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Treatment for colorectal cancer - Online Doctor Chats

Date : 21-Feb-2012
User rating for this question
Very Good Posted in: Colon Cancer
Answered by

General & Family Physician
Practicing since : 2005
Answered : 2585 Questions
User :   hello
Doctor :   hi
User :   i had a cbc done
Doctor :   ok
User :   my levels of neprophil were high
Doctor :   have u done the differential counts too ?
User :   normal was 7500 mine was 8200
User :   yeah that is the absolute
User :   also wbc was 11.6
Doctor :   8200 is not that high as well
Doctor :   in case of any underlying infection it does go up
User :   i also have frequent bowel movements could this be cancer
User :   im afraid that maybe these cells are being sent to the cancer sight
Doctor :   can u tell me your age ?
User :   im 37
Doctor :   can can u specify what you mean by frequest bowel movements ?
User :   up to five a day
Doctor :   ok
User :   does colon cancer present with high wbc and neprophils
User :   hello
Doctor :   there is no relation with a high neutrophil count and increased bowel movements
Doctor :   also cancer does not present with high neutrophil count
Doctor :   can u give me the differential count levels ?
User :   is high neutrophil associated with cancer like colon
Doctor :   no
User :   what is differential
Doctor :   it is not
Doctor :   differential count give the percentage of WBC typing
User :   ive read on net that these cells could be sent to the cancer cite
User :   71%
Doctor :   cancer is basically countered by lymphocytes
User :   what about cardiac crp
Doctor :   can u mention the % of lymphocytes ?
User :   mine was 3.6
User :   it was normal 5
Doctor :   CRP is a protien to check the level if inflmmation in the body
User :   yes mine was elevated i also read that that might indicate cancer
Doctor :   increased bowel movements in your case could be due to an infection due to a bug in something that u ate
User :   do you think i should have an upper and lower endoscopy
User :   they are chronic over 2 months
Doctor :   there are a lot of causes like infection that can cause an elevated CRP , not just cancer
User :   i think based on my symptoms i have stage 3 or 4 colon cancer and blood work
Doctor :   I guess you are very anxious
User :   so i have been ruled out for thyroid and hepatitis
Doctor :   can u tell me all your symptoms other than that mentioned here
User :   crp is caused by cancer
User :   what do u think i should do
Doctor :   please understand CRP = chronic reactive protien and it does not stand for cancer
Doctor :   first an evaluation is needed to be done for ur increased bowel movements
User :   but it could indicatye a presence of malignancy just as elevated neutrophils
Doctor :   do u have blood in ur stools ?
User :   no
Doctor :   do u have constipation
User :   no
Doctor :   do u have had weight loss ?
User :   no
Doctor :   dio u have any chronic body pain, low appetite etc ?
User :   what is my next step
User :   no
Doctor :   do u have nausea, vomiting, ?
User :   no burping
Doctor :   in that case the chances of u having cancer is very low
User :   why do you say that
Doctor :   to control ur symptoms take imodium tablets to control your watery bowel movements
User :   should i run an endoscopy
Doctor :   as i said , absence of all the above symptoms that i just asked decrease the probability yhat u ahve cancer
User :   so you would not reccomend colonoscopy
Doctor :   yes an endoscopy would help u to allay fears of cancer and reduce your mental anguish
User :   what about ultrasound
Doctor :   a ultrasound does not detect colon cancer
User :   it cannot be ibs
User :   because of the crp and neutrophils
User :   hello
Doctor :   no
Doctor :   why do u think u have IBS ?
User :   so most likely it is cancer then
Doctor :   hAVE U HAD A physical examination lately ?
User :   ibs causes frequent bowel movements
User :   yes and blood work
Doctor :   please read the above chat transcriopt where i ahve descreibed that the symptoms that u dont have, and hence the chances of cancer is less
User :   no masses found
User :   so what can it be then
User :   what can it be
User :   hello
Doctor :   hence if you are still concerned , then you consult a gastroenterologist who can do the additional workup as a UGI endoscopy, a colonoscopy as well as a CT scan to completely allay your anxiety and fear of cancer
Doctor :   please wait for a few minutes so that i can type my responses
User :   i went to gasroentoroligist he ordered ultrasound of pelvic and upper abdomen
Doctor :   so as per ur physical examination, what was the doctors inferance ?
