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My telopeptide markers in my urine are a bit high. My other bone turnover markers are all good. For example, bone specific alkaline phosphatase was 26.3 (range should be 14.2-42.7).
I have very dense bones, so I would think these should be low. However I am 58, so maybe that's why they are raised.

collagen cross-linked n-telopeptide (NTX) is 86 (should be 4-64)

collagen type 1 c-telopeptide (ctx) is 529 (should be 40-465)

1.Do you think these indicate bone cancer?

2. Do you think A/C chemotherapy can increase bone turnover?

Category: Oncologist

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Category: Hematologist
 21 Doctors Online

Thank you for your query at
Dear patient,
These markers can be elevated in many conditions and not very specific for cancer. These will be elevated in all conditions where there is a bone remodeling occurring irrespective of the bone. considering your age, prior (dense) bone condition, normal marker levels, negative scans and asymptomatic status, I definitely would not consider metastases to bone now.
Kindly be assured that there is no sign of any bone spread at this point of time.
Feel free to ask queries.
Kind regards.

Patient replied :

I'm worried about cancer getting worse during chemo. I've heard it can actually spread or get bigger. In what cases does that happen? Is it likely to happen in my case?

Hello. Thank you for writing to us again.
A responding cancer will not get worse during chemotherapy. If tumor grows it will be obviously evident. There are no specific conditions which can be cited here. This is very unlikely to happen in your case due to high ER positive status.
Feel free to discuss further,

Patient replied :

Thank you.
Question #1: Why does the high ER positive status prevent the tumor from growing during chemo?
Question #2: Also, it occurred to me that since the cancer is lobular, and divides slowly, it could grow during chemo, because the chemo only works on quickly dividing cells.
Thank you.

Hello. Thank you for writing to us again.
This implies more technical medical answer which is very difficult to explain over email consult. This needs to be personally explained to you with each step of normal and cancer cell cycle pathways with lucid explanations.
A possible short answer:
1. High ER is a marker of good prognosis due to slow growth
2. This does not mean chemo does not act on slow growing cells. Chemo acts by causing DNA damage which kills the cells during subsequent cell replication.
Feel free to discuss further,

Patient replied :

So am I correct in saying that it is highly unlikely that my cancer will progress or metastasize during chemo?

Yes. A regressing / responding tumor will not metastasize during chemo.

Dr. Prasad Eswaran
Category: Hematologist
Doctorate in Medicine (Fellowship in Oncology), DM,  Madras Medical College & Govt. General Hospital, Chennai, India.

Doctor of Medicine (Residency in Radiation Oncology) , MD, Christian Medical College, Vellore, Tamilnadu, India, 2004-06.

Diploma in Medical Radiology & Therapy (Residency in Radiation Oncology), D.M.R.T, Madras Medical College & Govt. General Hospital, Chennai, India, 2004-06.

Bachelor of Medicine & Bachelor of Surgery - M.B.B.S, Govt. Stanley Medical College & Hospital, Chennai, India, 1998-2004.
Dr. Prasad Eswaran and 4 other Medical Specialists are ready to help you

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