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What Does My Blood Test Report Indicate?
Question: Hi. 55 yoa male. From blood work, hemoglobin of 9.5, RBC 3.85. HCT 30.9. Mcv 80.3 Platelet at 603 instead of 150 to 400. Have a colonoscopy and stomach camera scheduled. GP went ape, says this could be colon cancer - before he backs off and talks about ulcers. Totally disregards significant problems I'm having with bleeding hemorrhoids - hasn't even looked. Is he right and am I on the right path?
Brief Answer:
Investigation for blood loss from probable cancer is justified in your case
Detailed Answer:
Hi xxxxxxxxx,
Thanks for writing in to us.
I have read through your query in detail.
Please find my observations below.
1. Medical literature specifies that in a case of low hemoglobin with hemorrhoids, other causes of anemia should first be investigated for. If no other cause is found then the patient is treated for hemorrhoids. The anemia in case of hemorrhoids should correct itself in three months and most hemorrhoids patients have normal hemoglobin in six months.
2. Increased platelet counts can be a reactive state to the blood loss or a cancer. Therefore getting a cancer screening done of the gastrointestinal tract by stomach camera and colonoscopy is a good method of investigation.
3. Bleeding hemorrhoids can contribute to some amount of blood loss but a hemoglobin level of 9.5 is quite low and requires detailed investigation. The stomach camera and colonoscopy will surely pick out any major bleeding point should you have one.
4. There is another test called CEA which is a simple blood test to look for a tumor marker for colon cancer. The CEA is increased in most patients having colon cancer. There are investigations like CT scan abdomen which are important in confirming a cancer should there be a suspicion.
5. Usually patients with cancer have a rapid weight loss and generalized weakness but with a hemoglobin of 9.5 and increased platelets, I would also recommend a cancer screening, especially if you have recently developed periodic constipation. Cancer has become treatable if detected early.
In conclusion, your GP is giving due attention to your anemia and high platelets and therefore investigating in detail.
Hope your query is answered.
Please do write back if you have any doubts.
Regards,
Investigation for blood loss from probable cancer is justified in your case
Detailed Answer:
Hi xxxxxxxxx,
Thanks for writing in to us.
I have read through your query in detail.
Please find my observations below.
1. Medical literature specifies that in a case of low hemoglobin with hemorrhoids, other causes of anemia should first be investigated for. If no other cause is found then the patient is treated for hemorrhoids. The anemia in case of hemorrhoids should correct itself in three months and most hemorrhoids patients have normal hemoglobin in six months.
2. Increased platelet counts can be a reactive state to the blood loss or a cancer. Therefore getting a cancer screening done of the gastrointestinal tract by stomach camera and colonoscopy is a good method of investigation.
3. Bleeding hemorrhoids can contribute to some amount of blood loss but a hemoglobin level of 9.5 is quite low and requires detailed investigation. The stomach camera and colonoscopy will surely pick out any major bleeding point should you have one.
4. There is another test called CEA which is a simple blood test to look for a tumor marker for colon cancer. The CEA is increased in most patients having colon cancer. There are investigations like CT scan abdomen which are important in confirming a cancer should there be a suspicion.
5. Usually patients with cancer have a rapid weight loss and generalized weakness but with a hemoglobin of 9.5 and increased platelets, I would also recommend a cancer screening, especially if you have recently developed periodic constipation. Cancer has become treatable if detected early.
In conclusion, your GP is giving due attention to your anemia and high platelets and therefore investigating in detail.
Hope your query is answered.
Please do write back if you have any doubts.
Regards,
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
Thanks for the advice.
A little more on my situation. I am successfully taking Linzess following an IBS-C suspicion. I am currently displaying some significant bright red blood on toilet paper following a bowel movement, about the size of a half-dollar. No abdominal pain, no weakness.
I have a friend who is a colon cancer patient currently who agrees with you, but he says colon cancer generally manifests itself with occult bleeding, not the kind of bleeding above. Your thoughts?
