Conversation: The conversation between human and AI assistant.
[|Human|] I have a history of upper back pain and have had lower back surgery.My family doctor wont refer me to a orthopedic surgeon.Now I am being treated for bladder cancer and I am concerned that the upper back pain is cancer.How can I convince my family doctor to refer?
[|AI|]  Pain in back (spine) in presence of bladder cancer should be investigated. What is your serum Alkaline Phosphate levels (serum ALP levels). This test is part of liver function tests(Lots) which are routinely performed in patients undergoing treatment for cancer. Serum ALP is also released from bones in case of metastasis to bones. See if serum ALP is high as it may indicate bone metastasis. Was your bone scan done as part of your staging investigations. If not, bone scan should be done in presence of symptoms. Please discuss it with your doctor.