Ask The Doctor

Dear Ask The Doctor: Hi Dr., About 2 months ago, my Mother, a smoker, noticed a lump in her throat. After a trip to her Doctor and an ultrasound, she was told that she had several swollen lymph nodes and that the lump she was feeling was was a growth in her thyroid. She was referred for blood work, to test her WBC, which turned out to be elevated at around 12000. She was told the normal range was between 4000 and 11000. and a high level was 20000. After reading a bit online, I have learned that high white blood cell counts can be an indication of cancer, but more so for infection and inflammation. Obviously, the lump in her throat is causing inflammation. Her doctor is away for one week, so we are left with many questions. How high is a WBC when it is associated with cancer? She is 44 years old, a smoker for at least 20 years, and has severe allergies to pollen. I would really appreciate to know, from the information I have given you, what you think is the likelihood that this is cancer. I very much appreciate your time, Josh Lind

Dear Josh: It appears you are very concerned about your mothers health. It is impossible to give a proper diagnosis without a thorough history and physical exam.

When ever dealing with abnormal lab results, it is important to not look at the numbers but look at the person. Are there other symptoms? Is the patient stable, improving, or deteriorating? Are there family members with similar symptoms currently or in the past? Has this happened before tot he patient?

I understand your concern but many times in medicine the wait to see your doctor may be beneficial.  Your doctor may decide to repeat the blood test after a certain period of time to see if the WBC count remains elevated or returns to normal. This would probably be the most useful test to perform based on the information you provided before conducting more invasive testing.  Depending on the type of  cancer, the WBC count may be elevated, normal or low.

I hope this helps.