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Hello,
   5 years ago I was diagnosed with clear cell renal carcinoma. They did a open partial nefrectomy. It was stage. 1 grade 3.  One year ago there was a mass in the other kidney. It is small and stable so we are watching it. I have been recently been falling a lot and I broke some ribs. Had a bone scan done last month, along with some blood work the bone scan came up wth mild diffuse increase uptake in the calvarium likely due to hyperostosis. I have had a headache for 2 months and the last month dizzy and nausea.
I had labs in May which were,
Creatinine.    .70.     Normal for me never been higher than .80
Calcium.       10.0.    Higher never been over 9.7
Other wise everything was normal.
I am having a Mri of the head so I had a new test for Creatinine which was 1.0
I had a Pth intact which was 71 normal range is 14-64
Alright my questions are:
1. Should I be concerned and alert my medical team at the Mayo clinic? Or is it ok to wait until end of September? Would you care about the levels jumping in a month or is that normal to fluctuate?
2. Does the Pth intact test have anything to do with Kidney Cancer?
3. Hyperostosis is that cancer related?
Thanks for all your help. I really want to be prepared for anything so I would appreciate anything you can tell me. I realize this is over the internet but if you can help me that would be great.mthank you

Answer
Sarah:
Hyperostosis may be cancer related in some people, but it is not typical for renal cancer.

An elevated PTH suggests hyperparathyroidism which is suggested also by the relatively high serum calcium at 10.  You should make your physicians aware of this as they can repeat the lab tests just before your visit to see if they have changed as you could have hyperparathyroidism.

High urinary calcium in patients with renal cell carcinoma frequently mimics primary hyperparathyroidism and has been attributed to tumor secretion of parathyroid hormone related protein.  In other words, the two can appear somewhat similar.

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Stephen W. Leslie, MD

Expertise

Questions concerning erectile dysfunction, kidney stones and prostate disorders including prostate cancer. I have a special interest in kidney stone disease prevention.

Experience

Full time practicing urologist with 30 years experience. Associate Professor of Surgery and Chief of Urology at Creighton University Medical Center. Editor in Chief of eMedicine Urology internet textbook. Author of only NIH approved book written for patients by a urologist on the subject of kidney stones "The Kidney Stones Handbook". Inventor of the "Parachute" and "Escape" kidney stone baskets and the "Calculus" stone prevention analysis computer program.

Organizations
American Urological Association, Ohio State Medical Association, Sexual Medicine Society

Publications
Men's Health, Journal of Urology, Urology, Healthwatch Magazine, Emergency Medicine Monthly, eMedicine, "The Kidney Stones Handbook", and numerous articles in various newspapers. He is also the editor of the Urology Board Review by McGraw-Hill used by urologists to study for their Board Certification Examinations.

Education/Credentials
Graduate of New York Medical College with residencies completed at Metropolitan Hospital New York, Albany Medical Center and University of Wisconsin-Madison.

Awards and Honors
Thirlby Award of the American Urological Association. Rated as one the country's Best Urologists by the Independent Consumer's Research Institute

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