Can a doctor rule out cancer with a simple cbc test?

Question

I've got swollen glands on my neck, behind my ear, on my upper back (close to base of neck). I've had itchy skin all over, some increasing breathing problems, and intensifying fatigue. My mother had Hodgkin's Disease around my age (I'm 27). My doctor seems to laugh me off, and says my blood tests are normal.

I know Hodgkin's isn't genetic, but I've read family history places you in a higher risk category.

Answer 1

I can appreciate your apprehension and concern regarding your symptoms of swollen glands, itchiness of your skin, some difficulty breathing, and intensifying fatigue especially since your mother had Hodgkin's Disease in her late twenties. You are quite right that a normal CBC blood test is not "the Gold Standard" for ruling out the diagnosis of Hodgkin's. "The Gold Standard"is a lymph node biopsy. By the way, Medical Research indicates that genetic, immunological, and viral factors interact to cause Hodgkin's in a yet unknown process. I am a Registered Nurse Educator who taught nursing for over 25 years so provide my information from approved Medical sources and resources. Hodgkin's does have specific blood markers characterized by proliferation of abnormal histiocytes called "Reed-Sternberg cells". These Reed-Sternberg cells , a specific diagnostic feature, are malignant histiocytes with large, multinucleated cells. These cells are often seen in lymph node biopsy material BEFORE THEY APPEAR IN PERIPHERAL BLOOD OR IN THE BONE MARROW. I capitalized the previous statement for intended emphasis;i.e. a negative blood test whether a CBC or specific evaluation of the blood for these abnormal histiocytes called Reed-Sternberg cells is of little value given your symptoms and Medical History. As you are probably aware, patient complaints may include weight loss, fatigue, weakness, fever, chills, rapid heart beat, and night sweats. Generalized pruritus (itchiness)without skin lesions, cough, difficulty breathing, and difficulty swallowing may also be present depending on the type of lymph node involvement. My RN experience and training taught me that peripheral blood analysis including special blood tests, lymph node biopsy, and radiological evaluation are ALL important means of evaluating Hodgkin's Disease. Since you do appear to have significant signs of Lymphatic Disease I think that it is time you were evaluated by a physician who specializes in this area of Medicine and who has had lots of experience diagnosing these kind of diseases. I would start with an Oncologist and preferably one who has specialized in lymphatic and hematologic (blood) diseases.( I had two large malignant breast tumors each containing a different type of cancer and was told that everything was fine as a result of a normal CBC and a normal Mammogram) So I congratulate you for reaching out to others in your path to obtain healing for yourself. Good luck to you and God's blessings. Please make that next Medical appointment as soon as you are able to do so.

Answer 2

As a general rule, if a doctor uses just the CBC as a diagnostic tool, he or she is a fool. With swollen glands, the only thing they will find out is if there is a possible infection in your body. Could be an elevated white count, but is it from the swollen glands, or some other infectious process going on in your body.

There are test for cancer markers and if your comfortable with your doctor, fine. If not, get a second opinion and don't waste a lot of time doing it. Something is telling you it isn't right, so, get on with a second opinion.

Answer 3

A normal CBC does not rule out lymphoma.
However, lymphoma may cause a lower platelet count. Occasionally, lymphoma cells do appear in the peripheral blood, but it is not likely they will be at high enough levels to be detected by routine testing. Although Reed -Sternberg cells are diagnostic, they are generally seen in the bone marrow - in the peripheral blood I have seen very early cells - blasts - the same as in leukaemia, but again uncommonly. To be certain, a biopsy of one of the affected nodes would need to be done. Most lymph node swellings are due to viral illnesses, which may well be apparent in a routine CBC as a raised lymphocyte count or by the presence of atypical lymphocytes.

Consider this - if you had such an advanced stage of lymphoma that nodes would swell on several parts of your body, your CBC would unlikely to be normal. There would likely have been a low haemoglobin and platelet count, and possibly supression of other white cell lines such as neutrophils. I can't be certain, but this sounds like a viral condition.

This, of course, is general advice only. A doctor will advise you better (possibly differently), because they have you there in person. If you're not happy with your doctor, ask to speak to an Oncologist or a Haematological Pathologist at a hospital laboratory, they have the knowledge and experience.


I hope this helps

Answer 4

It is no laughing matter, but Hodgkins disease is not genetic,and if your doctor says that the CBC is normal, don't worry about it. There are lots of bugs with the same symptoms, and worrying will only make them worse.
Of course, you entitled to get a second opinion if you are not satisfied. Personally, I would advise it, if for nothing else than your own peace of mind.

Answer 5

The blood test is probably pretty good for this type of cancer, the fact that your blood is normal is a good thing. That still does not answer why you have all those swollen glands and everything else. Maybe it is time to see another doctor, maybe one that did not graduate at the bottom of his/her class. No doctor should laugh this off.

Answer 6

No
you need to get a biopsy for a definitive diagnosis

Hodgkin's lymphoma must be distinguished from non-cancerous causes of lymph node swelling (such as various infections) and from other types of cancer. Definitive diagnosis is by lymph node biopsy (removal of a lymph node for pathological examination). Blood tests are also performed to assess function of major organs, to detect lymphoma deposits or to assess safety for chemotherapy. Positron emission tomography (PET) is used to detect small deposits that do not show on CT scanning. In some cases a Gallium Scan may be used instead of a PET scan.

Answer 7

I asked a question very similar see my answer from a doctor
the answer states that a cbc can not rule out hodgkins they need a biopsie of your lymph nodes

Answer 8

u cant rule out cancer just by cbc....u need biopsy of those glands if they are consistently swollen...

Answer 9

yes....the test counts the white blood cells for either cancer or AIDS....so it is a effective test.

Answer 10

It is possible but if you have concerns get a second opinion.