A little more on my situation. I am successfully taking Linzess following an IBS-C suspicion. I am currently displaying some significant bright red blood on toilet paper following a bowel movement, about the size of a half-dollar. No abdominal pain, no weakness.
I have a friend who is a colon cancer patient currently who agrees with you, but he says colon cancer generally manifests itself with occult bleeding, not the kind of bleeding above. Your thoughts?
Brief Answer:
Occult bleeding or XXXXXXX bleeding depends on size and location of lesion
Detailed Answer:
Hi xxxxxxxxxxxx,
Thanks for writing back with an update.
1. Any blood in the stool is not to be ignored. Occult blood hols importance when there is low hemoglobin without any significant XXXXXXX bleeding in the stools. Occult means hidden and this "hidden bleeding" is looked for by specific test.
2. I have worked in cancer institute for few years and in my experience a probable cancer high up will cause occult bleeding while one that is lower down in the large bowel, close to the anal opening, will cause XXXXXXX bleeding. Therefore the presence of occult blood or XXXXXXX bleeding depends on how far is the disease process (not necessarily a cancer) from the anal opening.
3. Hope you do not have a cancer and the bleeding is from a benign cause. Any illness is best treated if an early diagnosis is made. The IBS in your case is clinically suspicious but not confirmed! Therefore having a detailed investigation and screening for cancer can give you peace of mind and help in confirming the condition which you have.
Hope your query is answered.
Please do write back if you have any doubts.
Regards,
Occult bleeding or XXXXXXX bleeding depends on size and location of lesion
Detailed Answer:
Hi xxxxxxxxxxxx,
Thanks for writing back with an update.
1. Any blood in the stool is not to be ignored. Occult blood hols importance when there is low hemoglobin without any significant XXXXXXX bleeding in the stools. Occult means hidden and this "hidden bleeding" is looked for by specific test.
2. I have worked in cancer institute for few years and in my experience a probable cancer high up will cause occult bleeding while one that is lower down in the large bowel, close to the anal opening, will cause XXXXXXX bleeding. Therefore the presence of occult blood or XXXXXXX bleeding depends on how far is the disease process (not necessarily a cancer) from the anal opening.
3. Hope you do not have a cancer and the bleeding is from a benign cause. Any illness is best treated if an early diagnosis is made. The IBS in your case is clinically suspicious but not confirmed! Therefore having a detailed investigation and screening for cancer can give you peace of mind and help in confirming the condition which you have.
Hope your query is answered.
Please do write back if you have any doubts.
Regards,
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
One other thing I wanted to mention: I have a burning sensation along the left side at my belt line, a sensation that is slightly aggravated by a bowel movement. Thoughts?
Brief Answer:
Your symptom is non specific and requires clinical examination
Detailed Answer:
Hi xxxxxxxxxxxx,
Thanks for writing back with an update.
1. The sensation of burning along the left side in your belt line during bowel movement is a non specific and vague symptom.
2. Burning over the skin on one side in abdomen is a common symptom associated with shingles but that is not likely to aggravate with bowel movement.
3. There can be groin lymph nodes which can cause burning and this can be more when there is increased pressure in lower abdomen during bowel movement. Rarely a hernia can cause stretching of nerves and lead to burning on one side. This requires clinical examination.
Hope your query is answered.
Please do write back if you have any doubts.
Regards,
Your symptom is non specific and requires clinical examination
Detailed Answer:
Hi xxxxxxxxxxxx,
Thanks for writing back with an update.
1. The sensation of burning along the left side in your belt line during bowel movement is a non specific and vague symptom.
2. Burning over the skin on one side in abdomen is a common symptom associated with shingles but that is not likely to aggravate with bowel movement.
3. There can be groin lymph nodes which can cause burning and this can be more when there is increased pressure in lower abdomen during bowel movement. Rarely a hernia can cause stretching of nerves and lead to burning on one side. This requires clinical examination.
Hope your query is answered.
Please do write back if you have any doubts.
Regards,
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Above answer was peer-reviewed by :
Dr. Yogesh D
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