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Had Hodgkins Lymphoma. Suffering From Pain Around Rib Area. Tkaing Panadol. Can Blood Test Detect Cancer?
Question: Hello Doctor, i have been on here before a few times i have already asked this question but not to a doctor dealing in multiskeletal problem i will start from the beginning , i been having ruq pain since march, i did have tummy problems and i was connecting both pain and tummy together, i dont have gallbladder it was removed in 1986, i had hodgkins lymphoma in 2005 in remission since thankfully, since this pain started in march i have had chest x rays, heart ultrasound, colonoscopy and endoscopy, upper abdomen ultrasound showed "fatty liver /pancareas" but normal they said all other reported normal i also had blood tests done, no elvated liver etc in that so they tell me they are normal, can a blood test detect cancer ??, my own doctor said when i asked if it might be ibs she said colonoscopy cant detect ibs i always thought it could, i also have been attending my original oncology dr just recently telling him of the ruq pain as i gave him copies of my other results as it was from a different hospital. To get back to the pain my onc is ordering an mri scan for july 3rd he says he thinks its muscular. The pain is there most days now, starting under right rib area, and around right side, eased only by half xanax of which i dont have many as doc says they are addictive,, also laying on my back eases it , i am not getting answers i know the mri is coming up but i still in pain till then and can only take panadol for pain. I am paranoid thinking it is cancer of sime type, my onc says the bloods show nothing sinister, the hodgkins i had was in my groin area, onc has examined most areas. Would u think its a muscular issue Doctor , i was told at 27 that i had spine of 50yr old woman, i am now 51 , could that be the cause if this? My onc is doing best he can i live 49miles from his hospital, my own doc doesnt seem to be much help, she seems to rush, in the area where i have the pain are there ribs etc, do my ribs come round under my right breast area ? I was convinced it was my liver but my onc said my bloods didnt show any liver signs, whatever he means ?? I am curious as i cant even do my chores with this niggling ache, like a toothache in my right rib and side area. I also have secondary left limb lymphodema due to hodgkins groin surgery, i am a mess :-D this pain makes me very snappy, i also use bio freeze gel and roll on this is not working now either, i cannot take anti inflammotorys as i get rash etc from them. The only sort of relief is to lie down flat, i am physically and mentally tired from this ache. In feb i had chest xrays doctor said they were "unremarkable" i had a thoraic and lumbar x XXXXXXX not scan, the dr who ordered this is not my regular doctor and was very arrogant i asked him the results of back x rays he said "i dont know whats causing your pain XXXXXXX he never did send my results, can x rays show spinal damage or even tumours?? I know mri is more effective, i just need these questions answered in some way please from someone who knows what they are talking about
Thank you i await your reply
XXXXX
Thank you i await your reply
XXXXX
Dear XXXXXXX
Thanks for posting your query on XXXXXXX
Well looking into your problem I could see that your main concern is about pain in right ribs that is affecting your activities of daily life also.
Since you have already undergone multiple number of tests and they are all normal , just by history it is very difficult to pin point a diagnosis .
But we can discuss your concerns. Yes, your doctor has rightly prescribed MRI which is able to detect muscular pathologies with clarity. Sometimes hair line fractures can also be there leading to this pain . Since you are 51 years a possibility of osteoporosis leading to fractures also exist .
Next thing is malignancy or its relapse . Yes, certain blood tests can detect cancers but what test you have undergone I don't know. A whole body PET scan would be a good way to pick up any residual or relapse of malignancy.
Other thing I would suggest is to get Vitamin D levels, DEXA Scan and calcium levels done which could be of some help. A rare possibility of costochondritis also exists.
Other thing is that your doctor is right in saying that colonoscopy cannot detect IBS.
Since you have multiple problems I would advise you to follow your treating doctor completely as he could see your problem as a whole.
Hope it suffices.
Take care.
Dr. Shruti
Thanks for posting your query on XXXXXXX
Well looking into your problem I could see that your main concern is about pain in right ribs that is affecting your activities of daily life also.
Since you have already undergone multiple number of tests and they are all normal , just by history it is very difficult to pin point a diagnosis .
But we can discuss your concerns. Yes, your doctor has rightly prescribed MRI which is able to detect muscular pathologies with clarity. Sometimes hair line fractures can also be there leading to this pain . Since you are 51 years a possibility of osteoporosis leading to fractures also exist .
Next thing is malignancy or its relapse . Yes, certain blood tests can detect cancers but what test you have undergone I don't know. A whole body PET scan would be a good way to pick up any residual or relapse of malignancy.
Other thing I would suggest is to get Vitamin D levels, DEXA Scan and calcium levels done which could be of some help. A rare possibility of costochondritis also exists.
Other thing is that your doctor is right in saying that colonoscopy cannot detect IBS.
Since you have multiple problems I would advise you to follow your treating doctor completely as he could see your problem as a whole.
Hope it suffices.
Take care.