Doctor :   what did he tell u regarding ur symptoms ?
User :   my primary doctor ran the bloodwork and told me that it was normal but that seems wrong
User :   nothing
Doctor :   so the lab report indicating a elevated neutrophil count seems to be bothering you ? is this right ?
User :   how can it be normal with these neutrophil and crp
Doctor :   does the report indicate that there are atypical cells and cancer like cells in the blood ?
User :   yes because i was almost thinking that it could be ibs
User :   no they did not run that test
Doctor :   these are just numbers and they go up and down with presecne of a diarheal infection
Doctor :   no they dont need to run an additional test
Doctor :   the same test will detect that
User :   but what other than cancer or ibs can cause it and i have no anemia which could mean ibd
Doctor :   since the test did not detect the cancerous cells in the blood as well as the lymphocytes count is normal , i dont think there should be any apprehension about cancer
Doctor :   can u tell me your symptoms befoe u can jump to the final diagnosis ?

User :   no im not concerned with leukemia that is much higher level but low level could be sent to fight tumor
User :   i have an urge to have bowel movements and burping
Doctor :   tell me your symptoms ? that u have had
Doctor :   and other than that any other symptoms ?
Doctor :   any kind of pain anywhere ?
User :   just cramping
Doctor :   any constipation ?
User :   no
Doctor :   do u have fever ?
User :   no that is also y i suspect cancer
User :   no fever
Doctor :   please understand that at the age of 37, without having major symptoms that i have discussed above, the chances of cancer cannot be dtermined by just a high NEUTROPHIL COUNT , and a normal differential count
Doctor :   u need to take medicaitons like imodium to control the bowel movements, and most of ur issues will be controled easily
User :   also crp and bowel moveme nts
User :   so y is the wbc high
Doctor :   as i have said, the wbc count is not high
Doctor :   it is within the normal limit of the WBC range
Doctor :   you need to consult your GP and ur gastroenterologist for additional info and help
Doctor :   hello
Doctor :   are u back ?
User :   the tnormal level was till 10.8
User :   mine was 11.6
Doctor :   different labs have a different criteria
User :   does ultrasound pick up colon cancer
Doctor :   even 11.6 is not considered to be that high
Doctor :   and inspite of that, it doe not indicate bowel cancer or any cancer by that levels
User :   but absolute neutrophil 0ver 8000 is, mine was 8200 if it were just wbc i would not be alarmed
Doctor :   No ultrasound is not sensitive for bowel cancer, though it can detect any masses or cysts in the gut
User :   i read a study where levels over 7 indicate more colon cancer and neutrophil presence spread cancer
Doctor :   physicians do not take just the lab reports into consideration, if the symptoms and presentaion does not match
User :   what would you think i have
Doctor :   what was the lymphocyte count ? and what was the presence of atypical lymphocytes and monocyte count?
Doctor :   In your case , i would redo the lab tests again.
User :   it says that neutrophil is associated with spreading cancer
Doctor :   the main cells that fight cancer cells are NK cells and lymphocytes
Doctor :   NK cells = natural killer cells that kill cancer cells
User :   i was surprised that my primary did not run follow up exam everything in blood normal other than neutrophil and the protein
Doctor :   just false elevation of neurtophils that is just above the levels mentioned by the labs is not the criteria for diagnosis of cancer
User :   exactly doctor that is why im terrified that i am dying
Doctor :   as i said physicains do not just blindly follow lab reports
Doctor :   are u taking any other medications ?
User :   the average colon cancer patient has neutrophil of 7000 and not cancer have 5000
Doctor :   please answer my last question
User :   so only lymphomas and leukemias have excessively high levels 0f 0000
Doctor :   when was the last time u consulted your GP OR Gastroenterologist ?
Doctor :   yes that is right
User :   im taking b12 and vitamin d and c and acidophulus
Doctor :   cancer is not detected based on the level of neutrophils and CRP
Doctor :   they are nonspecific findings seen in any chronic condtion
User :   but when cancer grows the body sends these neurophils there and i have no fever
Doctor :   have u checked online for the diagnostic criteria for cancer ?
