Question: Hi Dr. Oana, I am a 51 year old female with Stage 4 metastatic breast cancer to the bones currently on Xeloda oral chemo - 7 days on and 7 days off (since 2012) and a monthly Xgeva shot (since 2011). Late last night, I noticed that my urine looked a little pink, and this morning, I had a Rapid Screen urinalysis done at my naturopath's office - a urine dip read in one minute. The blood/hemoglobin is about 250, the bilirubin is negative, the urobilinogen is normal, the ketones are negative, the protein is 30, the nitrite is negative, the glucose is normal, the ph is 6, the specific gravity is 1.025, the leukocytes are trace, and the color is auburn and turbid. I was given A-Biotic, which contains garlic - 2 caps a day three times a day for 7 to 10 days. For most of today, I have not seen blood; however, just now (at 12:05 AM MST), I urinated a more reddish color. I will be seeing my oncologist on Wednesday, April 30; she is not in the clinic on Tuesdays. I have no pain urinating, no back pain, no urgent need to urinate, nothing - just the blood in the urine. I'm worried that the blood may be a symptom of something more serious, like renal problems. What is the next step, please - wait until Wednesday? Drink cranberry juice? Go to the ER? Thank you for answering my question.

Thank you, Dr. XXXXXXX It is so helpful to know what types of tests to ask for, and I will certainly do that at my monthly oncologist appointment tomorrow (Wednesday) to find out whether or not I should go to a urologist or be referred to someone at my place of care. I receive my care at Banner MD XXXXXXX in XXXXXXX AZ (a subsidiary of the University of Texas' MD XXXXXXX in Houston, TX) and I just checked the list of physicians at Banner MD XXXXXXX - there are 2 that specialize in genitourinary cancer FYI. Now, of course, I'm not saying that I have cancer in that area, but maybe I'll be able to stay in-house and get the tests that you are recommending from those folks or even from my own oncologist. By the way, I was diagnosed with Stage 4 metastatic breast cancer to the bones in 2009, and I'm happy to say that I'm still here, and overall, maintaining well!