Dr. David Chism, MD

Congrats on quitting smoking. That’s an achievement and most likely you have helped yourself prevent smoking related cancers in the future. Continue to stay close to your ideal body weight and stay active as well. Establish good dental hygiene and monitor your health with your primary care doctor. If anxiety persists, contact your doctor for a brief visit. Finally, as you age, stay uptodate with cancer screening.

If ultrasound not certain, mri of liver is gold standard to diagnose primary liver cancer. Liver enzymes are mildly elevated. Primary liver cancer or hepatocellular carcinoma usually evolves from background of cirrhosis; given lack of cirrhosis, hcc is less likely but please follow up w ultrasound. Older scans if available is helpful too.

If not resolved, please have your primary care doctor take a look.

It’s very difficult to speculate based on above. Type of chemo and dose and frequency of exposure would be important to know. These details will not readily be available. In general, precautions during any receipt of chemo and those in the household are recommended.

Primary or essential thrombocytosis often occurrs with plts above 600k. Viral illnesses can result in fluctuations in lymphocytes; also iron deficiency anemia, which is quite common, can result in reactive thrombocytosis which improves with iron supplementation. Continue to monitor with your pcp and check iron levels and if persists request a referral.

Based on above, first see your primary care physician. They will likely do basic blood work and refer you to a specialist if required.

The term chemotherapy is too general to give specifics. Risks are measured for each type. For example doxorubicin used to treat breast cancers, lymphomas among others can affect the heart function requiring thorough pre-assessment; there is a long list of other side effects. When used with other particular chemotherapy it can result in cure Hodgkins lymphoma. In addition, the best rates of cure using chemotherapy includes testicular cancer with rates well over 90%. I agree chemo in general should be safer; more research in understanding how each individual process particular chemotherapy’s would be helpful. During the consenting process, the oncologists should explain in detail the indication—is it palliative or curative,—and the risks and benefits. Choice will fall in the patient whether or not to proceed understanding above. On a side note, over the past decade immunotherapy has been placed a the forefront giving patients longer responses—but they too have side effects.

I would start with a physical exam with your primary care physician.

Thanks for your question. I agree with the biopsy given the tumor's rapid growth which makes malignancy suspicious. He would need to determine if surgery is feasible with a local urologist. In regards to cryoablation, often the procedure is reserved for renal much smaller, i.e., < 4 cm diameter. Further discussion based on the results of above with his healthcare team.

False positives do exist; however, if mammogram saw a suspicious area followed by an ultrasound, biopsy is warranted. Risk factors for breast cancer can further assess whether or not a true malignancy exists, i.e., age, family history of breast cancer. I think we have to wait for the results. Your following up with this is phenomenal and takes courage; so many are lost with cancer screening in general and sometimes subsequent follow up.

In some cases, chemotherapy can have effects on the children and therefore precautions should be taken; this question should be addressed promptly with your treating physicians including your oncologist.

I recommend an evaluation with a health care provider as possible. Your primary care physician can refer you to an expert for biopsy to determine if cancer is present. If present, he or she can then refer you to a local cancer doctor who would discuss your case with other experts.

Given above, please start with a visit with your primary care physician or pediatrician asap. He or she can refer to the appropriate specialists to determine next steps. Ultimately, a biopsy must be considered.

The most effective relief is likely treatment. Night sweats are considered B symptoms and often resolve with treatment. You should discuss options with an oncologist.