testicular cancer or what?

[yahboo]

i felt a dull ache and slight swelling in my left testicle area that wouldnt go away so i went to the urologist after reading about possible causes. i didnt have any other syptoms. the urologist did a physical examination of the both testicles and penis. then he did an ultrasoud. he said he didnt see any mass but just some calcification in both testicles. he gave me a pescription of lavaquin and ordered a blood test (my request as read on the internet to ask for peace of mind). the antibiotic worked well and in two weeks the ache and swelling disappeared -- its pretty much over.

HOWEVER, the blood test for two tumor markers came back negative for one and abnormal for another. he ordered blood test for two tumor markers. one was AFP the other i cant recall. theAFP came in abnormal: 15 (also did subsequent blood test with similar results). now after hearing this i feel every ache in my body (probably mental because i felt great before the confirmation of the AFP level abnormality.

i will have CT scan first week of new year 2008 and possibly lung x-ray after CT scan review.

is 15 AFP level bad or very bad (can someone explain the degree/relative scale)? can there be another causes other than cancer? can i have cancer eminating from my testicles even if the urologist doesnt think i have testicular cancer (such as cancer spreading to adominals or lung)? if this is possible shouldnt i have more symptoms.

i am age 41 and maybe i could be in better shape but i was feeling good just before i heard the confirmation of AFP level.

TIA

[Fernando Roque, MD]

Hi.  I wouldn't be too worried about that elevation of AFP. It is a very mild elevation. In adults, some AFP is normally being produced by the liver. Sometimes when the liver sustains injury (example: viral hepatitis), more AFP is released into the bloodstream, causing its levels to rise.

From the additional information you've mentioned, I seriously doubt that you have testicular cancer.  If you really want to make sure, you can have your AFP levels taken two months from now, just to see if it increased further.

[yahboo]

CT scan came up clean -- ntg on liver or lymph nodes. my urologist wants me to see a gastro-intestinal specialist for the next step. he wanted to wait on the x-ray of the lung until after this visit.

the other marker which i couldnt recall was HCG. that came up normal (negative).

any idea why my AFP would be abnormal? what else can cause this abnormality or can this abnormality be a normal variation?

TIA

[Fernando Roque, MD]

Hi.  Testicular cancer comes in two forms, seminomatous and non-seminomatous. Alpha fetoprotein (AFP) is a tumor marker which is elevated for the non-seminomatous type, but is not increased in seminomatous cancer.  There are two other markers: Beta-HCG (human chorionic gonadotropin) and LDH (lactate dehydrogenase) which may be elevated when either type of testicular cancer is present.  

Although an AFP level of 15 is elevated (normal: less than 5 ng/ml), cancer is usually suspected only when the levels reach more than 25 ng/ml (AFP in non-seminomatous  cancer is usually found in the level of hundreds of nanograms/ml). Since the levels of the other markers are normal, and no mass was found on ultrasound, I am having doubts about the diagnosis of testicular cancer in your case.  Still, it might be prudent to have that CT scan and x-ray done, just to be sure.

Feel free to make a post if there are further developments, or if you have other questions.