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What does a high LDH indicate and what should I do?

Forums General Melanoma Community What does a high LDH indicate and what should I do?

  • Post
    arthurjedi007
    Participant

      My Dr office has LDH at 100 – 250 as normal. Mine has been around 190 for as long as I know until this month.

      On 3/3 it was 259. Dr thought it was the T10 vertebrae and the radiation would cause it to drop but it hasn't.

      On 3/31 it is 396.

      My Dr mentioned it was still high but when I left I got the report and I'm like what the heck. That's a huge jump. I also know I've been feeling a bit lousy for over a month.

      Any advice what I should have my Dr do to find out what is going on? Currently he's not planning on doing anything except continuing to try to get me into the Merck PD1 EAP.

      Any advice on anything I can do about it?

       

       

    Viewing 16 reply threads
    • Replies
        Janner
        Participant

          This site has a decent explanation:

          http://skincancer.about.com/od/diagnosis/a/LDH.htm

          Janner
          Participant

            This site has a decent explanation:

            http://skincancer.about.com/od/diagnosis/a/LDH.htm

            Janner
            Participant

              This site has a decent explanation:

              http://skincancer.about.com/od/diagnosis/a/LDH.htm

              LuckyMan51
              Participant

                That link has a  good summary… Stay calm as this number can be pretty volatile. I had it as high as 450 once but the next lab a week later had it down 200 points from there. I would guess since your Dr mentioned it looked high he probably  has another test scheduled for you shortly. If not ask for one.  If you log into your medical facility data base can you locate your lab results and then click on your historical results to put the swings in perspective?  I watch this number pretty hard but given the volatility not sure how much sense that makes. Good luck.  

                LuckyMan51
                Participant

                  That link has a  good summary… Stay calm as this number can be pretty volatile. I had it as high as 450 once but the next lab a week later had it down 200 points from there. I would guess since your Dr mentioned it looked high he probably  has another test scheduled for you shortly. If not ask for one.  If you log into your medical facility data base can you locate your lab results and then click on your historical results to put the swings in perspective?  I watch this number pretty hard but given the volatility not sure how much sense that makes. Good luck.  

                  LuckyMan51
                  Participant

                    That link has a  good summary… Stay calm as this number can be pretty volatile. I had it as high as 450 once but the next lab a week later had it down 200 points from there. I would guess since your Dr mentioned it looked high he probably  has another test scheduled for you shortly. If not ask for one.  If you log into your medical facility data base can you locate your lab results and then click on your historical results to put the swings in perspective?  I watch this number pretty hard but given the volatility not sure how much sense that makes. Good luck.  

                    BrianP
                    Participant

                      Art,

                      The link has a pretty good explanation.  LDH is not the end all be all for predicting melanoma spread.  Some people find out they have a heavy tumor burden yet their LDH never changed.  Some people have swings in their LDH that never amount to anything.  I do think a big jump would be worth investigating though.  Not sure what defines a big jump.  I seem to remember some people reporting LDH numbers 2 and 3 times what your number is.  When was your last scan and when is your next one scheduled for?  I think if it were me I'd be pushing for another LDH check in a few days and if it's still high maybe another scan.

                      Brian

                      BrianP
                      Participant

                        Art,

                        The link has a pretty good explanation.  LDH is not the end all be all for predicting melanoma spread.  Some people find out they have a heavy tumor burden yet their LDH never changed.  Some people have swings in their LDH that never amount to anything.  I do think a big jump would be worth investigating though.  Not sure what defines a big jump.  I seem to remember some people reporting LDH numbers 2 and 3 times what your number is.  When was your last scan and when is your next one scheduled for?  I think if it were me I'd be pushing for another LDH check in a few days and if it's still high maybe another scan.

                        Brian

                        BrianP
                        Participant

                          Art,

                          The link has a pretty good explanation.  LDH is not the end all be all for predicting melanoma spread.  Some people find out they have a heavy tumor burden yet their LDH never changed.  Some people have swings in their LDH that never amount to anything.  I do think a big jump would be worth investigating though.  Not sure what defines a big jump.  I seem to remember some people reporting LDH numbers 2 and 3 times what your number is.  When was your last scan and when is your next one scheduled for?  I think if it were me I'd be pushing for another LDH check in a few days and if it's still high maybe another scan.

                          Brian

                          Mat
                          Participant

                            Agree with the other posts.  While an elevated LDH (330) was one of my only symtoms at diagnosis, my LDH is now less than 200–yet I still have 15 tumors in my liver.  Prior to my initial treatment (GSK combo), I did have a big jump in my LDH level to 600.  As others have said, continue to monitor, but they probably won't re-scan off schedule unless there is a big jump.

                            Mat
                            Participant

                              Agree with the other posts.  While an elevated LDH (330) was one of my only symtoms at diagnosis, my LDH is now less than 200–yet I still have 15 tumors in my liver.  Prior to my initial treatment (GSK combo), I did have a big jump in my LDH level to 600.  As others have said, continue to monitor, but they probably won't re-scan off schedule unless there is a big jump.

                              Mat
                              Participant

                                Agree with the other posts.  While an elevated LDH (330) was one of my only symtoms at diagnosis, my LDH is now less than 200–yet I still have 15 tumors in my liver.  Prior to my initial treatment (GSK combo), I did have a big jump in my LDH level to 600.  As others have said, continue to monitor, but they probably won't re-scan off schedule unless there is a big jump.

