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Molly Maloof, MD

Director of Clinical Content

22 year old, pancreatic cancer?

ello. I'm a 22 years male. I don't smoke or drink i don't have diabetes and no one in my family had ever got cancer . I weigh about 130kg and I'm 180cm tall. It starts when i noticed my stool was a bit light in color. At first i didn't think much of it and it didn't change for about a year now. Then i read on the Internet that it could be pancreatic cancer so i got really scared. I went to the doctor and did some tests. Liver enzymes (ALT/AST) were elevated (140/58). Total bilirubin was 1 ( norm
  • Male | 22 years old

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1 UpVoted this answer
I'm glad that you are already seeing a doctor to address this but you didn't mention what, if any, testing your doctor has ordered after getting the test results you have mentioned. You need further blood tests to evaluate causes for elevated liver enzymes such as exposure to hepatitis, autoimmune disorders, tests to check for autoimmune hepatitis, Viral infection such as Ebstein Barr Virus, tests to evaluate for heavy metal disease including copper and iron deposition on the liver and other tests. Your doctor can refer you to a gastroenterologist to have this liver enzymes elevation worked up. You should have at the very minimum a liver and gallbladder ultrasound done as well and if needed a CT of you abdomen can be obtained as well. Only thing you haven't mentioned is if you take any medication. Even over the counter medications such as Tylenol(acetaminophen) can cause abnormal liver function tests so it's use should be evaluated. Based on your weight, the possibility of fatty liver disease called NASH(Nonalcoholic Steatohepatitis) is highly likely and if all your bloodwork work up yields no specific problem, then a liver biopsy to confirm the diagnosis will be needed. I have had several patients with such liver enzymes and it has turned out to be NASH. It's is a reversible problem with weight loss. Have your doctor check a fasting cholesterol profile and a fasting blood glucose level and if your triglycerides and glucose is elevated then this would support NASH even more. Hope this helps.
Pancreatic cancer is a rare disease and even rarer in young people. The LFTs are minimally elevated, blirubin is normal, no weight loss. There are far more likely cuases for LFT abnormalities, like alcohol and medications, or hepatitis. An ultrasound of the liver, pancreas and abdomen will be helpful to evaluate and would also rule out pancreatic cancer and gallstones.
Klaus Hollmig
Follow up with your doctor and get to the bottom of why your liver function tests are abnormal.
Your age , symptoms and family are not consistant with a cancer but there is a reason the liver function tests are abnormal. Fatty liver has been shown on the ultrasound and the best treatment for that is weight loss but you also need to check for mono, hepatitis a, b, c etc.....all of which can be done by routine lab tests. Be careful with supplements of any kind..they could help or they could hurt...I would stick with the basics of diet and exercise once the additional labs are done ...also you should repeat the labs in 3 months or so...Best of luck...I wonder if you are in north america because you are using metric ....
There is definitely something going on in the digestive tract, but the lab tests are for the liver. You'll need to go back and get pancreatic lipase and amylase tested. Continue to stay away from alcohol. Many people with pancreatic cancer recover seeing Dr Gonzalez in NYC (not that you have this, though). Lighter stools are usually a gall bladder thing. Any difficulty with greasy foods? Do you eat fruits and veggies daily as opposed to the junk your friends eat? I would definitely want to find out why the liver enzymes were up and if this doctor can't help you find someone else, or go to find someone near you.

One way to help the liver is with a castor oil pack.
As others have said, fatty liver could be the problem and at a minimum I would work on weight loss and recheck the liver enzymes in 1 to 3 months. However, the ALT is a little high for fatty liver alone and I would make sure that your internist checked for other things as well such as celiac disease or thyroid disease.
FAtty liver could be the problem. You should really do further testing and there is evidence that taking Vitamin E may help reverse non alcoholic fatty liver disease. See an internist who specializes in liver problems.
Im sorry I posted a longer message but it was cut. I did an US and they found a fatty liver. but I also did a urine analysis and traces of bile pigments were found. is it normal?
This is not likely pancreatic cancer as light colored stools is a result of blockage of the bile ducts which leads to pale stools. Your bilirubin was normal. With liver enzyme elevation I would make sure your doctor considers whether you might have viral hepatitis or steatiohepatitis (fatty liver). Some bloodwork and a liver ultrasound would be the first step. And then depending on these results sometimes your doctor may consider obtaining a liver biopsy.
Alberto Montero