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What Do My Lab Test Reports Indicate?

Posted on Fri, 3 Jun 2016

Question: I am certain based on my symptoms I am suffering from an early onset of Pancreatic Cancer.

Questions:

1- I am wondering if I have pancreatic cancer? I am a nervous wreck and need some help. I am afraid that all of my tests have missed the cancer and I am doing these tests too early.

2- I had an Endoscopic Ultrasound done at XXXXXXX Asia Hospital XXXXXXX Is this a reputable place? 12 biopsies taken (Duodenum, Antrum, Jejunum) (See attached Report)

3- Can CT, MRCP, and Endoscopic ultrasound miss Pancreatic Cancer? How good is MRCP and Endoscopic ultrasound?

4- Can small tumours (< 2cm) cause many symptoms?

5- Should I get a PET for confirmation?

6- What does hyperechoic pancreatic duct wall but not dilated mean? Does this suggest pancreatitis or pancreatic cancer? Could you explain this in simple terms?

Follow up: Dr. Dr.P.Ratnakar Kini (3 minutes later)

Had CT- Negative (John's Hopkins) -- See Discharge Report attached.

MRCP- Unremarkable

Endoscopic Ultrasound- Unremarkable (Columbia Asia Hospital Bangalore) HEP A,B,C- Negative Total Bilirubin- .82 AST-28 ALT- 40 ALP- 36 CA- 19.9- 9.1 T3- 1.1 T4- 7.88 TSH- 2.6

Hello Dr-

Just following up on your response.

Answered by Dr. Dr.P.Ratnakar Kini (21 hours later)

Brief Answer:
Need more information

Detailed Answer:
Hi,
Thanks for posting your query.
I am Dr.R.K and I am pleased to assist you.

I would like to know why were these tests done?
What symptoms you have?
Do you have any symptom like abdominal pain, jaundice or weight loss?

Regard,
Dr.R.K.

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar

Follow up: Dr. Dr.P.Ratnakar Kini (1 hour later)

Yes doctor I have lost 3 kg in 1 month. Have night sweats for 10 consecutive nights. Nausea, bloating, feeling full quickly after meals. Feeling tired.

EUS showed no lesions on pancrease.

CT showed nothing

MRCP showed no blockage in duct.

How do pancreatic symptoms present themselves early in infection?

Hello Dr.-

Kindly awaiting your response.

Best

Answered by Dr. Dr.P.Ratnakar Kini (11 hours later)

Brief Answer:
Answer given below

Detailed Answer:
Hi,
Thanks for the additional information.

Infection in the pancreatic tissue present with abdominal pain and fever.
Pancreatic cancer presents with abdominal pain, weight loss, jaundice etc.

It is unlikely that you have pancreatic cancer as the EUS and CT scan did not reveal any cancerous lesion. Also Ca 19-9 which is a tumor marker is not raised.

Let me know if you have any more questions.
Regards,
Dr.R.K.

Above answer was peer-reviewed by : Dr. Raju A.T

Follow up: Dr. Dr.P.Ratnakar Kini (4 hours later)

thanks doctor. what could be causing the weight loss, and lack of appetite? Could I have a pre-cancerous process going on?

Thanks for your reply doctor.

I was reading that the CA 19-9 is not a good tool for diagnosis as many people don't have these levels raised until advance cancer.

I know that the EUS and CT didn't show anything, however, could smaller processes be causing this issue?

Answered by Dr. Dr.P.Ratnakar Kini (8 hours later)

Brief Answer:
Answer given below

Detailed Answer:
Hi,
Ca 19-9 alone is not taken for diagnosis. I included the EUS and CT report along with Ca 19-9 to rule out pancreatic cancer. It is unlikely that smaller lesions would be causing these symptoms.

I would like to see other reports like complete blood count, ESR, peripheral smear, thyroid function test, stool test and upper GI endoscopy before I can give my opinion on weight loss.

Regards,
Dr.R.K.

Above answer was peer-reviewed by : Dr. Deepak

Follow up: Dr. Dr.P.Ratnakar Kini (2 days later)

Hello Dr-

Please find the other labs as you had indicated.

I am at a real loss and don't know which road I showed be going down? Your advice would be very helpful.

I have uploaded the reports (Lab work). I also had a colonoscopy done and everything was normal.

Yes, I am having weightloss and abdominal pain (on the sides) and upper abdomen (upper left side). I am struggling to keep weight on. I have tried to increase my caloric intake, however, to no avail.

What do you suggest?

Answered by Dr. Dr.P.Ratnakar Kini (33 hours later)

Brief Answer:
What is your weight?

Detailed Answer:
What is your weight and are you still losing weight?
Your CK is high.
Do you exercise regularly?

Above answer was peer-reviewed by : Dr. Yogesh D

Follow up: Dr. Dr.P.Ratnakar Kini (39 minutes later)

Hello Dr.

My weight is currently 85 kg's, I used to be 88kg.

Muscles hurt and are getting smaller and smaller every weak. My underwear is becoming loose.

I exercise moderately.

What other tests would you recommend?

Answered by Dr. Dr.P.Ratnakar Kini (23 hours later)

Brief Answer:
Muscle related issue

Detailed Answer:
Hi,
I do not find that you have any GI related issues.
It looks more like a muscle related issue as evident by the high CK values.
Though CK level can increase due to exercise also, your statement that muscles getting smaller point towards a muscle related issue.

You can discuss with your physician about this.

Regards,
Dr.R.K.

Note: For further follow up on digestive issues share your reports here and Click here.

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar