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Oncology (General Cancer)/Recognizing cancer in a person with chronic illness

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Question
I have several rare disorders, making me a complex patient and a medical zebra.

There are several people in my support group who died from cancer because their symptoms were chalked up to being part of this rare stuff we battle. With another woman in the group just diagnosed with Stage 4 cancer and an identical story with her symptoms being excused away by her doctors until they could no longer be ignored, I think it wise to educate myself to hopefully avoid following the same path.

With my family history and risk factors, I believe it is most likely that if I were to get cancer, it would be skin, blood, or bone. Skin cancer I know what to do with and am set. (Sunscreen, shade, see  doc for suspicious looking spots which are well illustrated and defined, 6 month check-ups, biopsies and removals as needed, etc.)

Blood and bone cancer, not so much. Can you please point me toward similar preventive education on signs and symptoms of blood and bone cancer? Do you have any advice for a person in my position on how to prevent cancer from going undetected because it is chalked up as part of one's preexisting conditions? Also, as a person with chronic health issues, it is easy to overlook new annoyances. What are some things that absolutely shouldn't be ignored when it comes to blood and bone cancer red flags? Are there early warning signs that stand out?

If you know a link that covers this, it would be great, too. Whatever help you have is much appreciated!

Answer
If I knew more about your rare condition, I could help better.  If I knew what kind of blood and bone tumors were associated with your condition, that would help as well.  With bone tumors, the first sign is usually pain or a fracture.  Sometimes the blood calcium level and/or the "bone alkaline phospatase" goes up, but you aren't going to get anyone to order those tests routinely -- and we don't know if they make a difference in the long run.  As for blood problems, the first signs have to do with the signs of anemia (shortness of breath, easy fatigue, pallor) or infection, or bleeding.  Some "blood cancer" also starts with enlargement of the nodes, the spleen, or the liver.  Again, other than being aware of changes in your body there aren't any sure ways of picking these things up before they happen, and if you did, we don't know if it would make a difference in the long run.  The best thing would be to have a good physician who understands your whole situation and knows about the ins and outs of your basic disease process -- and then put your trust in him/her.  Hope this helps.

Oncology (General Cancer)

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Donald Higby, M.D.

Expertise

I can answer almost all questions related to the treatment and natural course of most kinds of cancer, especially cancers of prostate, colon, lung and breast.

Experience

I have been a practicing medical oncologist for 36 years, and have been chief of service at a major medical center for 25 years. I've also done research in cancer treatments.

Organizations
American Society of Clinical Oncology

Publications
New England Journal of Medicine American Journal of Medicine Journal of the American Society of Clinical Oncology Hematology Transfusion Medicine

Education/Credentials
MD, Stanford University Internal Medicine residency, St. Louis University School of Medicine, St. Louis, MO Medical Oncology Fellowship, Roswell Park Cancer Institute, Buffalo, NY

Awards and Honors
America's Best Physicians, last 14 years

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