Scared by Speed of Testing, Please Help

[Geebagirl]

My brother had abdomen discomfort for a few weeks and after a stomach flu failed to "flush" what he had assumed has a blockage, he went to the doctor last Friday. After feeling his abdomen, the doctor ordered tests, including a cat scan and when they returned he gave my brother a referral to a Hematologist at a cancer center in our city for the following Wednesday (yesterday). Leukemia was mentioned.

Today, my brother went to the Hematologist and following a blood smear test with results described to me as "not good", the doctor ordered a bone marrow biopsy scheduled for tomorrow morning.

I'm *incredibly* scared and worried for my big brother, and the fact that they are getting him a bone marrow test so fast has scared me even more. My understanding is that Doctors prefer to avoid them if possible and while I'm sure that it's necessary I am wondering if it is common for a Hematologist to be able to get a patient in to have this test done so quickly? Does that mean he's in worse shape? I don't want to ask him these questions because he's got enough stress on his plate, but I'm going crazy with worry. If *anyone* can help and just let me know if this is or is not a normal time table from referral to biopsy, I'd appreciate it. Even if it is indicative of him not doing well (well... as well as one can be when diagnosed with Leukemia) it would ease my mind to at least know that.

[Ken_PA]

hi, it might take a little of the mystery out to see an actual image, if you haven't already:
http://www.nlm.nih.gov/medlineplus/ency/imagepages/1217.htm

and then a list of possible causes might take away some of the worry:
http://www.nlm.nih.gov/medlineplus/ency/article/003665.htm

The presence of teardrop-shaped cells may indicate:
Myelofibrosis
Leukoerythroblastic anemia
Thalassemia major
Severe iron deficiency

it's one site, but being NIH I'd regard those as the common causes

a quick look (sorry I might be wrong, doing it quickly) says that #2 is the worst, but probably doesn't apply because of your/his age being not consistent with prostate cancer. So that's good news, I'd think.

Also:

#1 usually >50 yrs age
#3 usually in infants

#4 does he have bad shortness of breath?

(also "feeling his abdomen" was probably looking for enlarged spleen)

[Geebagirl]

Thank you so, so much for replying. He's got the results of the liquid test back, and it came back negative. So at this point we're waiting for the solid test.

I'll ask him about the CBC. I did find out that he had teardrop shaped red blood cells, so there is obviously something very wrong going on.

Again, thanks for the reply, well wishes and the guidance. It is greatly appreciated.

[Ken_PA]

Hi. Sorry to say but you are right to be concerned. However, AFAIK the BMB will generally be done right away or not at all. How quickly the procedure gets scheduled is not a function of how good or bad things seem.

What *is* a function of severity would be how quickly any chemo is insisted on. Some cases are watch-and-wait, others call for starting treatment ASAP.

So keep in mind that there are many varieties or subtypes. Prognosis can vary a lot, so hope for the best.

What I'd do is get a copy of the CBC and other tests. Then it's possible to know pretty much what the docs are thinking. Good luck.