AFP elevated to 897 after returning to normal after resection for HCC (4 months post surgery)

Annie_A

Has anyone had their AFP elevate after returning to normal post resection?

My husband had a 1.9 x 1 x 1.1 lesion removed from the left lobe of the liver. The pathology showed focal vascular invasion but the surgeon expected that it was completely curative. AFP returned to normal 1 week post resection

At our three month check up post resection, MRI of the abdomen came back fine, CT of the chest came back fine but AFP was elevated to 191. Oncologist had us return next day for a Pelvic MRI and another AFP. Next day she reported that the Pelvic MRI came back normal but AFP was now 212. The following week a PET scan was done and the PET scan only showed a very dim light up near the surgical site. Radiologist nicknamed "Eagle Eye" performed the ultrasound himself and did not see any suspicious activity where the PET scan indicated.

A week later we saw the Transplant surgeon that performed the resection. He had a lipiodol angiography ordered and he ran the AFP again. It was now elevated to 505.

The following week the angiography was done and it came back inconclusive. A week later they repeated the CT to look for remaining lipiodol which would indicate where the cancer was and it came back inconclusive again.

Back to the oncologist yesterday. She suggests waiting and repeating CT in 30 days. She stated that she believes there is HCC recurrence but they cannot find it. AFP yesterday was 897.

So to recap - AFP has elevated to 897 in 30 days. Abdomen MRI, Chest CT, Pelvic MRI, PET scan, liver ultrasound and two CT's of liver only have been performed in the last 30 days and cancer cannot be found. All of the doctors are telling me this is a rare occurrence.  Doctor is recommending Y90 therasphere to the left lobe even though they cannot find a tumor.

Has this happened to anyone else out there? I cannot find anything and I mean anything regarding this scenario. BTW we are being treated at Northwestern Memorial in Chicago.  Have an appt with Mayo scheduled October 24.

 

AnthonySam

AFP

Hi Annie, I have had hepatacellur carcinoma for about twenty months . I had rfa ablation first ,it came back within three months . Next was microwave ablation , it was back in three months ! My afp was 167 after last treatment, it went up about 20 points a month to 292 . About 45 days later it jumped to 1992 ! I just found out today ! Quite a shock to say the least ! I do not know why or what will happen from here ! I was turned down for transplant at the VA because of age, 58, diabetes, they said POSSIBLE cardiac troubles ! I have no heart trouble ! They can't do resection because rfa and microwave do so much damage ! I do not want chemo because of the already existing damage ! Why afp jumped so much I don't know ! I can't go anywhere else for a transplant because I can't afford it . I don't have a clue whats going to happen, well I can guess ! Any thoughts from anyone else ! I haven't drank or smoked in over tweny years ! I drank way back then while taking diabetes pills that had a cross and skull on it ! That did make me very sick back in the early ninetys !

Annie_A

I know it has been some time

I know it has been some time since I have been able to catch up on this discussion board.  Mayo Clinic was not a success.  They agreed with Northwestern on some points and disagreed on others.  We came back to Chicago and did another Y-90 treatment right before Halloween.  At this time my husband's AFP was 1954.  One month after treatment AFP decreased to just over 1,000 and a week later it was 706.  I was tested as a potential donor and it was determined a match.  Transplant was set for 1/29 but then we received the news that AFP on 12/31/13 was rising and now at 934; transplant was cancelled.  We returned to Northwestern on Friday for repeat CT's of chest, abdomin and pelvis - they are looking once again for metastasized cancer.  Hopefully this is not the case.  Interventional radiology/oncology recommended retreatment with Y-90, possibly treatment to right lobe this time, but as a team, treatment plan has not been determined.  I am beginning to think it is time to move onto another center if an acceptable plan is not proposed.  I am thinking Cleveland Clinic or University of Pittsburgh - any opinions out there?