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This question was answered on Wed 20, Feb 2008 11:44am by Dr Bobby V, MD

cancer - lost 10 lbs in 3 weeks without trying: Chances of cancer


    
Asked by cctrn8920 (Male ) on Tue 19, Feb 2008 03:10pm

lost 10 lbs in 3 weeks without trying, urinating at night 3 times after going to bed, CT of head pelvis neg. ct of liver show two hemangiomas, psa, 24 hrs urine, thyroid okay. no blood in urine, no loss of appeptite.no headaches, DM ruled out. I feel normal. what are the chances I have some type of cancer?

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Answer by Dr Bobby V, MD  on Wed 20, Feb 2008 11:44am:

Hi, The symptom worrying you the most is unintentional weight loss, and you would like to rule out cancer as the underlying cause. Another symptom bothering you is that you have to get up a few times at night for urinating. There are many causes of weight loss. Gastro-intestinal causes of weight loss include infections (salmonella etc), infestations (giardia, amebiasis etc), bacterial overgrowth syndrome, inflammatory bowel disease, pancreatic causes (diabetes), short bowel syndrome etc. The predominant symptom in most of these conditions is diarrhea and abdominal discomfort. From your short description, it appears that you do not have significant gastro-intestinal symptoms. Diabetes too has been ruled out in your case. Hyperthyroidism causes heat intolerance, tremors, palpitations, and weight loss. Your normal Thyroid Profile result rules this out. Prostate Specific Antigen (PSA) too is normal, and argues against prostate cancer as a cause of your urinary symptoms. You have undergone imaging of head (because midline meningiomas can cause urinary complaints), abdomen and pelvis (to look for prostate enlargement and any abdominal mass like lymphoma, colon mass etc). The CT scans were normal. Urine test negative for blood indicates that there is no gross involvement of renal pelvis, ureter, bladder, or urethra by any lesion. Your appetite is good, and you “feel normal”. These are all good signs. So now, we have to look harder to find the cause of your weight loss, and rule out less likely causes. These include connective tissue disorders, malabsorption, and colon lesions. First you need to get all baseline investigations done including hemogram, liver and renal functions, Chest X-ray, HIV serology, HBsAg, routine stool microscopy, and routine urine microscopy. Additionally you should get a colonoscopic examination, stool for occult blood, fat estimation and parasites, erythrocyte sedimentation rate (ESR), serum LDH, and serum CRP. From your current symptoms, it is unlikely that cancer is a cause of your weight loss. However, you need to work with your doctors to identify the underlying cause. Are you a smoker? What is your age? Do you have low grade fever? Have you noticed any joint pain or skin rashes? Have you had diarrhea recently? Have you traveled to a foreign country recently? Did your CT scan include a Thorax CT too? Have you noticed the presence of any lymph node swelling?

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