Blood Tests

[Ran2599dy]

Trying to determine what are the important blood tests one should have when battling metastatic prostate cancer.

[Tall_Allen]

PSA/PSADT is the most important. If it is metastatic to the bone, bone alkaline phosphatase is important. If you are on ADT, periodic checks of your T level is important, and the occasional lipid panel. The normal blood work and urine tests are important to monitor normal organ and bone marrow function. It's not a blood test, but periodic Dexa scans are a good idea too.

[mklc in reply to Tall_Allen]

Thank you so much for this information. The doctors never tell you this!! WArm regards,

[pjoshea13]

I would add that standard measures of inflammation are useful. They are predictive of survival. Cancer is an inflammatory disease, but inflammation can be reversed.

See my posts on:

"Inflammation. [1] Neutrophil-to-Lymphocyte Ratio [NLR]"

"Inflammation. [2] Albumin & C-Reactive Protein [CRP]"

"Inflammation. [3] SedRate, Fibrinogen, IL-6, TNFalpha."

Also, D-dimer is indicative of active blood clots. Cancer changes factors in the coagulation cascade. Nattokinase can break fibrin down fast. No need to end up in the ER with a DVT or a clot in the lungs. Some argue that micro-clots are needed for metastasis. Even when one already has mets, elimination might be useful.

-Patrick

[DrWrite in reply to pjoshea13]

"Persisting adverse body composition changes 2 years after cessation of ADT for localised PCa....Persisting adverse body composition changes 2 years after cessation of ADT for localised PCa."

[EdBar]

Ditto to what Tall Allen has listed also important to get red blood cell count, hemoglobin, etc. if you are on ADT since it can cause anemia which will add to the fatigue that ADT causes (perhaps this is what he meant regarding bone marrow function). If this is the case then dietary modifications and an iron supplement may be in order. I also get my DHT level checked every 3 months.

Ed

[Ran2599dy]

Thanks for all the good information. I like to keep my DHT under 5 per Dr. Myers.

Any thoughts?

[Hidden]

Here are the tests which my Medical Oncologist have run quarterly since 2004. As he is in Prostate Cancer Research, they are probably very different than yours. I do know where I stand healthwise.

ELECTROLYTES:

SODIUM LEVEL

POTASSIUM LEVEL

CHLORIDE LEVE

CO2 LEVEL

ANION GAP

CHEM PANEL:

CREATININE

eGFR

BUN

B/C RATIO

GLUCOSE LEVEL

URIC ACID

PROTEIN TOTAL

ALBUMIN

GLOBULIN

A/G RATIO

CALCIUM LEVEL

PHOSPHORUS

MAGNESIUM LEVEL

ALT (SGPT)

AST (SGOT)

ALK PHOS

LD (LDH)

BILIRUBIN TOTAL

Vitamin D 1.25 (OH02 Total

Vitamin D, 25-OH Total

Vitamin D2 1.25 (OH)2

Vitamin D3 1.25 (OH)2

ALK=PHOSPHATEASE BONE'ALK-PHOSPHATASE LIVER

CHROMOGRANIN-A

Alk Phos Intestine

LD-1 ISOENZYMES:

LD-1

LD-2

LD-3

LD-4

LD-5

LD TOTAL

LIPIDS: (Note: Lips are a courtesy for my Cardiologist)

CHOL / HDL RATIO

CHOLESTEROL LVL

TRIGLYCERIDES

HDL CHOLESTEROL

LDL (Calculated)

VLDL

SPECIAL CHEMISTRY:

PSA

Free PSA

% Free PSA

PARATHYROID PROFILE:

INTACT PTH

ENDOCRINOLOGY:

PROLACTIN

DHEA Sulfate

Testosterone Total

hs Testosterone

DHT by LC-MS/MS

Testosterone Free

CBC:

HEMOGLOBIN

WBC

RBC

HEMACRITS

MCV

MCH

MCHC

RDW

Platelet

MPV

DIFF:

SEGMENTED NEUTROPHILS

LYMPHCYTES

MONOCYTES

EOSINOPHILS

BASOHILS

SEG-Band #

LYMPH#

MONO#

EOS#

HEM:

SED RATE

COAGULATION:

PROTIME

INR

aPTT

URINALYSIS:

U TURBIDITY

U COLOR

UA pH

U SPEC GRAVITY

U GLUCOSE

U BLOOD

U PROTEIN

U UROBILINGEN

U NITRITE

U WBC/HPF

U RBC/HPF

U BACTERIA/HPF

U SQUAMOUS EPITH/LPF

U AMORPHOUS/HPF

U RENAL EPITHELIA/LPF

U MUCUS/LPF

MICROSCOPIC REQUIRED

IMMUNO:

CRP

TUMOR MARKERS:

CEA

Keep kicking the bastard.

Gourd Dancer

[BigRich in reply to Hidden]

Between two doctors I get half of those tests, your doctor is very through.

Rich

[curt504a in reply to Hidden]

Tnx Gourd, but my talking to cancer Drs they have their approach to the above values and ratios of these values that just getting tests and the 'norm" ranges won't tell. Its in the tea leave interpretation of these tests is my view. In my hands getting these tests is a waste. But if I knew the ratios and good and bad trending directions I might be able to guess more. I have talked to Drs who say my blood tests are proprietary and won't talk about them... Just saying that tests aren't sufficient, one needs knowledge in interpreting most tests beyond CRP, PSA etc.

Any helps with more details re each test and interpretation re PCA or cancers in general? Patrick offered the CRP/albumin helps.

[Ran2599dy]

Wow - you must have great insurance. Medicare may not cover some of these tests.

Great Information

Thanks

[Hidden in reply to Ran2599dy]

i only pay the cost of my Medicare and Supplemental. Nothing out of pocket.

[j-o-h-n]

Test number one. Do have any?

Good Luck and Good Health.

j-o-h-n Wednesday 06/27/2018 6:43 PM EDT

[curt504a]

I buy my own blood tests from lef.org , or many many other DIY blood testing places. lef.org has blood work done at same LabCor as your Dr and `1/2 the costs of co-pay. Theres a rip off going on with co-pays, its actually more than cost + profit. LEF / others can charge a normal price and be about 1/2 of my co pay. I pay for all the tests I want...

[Ran2599dy in reply to curt504a]

Great Information. I forgot about LEF