Have Pressure In Rib Cage And Tastelessness In Tongue. Taking Pravastatin. Worried For Pancreatic Cancer

Posted on Thu, 28 Feb 2013

Question: I have pressure from time to time in my left back middle and left rib cage. And a tastelessness about my tongue. And intermitant sharp pain in my left chest for a couple months. I am on pravastatin 10mg. Synthroid 137mcg. And 10mg of a blood pressure med. my blood work shows sugar normal. Bilirubin regularly high (Gilbert's syndrome)what could these symptoms be? Pancreas cancer? I just got over a severe cold and had pale yellow stool but it is now returning to normal brown. I am 38 years old. My mom died of pancreatic cancer at 50.

Answered by Dr. Dipanjan Majumder (44 minutes later)

Hi,

Thanks for the query. I went through the details submitted and my comments are as follows:

1. You are suffering with a defect in bilirubin conjugation, characterized by increased unconjugated bilirubin. Here only mild increase in bilirubin takes place other hepatic functions remain unaltered. At times of stress, fatigue, alcohol use, reduced caloric intake and inter current illness,bilirubin levels may rise further. This syndrome needs no specific treatment because it generally cause mild jaundice and no other harmful effects.
Now, this syndrome is not associated with increased of pancreatic cancer.

2. You have mentioned that your mother died of pancreatic cancer at 50. There is increased chance of pancreatic cancer in first degree relative by 5-10 %. But we do not have consensus regarding screening because of high false positive rate. However screening tests may be reasonable with family history.
One recommendation is to commence screening at the age of 35 years or 10 years before the age of youngest diagnosed with pancreatic cancer. The best modality will be abdominal CT scan with pancreas protocol (triphasic cross sectional imaging and thin slices).

3. As far as your symptoms are concerned, chest pain and your other symptoms sound to me like anginal chest pain. I am not sure if you have done EKG's and other cardiac evaluation. If not, I think it is worth to consult a qualified cardiologist.

4. Pancreas pathology may sometimes has similar symptoms. Anyway, in my opinion a pancreas protocol CT scan will be helpful to you considering your family history.

Hope I have answered your queries. I will be available for follow up.

Wish you a good health.

Regards

Above answer was peer-reviewed by : Dr. Prasad

Follow up: Dr. Dipanjan Majumder (16 hours later)

I would like to avoid CT scans. I have had one for my lower back last year and I had one about in December for my brain because of dizziness and blurred vision. Results were ok. I have since had no trouble with that. It was attributed to cholesterol med and blood pressure med i had started. Is theEndoscopic ultrasound reliable? I plan on requesting one in a couple weeks if symptoms don't subside. I also am contacting a genetic counselor to see if I am genetically pre disposed to this cancer to get a better idea of my risk factors to plan the frequency of these screenings.

Answered by Dr. Dipanjan Majumder (5 hours later)

Hi,
Thanks for asking your queries.

You can avoid CT scan. Now pancreas protocol MRI is emerging diagnostic modality. This can be used safely if you have no contraindication of MRI. MRI has no radiation hazard.

Endoscopic ultrasound (EUS) is another option. Generally EUS is advised after finding any abnormality in CT/MRI.

EUS is very reliable in case of biopsy from any suspicious lesion.

Hope this answers your queries.

Note: For further queries related to kidney problems Click here.

Above answer was peer-reviewed by : Dr. Shanthi.E