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Alpha-fetoprotein Levels After Treatment for Testicular Cancer

Alpha-fetoprotein Levels After Treatment for Testicular Cancer

Question
Dear OncoLink "Ask the Experts,"
Our 24 year old son has stage I non-seminomatous testicular cancer. Part of the follow-up is a check on the alpha-fetoprotein (AFP) in the blood every two weeks. The AFP is considered a marker for this type of cancer. We have not been able to pinpoint the acceptable level of AFP. To add to the confusion, our hospital reports normal levels are 6 or less, while another has a 10 or less. Further adding to the confusion, we have read on another site that a normal level in healthy human being can vary from 0 to 25. His AFP has dropped from a high of 120 pretreatment, to 3.8 in mid-July after one testis was removed in late-April. The problem is that the AFP has been going up ever since with his current level of 7.1 as of late September. CT scans, so far, have been OK.

Thank you for taking this matter in consideration.  
Sincerely,
D.G.


Answer
John Han-Chih Chang, MD, OncoLink Editorial Assistant, responds:

Dear D.G.,
Thank you for you question and interest.

Alpha-fetoprotein (AFP) is a tumor marker for non-seminomatous testicular cancer. Beta-human chorionic gonadotropin (ß -HCG) is also a known marker for this malignant entity. AFP is a glyocoprotein produced in the fetal yolk sac, liver and gastrointestinal tract. It is elevated in about 70% of non-seminomatous testicular cancer. It has a half-life of five days in the blood. Normal levels can vary. You must inquire about the normal levels for your hospital or oncologist, since each laboratory may be different in assessing the blood levels of AFP. If, as you seem to have stated, 6 is the upper limit of normal, the level of 7.1 is concerning.

Please discuss these issues with your son's oncologists or cancer team. They may recommend further imaging studies or prophylactic treatment with radiation or chemotherapy.