                                arthurjedi007
                                Participant

                                  Thanks everyone. My local onc doesn't have me on a planned scan schedule just planned visits schedule of every 4 weeks. Yesterday he asked me when I wanted my next pet scan. Since I've only been on taf/mek 3.5 weeks he didn't set it up. Now I'm thinking of asking to do the pet scan on the next scheduled checkup which is April 28. That will give the combo 7.5 weeks so if it was going to do any good it should do some good by then I would think but dunno. And it would see what this jump in ldh is doing. And it would be 5.5 weeks since the radiated tumor so it might see what is happening there. Granted he has no treatment for me except waiting for the Merck pd1 to happen. That will also be a little short of 3 months since my last pet scan. It's either that or give everything 4 more weeks on top of that 4 weeks but I believe that's too long.

                                  arthurjedi007
                                  Participant

                                    Thanks everyone. My local onc doesn't have me on a planned scan schedule just planned visits schedule of every 4 weeks. Yesterday he asked me when I wanted my next pet scan. Since I've only been on taf/mek 3.5 weeks he didn't set it up. Now I'm thinking of asking to do the pet scan on the next scheduled checkup which is April 28. That will give the combo 7.5 weeks so if it was going to do any good it should do some good by then I would think but dunno. And it would see what this jump in ldh is doing. And it would be 5.5 weeks since the radiated tumor so it might see what is happening there. Granted he has no treatment for me except waiting for the Merck pd1 to happen. That will also be a little short of 3 months since my last pet scan. It's either that or give everything 4 more weeks on top of that 4 weeks but I believe that's too long.

                                    arthurjedi007
                                    Participant

                                      Thanks everyone. My local onc doesn't have me on a planned scan schedule just planned visits schedule of every 4 weeks. Yesterday he asked me when I wanted my next pet scan. Since I've only been on taf/mek 3.5 weeks he didn't set it up. Now I'm thinking of asking to do the pet scan on the next scheduled checkup which is April 28. That will give the combo 7.5 weeks so if it was going to do any good it should do some good by then I would think but dunno. And it would see what this jump in ldh is doing. And it would be 5.5 weeks since the radiated tumor so it might see what is happening there. Granted he has no treatment for me except waiting for the Merck pd1 to happen. That will also be a little short of 3 months since my last pet scan. It's either that or give everything 4 more weeks on top of that 4 weeks but I believe that's too long.

                                        BrianP
                                        Participant

                                          I think that sounds very reasonable for a scan.  My trial had scans every 12 weeks to start and now is every 8 weeks.  A friend of mine in a different PD-1 trial has had scans every 8 weeks since the start of his.  I think you are definitely in the window around that 28 April appointment.  How have you been feeling otherwise?  Can you tell any difference in that tumor on your spine?

                                          BrianP
                                          Participant

                                            I think that sounds very reasonable for a scan.  My trial had scans every 12 weeks to start and now is every 8 weeks.  A friend of mine in a different PD-1 trial has had scans every 8 weeks since the start of his.  I think you are definitely in the window around that 28 April appointment.  How have you been feeling otherwise?  Can you tell any difference in that tumor on your spine?

                                            arthurjedi007
                                            Participant

                                              Thanks Brian. Yeah I've been feeling a little lousy but the radiation definetly helped the tumor on my spine so I'm not going to be paralyzed for awhile at least so that is great.

                                              arthurjedi007
                                              Participant

                                                Thanks Brian. Yeah I've been feeling a little lousy but the radiation definetly helped the tumor on my spine so I'm not going to be paralyzed for awhile at least so that is great.

                                                arthurjedi007
                                                Participant

                                                  Thanks Brian. Yeah I've been feeling a little lousy but the radiation definetly helped the tumor on my spine so I'm not going to be paralyzed for awhile at least so that is great.

                                                  BrianP
                                                  Participant

                                                    I think that sounds very reasonable for a scan.  My trial had scans every 12 weeks to start and now is every 8 weeks.  A friend of mine in a different PD-1 trial has had scans every 8 weeks since the start of his.  I think you are definitely in the window around that 28 April appointment.  How have you been feeling otherwise?  Can you tell any difference in that tumor on your spine?

                                                  gopher38
                                                  Participant
                                                    Does this have another name than LDH?  Can you calculate it from other numbers?  After reading this discussion, I went on MyChart, and I can’t find anything called LDH on either of the two testing summaries I get after they do a blood draw/test. Is it something for which the doctor would have to do a special request?  You’d think they’d do it automatically, seeing as how I’ve been metastatic for some time.
                                                    Bubbles
                                                    Participant
                                                      LDH (Lactate Dehydrogenase) is an enzyme that is released into the blood when there is tissue damage.  Here is a link that may help explain:  https://medlineplus.gov/lab-tests/lactate-dehydrogenase-ldh-test/

                                                      Can the level be elevated with cancer?  Yes.  Sometimes.  Mine has never been elevated even when I had known tumors in my lung and brain.

                                                      Granted a low or normal LDH is best when living with cancer, but since we know that LDH can become elevated even after strenuous exercise, it is not a terribly reliable indicator of cancer or cancer’s progression.

                                                      Hope that helps.  celeste

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