Patients diagnosed with a germ cell tumor may need special blood tests to test for tumor markers at different times before, during, and after treatment in addition to standard imaging tests. Talk with your doctor about what tests are needed for your type and stage of cancer, what the test results mean, and how often you'll need to be tested. For men with non-seminoma and advanced seminoma, it's important to continue with follow-up testing of tumor marker levels after treatment for a germ cell tumor ends, particularly because increases in the tumor markers levels are often the first sign that the cancer has returned. ASCO recommends the following schedule for testing tumor marker levels:
- For non-seminoma, AFP and hCG should be measured every one to two months in the first year after treatment ends, every two to four months in the second year, every three to six months in the third and fourth years, every six months in the fifth year, and annually thereafter, continuing for at least 10 years.
- For advanced seminoma, tumor marker levels should be tested every two to four months in the first year after treatment ends, every three to four months in the second year, every four to six months in the third and fourth years, and annually thereafter, continuing for at least 10 years.
In addition to testing tumor marker levels, additional tests, such as computed tomography (CT) scans, magnetic resonance imaging (MRI), and lung function, may be needed as part of your follow-up care for a germ cell tumor. Talk with your doctor about these tests and when they should be done because the schedule will likely be different from the tumor marker testing schedules listed above.