In article <[log in to unmask]>, [log in to unmask] writes
>But I did make a note that one should check AFP,LDH and HCG levels in any man
>with gynaecomastia because small testicular cancers can produce these hormones
>and metastasise before any lump is palpable in the testis. In fact a lump may
>never become palpable even when mets are huge and all over the place.
This is very good advice, and something I don't routinely do.
Having just read the MDU's "Delays in diagnosis" booklet, I've decided
to start doing them. (But would it be reasonable to do these tests
routinely in the adolescent cases, who are in an age group more likely
to go on to developing testicular Ca?)
However, I've checked my patient's records and no mention was made by
the hospital of tumour markers until just before he was due to have his
orchidectomy and start his chemotherapy, and even then they were
reported as normal. Sometimes you just can't win.
--
Dr John M King
GP North Staffordshire
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