slightly elevated alp and bone cancer?? chest and back pain
I am a 40 year old male, a non smoker 5'11 190 pounds. I suffer from depression, anxiety, and panic attacks. I have Asthma, IBS, Gout, Fybromyalgia & acid reflux
The medicines I take are alluporinol(Gout) Ventolin, Prevacid, Flovent, Serevent. Celexa and ativan as needed for panic attacks
I have a benign fatty liver confirmed by Biopsy 5 years ago, which causes elevations in GGT ALT AST ALP. Billi is always normal.
Recently about 3 weeks ago I started having mid chest and back pains and thought I was having a heart attack. I have had allot of tests including a chest x ray followed by a chest and Abdominal CT scans both with contrast and normal,
numerous blood workups including, CBC, Calcium, Magnesium all lytes, PTH, TSH T4, CPK, LDH ESR, Creatinine, Albumin, cholersterol, INR, Billirubin Lipase Amylase 2 hour fasting plasma test to rule out diabetis etc. Unrinalysis was also normal. These blood tests were all normal.
In addition while having chest pain on different days I have also had 3 normal ecg's with heart panels, Stress test Gastrocopy, which showed a small Hiatial hernia, Abdominal Ultrasound and a stress test. These tests, with the exception of the small hernia and liver workup are all normal.
I am concerned because of the back /chest pain and the slightly high ALP of 145 (lab says up to 129 u/l(in normal range) and what I have read about bone cancer on a few sites. My calcium and PTH are normal and my doctor is not concerned about bone cancer and a bone scan I asked about.
My family doctor says I have had a very thorough workup and enough tests and that I don't need a bone scan, which is more radiation because the ALP is just above normal and is likely liver related because of the ast alt ggt elevations caused by fatty liver (Isoenzymes a couple of years ago showed the alp increase to liver). He also says that the chest and abdominal CT scans with contrast are very accurate and look at everything including bone ribs spine and everything in between lungs liver pancreas spleen gallbladder etc. My doctor also said given that I don't have cancer anywhere else that primary bone cancer especially in the areas I am having pain is extremely rare and the CT would have showed something abnormal. He says my Fybromyalgia, muscle tightness from extreme anxiety and worry and depression are making the pain worse because I fixate on it. 2 ER doctors who did my chest pain ecg blood workups also did not seem concerned about bone cancer
I certainly do not want to have anymore tests especially radiation ones than I need and I worry tremendously while waiting for test results. Lastly he says that allopurinol for my gout can also elevate the ALP a bit. For the past 10 years my liver enzymes are elevated and the alp is usually 135 to 170 so my doctor says 145 UL is fine. he would be more concerned if it was over 300 with a high calcium reading. My calcium and pth are normal
Sorry about the length of the post, looking for feedback and a doctors opinion please and thanks
One thing I forgot to mention is that I am also along with the chest/back pain, I am feeling breathless/tight breathing sensations from time to time which my doctor also says is part of the tremendous anxiety and worry I have been under the past few weeks. My stress test was ok on Bruce Protocol for 15 minutes 180 heartbeats with a BP of 180/66 on the treadmill. My normal bloodpressure is usually around 122 over 80 to 83
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