Looking For Benefit of Experience

Hey guys,

I'm a 42 year old man from Michigan.  After a July of feeling a little more run down than normal, although still keeping up my normal activities of walking the dog a mile a day, playing tennis and baseball, and hiking in the woods, I found myself feeling utterly fatigued and just generally drained by mid-August.  It was hard to get up the energy to take the dog to the dog park, for instance, and I wanted to nap 2 or 3 times a day, which was impacting my ability to sleep through the night.

On a Saturday morning I woke up and was unable to eat my breakfast -- it just didn't seem appealing -- and ate little throughout the day, continuing to feel fatigued.  By this point, anxiety began to overwhelm me and I took a trip to a nearby urgent care that accepts my insurance.  The doctor looked me over for maybe three minutes -- listened to the chest, looked down the throat and in the ears, and declared I had a sinus infection.  But from that point forward the fatigue and tiredness worsened and my appetite all but vanished.  All told I ended up going about a week to a week and a half without eating much more than a couple hundred calories of food in a single day and lost somewhere in the neighborhood of 15 pounds.  During this time, I visited a different, and better equipped, urgent care, who did just about the whole works on me.  Chest x-ray (negative), urine analysis (positive for UTI), complete metabolic panel and several other blood tests.  The Nurse practitioner also diagnosed me with a sinus infection.  The blood tests came back showing high WBC and specifically high neutrophils, as well as elevated alkaline phosphatase and low testosterone.

A few days later I saw my PCP, who gave me more or less a cursory once-over and said I'd be fine.

Two days after that, with my appetite still nonexistent and worried about that and my weight loss, I decided to go to the emergency room.  They admitted me to the hospital almost immediately and ran a series of tests.  Initial blood tests showed elevated neutrophils and WBC but those went back to normal after some IV antibiotics.  The tests also showed an elevated ALP, although all other liver enzymes were fine.  An abdominal and pelvic ultrasound and an abdominal CT scan showed, however, a 3.2cm solid mass on my left kidney as well as gallstones and sludge in my gallbladder.  All other internals -- liver, pancreas, spleen, etc -- looked normal on CT and ultrasound.

I have a long history of severe anxiety disorders going back to childhood, and anxiety and stress always make me feel much worse than I actually do.  In the hospital, in addition to giving me saline and antibiotics, they also gave me Ativan (which my PCP had refused to prescribe) and my my appetite immediately began to come back.  In fact, while in the hospital for 3 days, I was largely restless to the point that I badgered them into giving me a campus pass so I could wander around off my floor.  

While at the hospital I consulted with a Urologist and was discharged with orders to follow up with him within a week.  I got an appointment within a few days.  I have since consulted with two urologists (the initial one, and his partner, who is a surgeon) who both say that the size of my tumor and the evidence on the CT scan and the general prognosis with tumors of that size all suggest that there has been no spread and that the renal tumor is likely not causing my symptoms.  I have surgery scheduled for the 28th to have the turmor removed.

In the meantime, since being released from the hospital, my appetite has mostly returned to normal.  I have managed to gain back a pound or two, anyway, and am eating upwards of 2000 calories worth of food a day.  However, I am still feeling fatigued and achy, especially in my lower and middle back, and a test ordered by my PCP shows elevated bone-specific ALP.  I am stressed out about the prospect of bone metastasis, but I know that when I am on my anti-anxiety meds (PCP finally prescribed Klonopin along with Buspar) I feel better and 90% of my symptoms go away.  Still, the anxiety is like a monkey with its claws in my brain.  All the empirical evidence -- small tumor, nothing else amiss on the chest x ray, abdominal and pelvic ultrasound, and abdominal CT scan (as well as a very low PSA level) -- suggest there is nothing cancer-related that's causing my symptoms of fatigue and tiredness and general achiness.  Add to that my history of anxiety and the fact that when my anxiety and stress are at low ebb I feel fine, and I'm not quite sure what to believe.

Does anyone else have a similar experience?  If there is no evidence of metatasis to nearby tissue or lymph nodes in the CT, could the cancer have spread directly to the bone and not shown up on all those scans?  What could be causing the elevated bone-specific ALP?  I am a smoker, I have been taking Prilosec daily for about two years, and I probably don't get a lot of calcium in my diet (although my serum levels of calcium on the blood test were normal).  Two years ago or so I had bone pain in my shins when I started walking daily to get in shape and lose weight.  Prior to that I'd had problems with shin splints while playing roller hockey.  

Any advice would be appreciated greatly!