My Sister-in-law was diagnosed 4 months ago with squamous cell carcinoma of the lung with metastasis to the humerous and pelvis.  She presented today with a bilirubin of 15, but her liver enzymes are normal and there is no biliary obstruction.  Over the past year, she was having a problem with anemia for which no one could find a cause.  Could her elevated bilirubin level be related to some sort of hemolytic anemia leaving an increased amount of bilirubin in the bloodsream?
Hi & Welcome. It is unfortunate to know that your sister-in-law is diagnosed to have squamous cell cancer of the lung with bone metastasis. Based on the history given, she seems to be suffering from hemolytic anemia. It is a form of anemia due to hemolysis, the abnormal breakdown of red blood cells (RBC's), either in the blood vessels (intravascular hemolysis) or elsewhere in the human body (extravascular) resulting in increased formation of bilirubin. She needs to be evaluated by a hematologist or physician for the proper assessment and treatment of anemia which may involve blood transfusion and certain immunosuppressive Chat Doctor. Hope this will help her.