrying babies with neural tube defects may have high levels of AFP. (A neural tube defect is an abnormal fetal brain or spinal cord that is caused by folic acid deficiency during pregnancy.)
In adults, high blood levels (over 500 nanograms/milliliter) of AFP are seen in only three situations:
· 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 HCC can have mild or even moderate elevations of AFP.
The sensitivity of AFP for HCC is about 60%. In other words, an elevated AFP blood test is seen in about 60% of HCC patients. That leaves 40% of patients with HCC who have normal AFP levels. Therefore, a normal AFP does not exclude HCC. Also, as noted above, an abnormal AFP does not mean that a patient has HCC. It is important to note, however, that patients with cirrhosis and an abnormal AFP, despite having no documentable HCC, still are at very high risk of developing HCC. Thus, any patient with cirrhosis and an elevated AFP, particularly with steadily rising blood levels, will either most likely develop HCC or actually already have an undiscovered HCC.
An AFP greater than 500 ng/ml is very suggestive of HCC. In fact, the blood level of AFP loosely relates to (correlates with) the size of the HCC. Finally, in patients with HCC and abnormal AFP levels, the AFP may be used as a marker of response to treatment."
I also had an elevated afp, prior to starting tx it was 30. I have cirrhosis and my hep said it is generally always elevated in pts. with hepc. During tx my levels came down to normal and have stayed normal for almost 2 yrs. I would suggest you ask your hep to do a cat scan to be sure everything is okay, if he hasnt already done so. I have yearly ultrasounds, afp is checked every 6mths b/c i have cirrhosis. Even though i have svr'd. hep says i need to have this done for the rest of my life, due to cirrhosis. Good Luck...Leah
how come no doctors or radiologists say anything about Cat scans actually causing cancer? I have read that a cat scan radiation is equalviliant to what you would get from 100+ chest xrays. I realized that people with cirrhosis and elevated AFP have to be screened but can't anything else be used and limit the CT to once a year of something? i.e. MRI, ultrasound instead.
Have you had any imaging studies to address the AFP level? I don't know of any data that correlates treatment with AFP-level response, sorry.
I guess it's a risk/benefit measure -- sure, radiation can cause cancer, but when there is a 5-10% risk of HCC in cirrhotics and a 50% chance of recurrence for HCC within two years (which is the risk percentages my husband faces), the minimal cancer risk posed by CT scan is worth the early detection. (Ultrasound is not a sensitive diagnositic tool, and many patients are not candidates for MRI -- my husband, with metal injuries/ surgeries, cannot undergo MRI). We did encounter some resistance in pursuing 3 month intervals instead of 6 month intervals, but the only thing the nurse said is "we don't want your husband to glow in the dark."
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