Dr. Shruti
Above answer was peer-reviewed by :
Dr. Vasanth
Hello Doctor Rijhwani
Thank you for your informative reply, I find that when I get up at first I dont have this ache in my side / front, since getting this pain I have tried to get my posture ok by sitting with back support but sitting aggravates the pain, this evening I put heat near the pain and even though it eased slightly it was still there, so I changed to an ice pack this seemed to work better, when I lay it on the front of my rib area, this makes me feel really tired, I am quite scared of malignancy even though my oncologist says the bloods don't indicate anything cancerous, I have the entire bloods tested, I will try and send you a copy on this note, below please find bloods from XXXXXXX - May 2013, If a colonoscopy doesnt show IBS how is it diagnosed? I am asking as I went through the colonoscopy / endoscopy and biopsies were ok, but wondered if it could detect the IBS. I await your view on the blood tests and I really do hope my MRI will be showing only muscular problem I am sick with worry. Thank you Doctor Rijhwani
Blood Test Results below:
WBC 6.8 7.6 7.9 9.1 6.8 7.5
RBC 4.43 4.80 4.32 4.43 4.47 4.44
HB 13.3 14.4 13.0 13.4 13.6 13.5
HCT 0.393 0.425 0.378 0.397 0.432 0.396
MCV 88.6 88.5 87.5 89.5 96.6 89.2
MCH 29.9 30.0 30.1 30.2 30.4 30.4
MCHC 33.8 33.9 34.4 33.7 31.5 34.1
RDW 12.8 13.4
PLT 160 243 225 230 246 235
MPV 8.8
ESR 12 27.1 25.1 25 8 16
Neutrophils 4.1 5.52 4.12 5.7 4.37 4.27
Lymphocytes 2.1 1.72 2.97 2.5 2.03 2.55
Monocytes 0.3 0.29 0.42 0.5 0.18 0.38
Eosinophils 0.2 0.04 0.30 0.2 0.20 0.28
Basophils 0.1 0.05 0.06 0.0 0.05 0.05
PT 10.8
INR 1.0 1.0
APTT 25.5 26.0
Sodium 139 137
Potassium 4.3 4.0
Magnesium 0.79 0.79
Calcium 2.33 2.34
Phosphate 1.10 1.00
Creatinine 56 60
Urea 2.7 3.9
GFR Estimation 90 90
Total Protein 68 69
Albumin 39 38
Total Biliubrin 11 12
Alkaline Phosphatate 72 72
ALT 26 15
AST 18 17
GGT 50 50
Uric Acid 249
CK 52
LDH 175 139
Cholesterol 4.4 3.8
CRP 5 5
Haemolysis Index 0 0
Glucose 7.3
Pregnancy Test ;-) NEG
Vitamin B 12 312 233 194 174
Serum Folate 7.0 10.5 3.8 3.0
Serum Ferritin 40 34 15 15 17
FreeT4 19.7
TBH 2.44
Thank you for your informative reply, I find that when I get up at first I dont have this ache in my side / front, since getting this pain I have tried to get my posture ok by sitting with back support but sitting aggravates the pain, this evening I put heat near the pain and even though it eased slightly it was still there, so I changed to an ice pack this seemed to work better, when I lay it on the front of my rib area, this makes me feel really tired, I am quite scared of malignancy even though my oncologist says the bloods don't indicate anything cancerous, I have the entire bloods tested, I will try and send you a copy on this note, below please find bloods from XXXXXXX - May 2013, If a colonoscopy doesnt show IBS how is it diagnosed? I am asking as I went through the colonoscopy / endoscopy and biopsies were ok, but wondered if it could detect the IBS. I await your view on the blood tests and I really do hope my MRI will be showing only muscular problem I am sick with worry. Thank you Doctor Rijhwani
Blood Test Results below:
WBC 6.8 7.6 7.9 9.1 6.8 7.5
RBC 4.43 4.80 4.32 4.43 4.47 4.44
HB 13.3 14.4 13.0 13.4 13.6 13.5
HCT 0.393 0.425 0.378 0.397 0.432 0.396
MCV 88.6 88.5 87.5 89.5 96.6 89.2
MCH 29.9 30.0 30.1 30.2 30.4 30.4
MCHC 33.8 33.9 34.4 33.7 31.5 34.1
RDW 12.8 13.4
PLT 160 243 225 230 246 235
MPV 8.8
ESR 12 27.1 25.1 25 8 16
Neutrophils 4.1 5.52 4.12 5.7 4.37 4.27
Lymphocytes 2.1 1.72 2.97 2.5 2.03 2.55
Monocytes 0.3 0.29 0.42 0.5 0.18 0.38
Eosinophils 0.2 0.04 0.30 0.2 0.20 0.28
Basophils 0.1 0.05 0.06 0.0 0.05 0.05
PT 10.8
INR 1.0 1.0
APTT 25.5 26.0
Sodium 139 137
Potassium 4.3 4.0
Magnesium 0.79 0.79
Calcium 2.33 2.34
Phosphate 1.10 1.00
Creatinine 56 60
Urea 2.7 3.9
GFR Estimation 90 90
Total Protein 68 69
Albumin 39 38
Total Biliubrin 11 12
Alkaline Phosphatate 72 72
ALT 26 15
AST 18 17
GGT 50 50
Uric Acid 249
CK 52
LDH 175 139
Cholesterol 4.4 3.8
CRP 5 5
Haemolysis Index 0 0
Glucose 7.3
Pregnancy Test ;-) NEG
Vitamin B 12 312 233 194 174
Serum Folate 7.0 10.5 3.8 3.0
Serum Ferritin 40 34 15 15 17
FreeT4 19.7
TBH 2.44
Dear madam,
Thanks for getting back .
Well almost all your investigations are fine in my knowledge . There exists a strong possibility that your pain may be muscular only .
IBS is a diagnosis of exclusion that is when we exclude all disease that can mimic this disease its diagnosis is considered. It can be diagnosed by combining disease related symptoms with normal investigations.For malignancy i told you whole body PET Scan can give the exact picture.
Take care.
Get well soon.
Dr. Shruti
Thanks for getting back .
Well almost all your investigations are fine in my knowledge . There exists a strong possibility that your pain may be muscular only .
IBS is a diagnosis of exclusion that is when we exclude all disease that can mimic this disease its diagnosis is considered. It can be diagnosed by combining disease related symptoms with normal investigations.For malignancy i told you whole body PET Scan can give the exact picture.
Take care.
Get well soon.
Dr. Shruti
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Above answer was peer-reviewed by :
Dr. Vaishalee Punj
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