Doctor :   please understand that they are NONSPECIFIC FINDINGS and are not TAKEN INTO CONSIDERATION for diagnosis of cancer
Doctor :   have u checked online for the diagnostic criteria for cancer ?
User :   i understand that i assume that my doctor the gi is running these us tests to check for colon wall and liver mets as well as primary pancreatic and other cancers other than colon prior to running the envasive lower endoscopy
Doctor :   the criteria will not have elevated neutrophils as a diagnostic criteria
Doctor :   if ur doctors were running those tests, the tests tehy would do - would have been a CT SCAN
Doctor :   or hrct scan
User :   i understand that im just confirming with you whether there is a high probability of neutrophils causing or rather gowing to fight a tumor as foreign agent rather than infection
Doctor :   have u found in any online site, having neutrophil count to be the diagnostic criteria for cancer ?
Doctor :   i have already mentioned that neutrophils do not have any role in fighting cancer
Doctor :   nor do they cause cancer in anyway
User :   no but it does say that a malignancy may cause higher neutrophil and crp counts
User :   no but they are red flags arent they
Doctor :   SO there is a WORD - MAY , which is not confirmatory
Doctor :   NO , they are considered to be - JUST NONSPECIFIC FINDINGS - and physicains do not consider them
User :   so what should i do if my us test comes back negative
Doctor :   you just have to relax and enjoy that you are disease free
User :   in your opinion do you think i have cancer and if not what else could it possibly be
Doctor :   OR if u are still concerned, then ask you GI to do a endoscopy and a CT scan
User :   ct scan and endoscopy may not pick up colon cancer as well
Doctor :   you just have a stomach bug, which is causing increased bowel movements
User :   for over 2 months and no fever how likely is that
Doctor :   you will benefit by taking a course of PROBIOTIC medication, and also IMODIUM, to control your bowel movement frequency
User :   you guys r just trying to make me fell better so i dont do anything drastic
Doctor :   food poisoning due to toxin producing bactria in the gut, does not produce fever
User :   it lasts for more than two months
Doctor :   as i have mentioned earlier, i would advice again and again that if u are still concerned, then ask your GI to do a endoscopy and a CT scan
Doctor :   this will definitely help you rule out cancer of any site
User :   so you think that i should do the colonoscopy
Doctor :   also get a few other tests as well - stool occult blood, cytology for malignant cells,
Doctor :   Blood test for CAE,
Doctor :   uPPER GI endoscopy and colonoscopy
User :   doctor did stool occult it was negative that would cause anemia with ibd otherwise im pretty convinced im dying
Doctor :   all these tests help to check for cancer
Doctor :   I am of the opinion that i have explained all that can be done to rule out cancer
Doctor :   and i have explained you what the symptoms of cancer can be as well
User :   what r the chances you think honestly that it is cancer
User :   yeah the biggest symptom of colon cancer is frequent bowel movements
Doctor :   what ever has been discussed here is completely honest and nothing incorrect has been mentioned here and as a doctor, i am not dishonest with any patient
User :   so what would you say my odds of having cancer would be
Doctor :   once you have all the tests that i have mentioned earlier that will help me to give u a exact picture of your status
User :   should i just wait and not do the tests
Doctor :   i dont advice you that
Doctor :   its in your best interest to get those tests done
User :   why
User :   because you believe that its probably cancer
Doctor :   as those tests will help u rule out cancer
Doctor :   NO, it will help you to know that u doint have cancer
User :   what would you think though
Doctor :   i have already explained you my impression
User :   in your opinion is it cancer and what % would you say that it is
Doctor :   0 % cancer
User :   so why should i get those tests
Doctor :   it will just help u to calm ur nerves and get over this that u ahve cancer
Doctor :   u dont have cancer
User :   how do you think is not cancer
User :   ok
User :   hello
Doctor :   yes
Doctor :   i am here waiting for you to read the chat transcript
Doctor :   it seem that you have loged out of the chat window
Doctor :   please log back in if u have any additional query
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