Elevated Alpha Feta Protein Question

[TnHepGuy]

I've had Hep C for about 20 years now. Since about 1995, monitoring the level of alpha feta protein (a tumor marker) has been a regular part of my blood work. Last December (2002) I had my first elevated AFP reading - 9.1, with normal at this lab considered < 8. This past May I had my second elevated reading of 9.3. After questioning my gastro about the possible causes, he believed the high reading to be consistant with my hepatitis and is considered only very marginally elevated. I just received my most recent blood work results and the AFP reading is now at 20.4. Also, my viral quant level has been increasing over this same period of time. My results from last week show it has increased rather sharply - almost four-fold - to nearly 2.4 million. I have a schedualed appointment with my gastro three weeks from now (during the first week of December) to go over my results.



A few questions that come to mind:



- is it possible for elevated AFP results to be related to anything other than tumor?



- is it possible for the elevated reading to correlate directly to increased viral activity?



- has it been shown that combo tx can lower AFP back into the normal range?



- at what AFP level is tumor considered a probabilty?



Any other discussion or information about AFP will be very helpful and greatly appreciated.





Thank you to all those who have been kind enough to take the time to answer my questions in the past and to those who continue to help me now and into the future.



May God's blessings and mercy be upon us all.





Sincerely,



TnHepGuy

[mikesimon]

The following is from: http://www.medicinenet.com/Alpha-fetoprotein_Blood_Test/article.htm



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



HCC

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. For example, an elevated AFP is expected to fall to normal in a patient whose HCC is successfully removed surgically (resected).



There are a number of other HCC tumor markers that currently are research tools and not generally available. These include des-gamma-carboxyprothrombin (DCP), a variant of the gamma-glutamyltransferase enzymes, and variants of other enzymes (e.g., alpha-L-fucosidase), which are produced by normal liver cells. (Enzymes are proteins that speed up biochemical reactions.) Potentially, these blood tests, used in conjunction with AFP, could be very helpful in diagnosing more cases of HCC than with AFP alone.



To read more about Hepatocellular Carcinoma (HCC), please read the MedicineNet.com Liver Cancer (Hepatocellular Carcinoma) article.



Medical Author: Tse-Ling Fong, M.D.

Medical Editor: Leslie J. Schoenfield, M.D., Ph.D.



Next page



I hope this helps a little. It would seem that your level is not high enough to indicate HCC but I can easily understand your concern. Stay on top of it and hopefully your doctor will be able to answer your questions and alleviate your anxiety. Good luck. Mike

[whybabe]

Sorry to butt in, however, I was hoping Travelmom would see this and let me know how Amanda was doing. I hope your family is well!!!

God Bless!

Deb

[TravelGrl]

Hi Deb,

  Thank you so much for thinking of us...as always...

  Things are not good.  Amanda just stopped all her meds.  Nothing was working.  Her last attempt was daily infergen and zadaxin..no response..We decided to give her body a rest for a month or two...Our next try will be alpha/gamma combo.  I here the results are quite promising...Anything is worth a shot at this point.  Amanda had a biopsy in September, it showed some fat, some copper and alot of scarring..cirrhosis.  We don't know why there was fat on her liver.  she is a thin girl.  Her tryglycerides are high and that may be the reason, so I think we will treat them.  The problem is finding a safe lipid lowering drug.  Anyone know of any?  I think Welchol may be one.  So that is the story..I haven't posted much lately, too depressing but still not giving up...Somewhere, something will work and we will find it..and when we do, we will share it with everyone..

  How are you doing?? Please let me know...My emial address is:

***@****   drop me a line..



Hope all is well,

Jodi

[aleta richardson]

my name is alet richardson my e-mail adress is ***@****. i was at the dr today for my liver disease. i have hep c cirrossis, ascities. i was told that my alpha feta proteien was elevated. and i might have some cancer begginnning. i was told told that the least little thing could trigger this test. do you know of any other reasons this can happen. i it is cancer the dr said it can be removed because they caught it early. i am scared to death, can you share anything with me about this. looking to hear from you

[TnHepGuy_]

Interesting that you've resurrected an early post of a question of mine (with a fine answer by mikesimon, I might add) - from nearly four years ago!

But to try and answer your question, I've since learned that a slightly elevated AFP (e.g. < 50) can sometimes be attributed to the Hep C itself - it's believed to be a possible indicator of ongoing and/or increasing progression. In a case such as yours, though, where cirrhosis is present - much more attention should be paid to whether or not the elevated AFP is an indicator of tumor. I would speak to your doctor to ask what more testing they can do (e.g. - CAT scan w/ contrast, etc.) to try and pin down if this truly is an hepatic cancer. You might also consider getting a referral to see a hepatologist for a second opinion.

May God's blessings and mercy be upon you, your family and your caregivers.


TnHepGuy

[miracles do happen]

Hi - I have hepC and developed hcc which was diagnosed from MRIs, CT scans etc.  I had a liver resection about 8 months ago.  It was a huge cancer - over 9cm.  I almost died after the surgery as I went into liver failure but God pulled me through.  I had ct scan in May 07 and tumor marker was 16 with no sign of cancer on scan.  I just had another ct scan which the doc said looked good but the tumor marker is now 43.  Have to retake afp in 6 weeks.  Was told hepC can flare up causing the afp to elevate.  Also, I have to get checked every 3 months so if C doe recur they can catch it in time, and they think it will years down the line.  I am trying to stay as positive as I can.  Would appreciate any input if you'd like.  Thanks.