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Will blood counts ever rise after last treatment?

RoseyR
Posts: 464
Joined: Feb 2011

Did any of you experience, after six rounds of taxol/carbo and radiation treatments, serious drops in your blood counts?

If so, did they eventually rise again? And did you need to take iron in order to recover?

It's ironic that I got through all the treatment with very few side effects. Was fine through first three rounds of chemo and 25 pelvic radiation sessions.

Then chemo #5 had to be twice postponed because of low platelets. Counts came up a bit for chemo #6 because my onc lowered the carboplatin just a bit.

But now that my treatment is over (for a year or two, I hope!), I'm feeling exhaustion for the first time.

My white counts are OK thanks to astragalus.

But despite two tranfusions in the past month, hemo (at worst, 7.3) is down to 8.4. And platelets, down to 24 last week, have "rebounded," the nurse joked, to 36 this week.

It's the hemoglobin that concerns me, for I am exhausted for the first time. (The end of my treatment has coincided with my return two weeks ago to full-time work. By 1:00 each day I am beyond wiped out!)

Did any of you have to contend with low hemoglobin or platelets at end of treatment?

And if so, did they rebound gradually--or did you have to take iron? (Am a bit afraid of iron as many books depict it as a mineral that cancer thrives on! But DID feel more energy after a large forbidden pork chop last night!

Appreciatively,
Rosey

lkchapman's picture
lkchapman
Posts: 105
Joined: Jan 2011

Hi Rosey,
I didn't have any problems with my blood counts not rebounding after treatment, so I can't comment on that, but I would inquire if you have been evaluated for a possible source of bleeding? You may need to undergo a colonoscopy and/or egd to assess for any possible source of internal bleeding if your hemoglobin keeps trending downward.
I'm sorry you are still not 100% after treatment.
Laura

daisy366's picture
daisy366
Posts: 1493
Joined: Mar 2009

Hi, Rosey,

I think fatigue is normal for chemo and radiation and I think it is common for it to be delayed like you mentioned (my nurse told me that I would feel fatigued a month after starting my tx). Your body (and mind) has been through so much. When we are in fight mode our bodies step up to the plate and deal with what needs to be done. Now that you are done with chemo (the fight) the body is understandably exhausted. Your return to work is certainly not restful for you. I think you are doing well to be working.

My blood counts returned to normal limits within a reasonable time after chemo. I would consult your nurse if you have any concerns. Continue to pump that water..

Wishing you the very best. Mary Ann

evertheoptimist
Posts: 140
Joined: Jan 2011

Rosy,

I did not have red blood cell or hemoglobin problem. However, I had white blood count problem. It took four month before my white blood count and neutrophilis number came within the normal range. I think it takes a while for the bone marrow to "heal".

My doctor said sometimes, the side effects of chemo can start AFTER the treatment is over, and can be worst 4-5 months AFTER the last infusion. For instance, I developed neuropathy a month after the last infusion. It's been four months, and it's much, much better.

Of course, everything is coming back to normal just in time for another chemo for the recurrence!

carolenk's picture
carolenk
Posts: 909
Joined: Feb 2011

PLEASE don't take iron unless you KNOW that you are iron deficient (you would need to check your ferritin level to know if you are iron deficient). Dietary/food sources of iron are FINE but supplemental iron will only add fuel to the fire for a cancer patient.

There is so much confusion/misunderstanding about the "anemia of chronic illness"--this is a different kind of anemia from iron-deficiency anemia.

When you have cancer/chemo, your red blood cells get "beaten up" and don't circulate as long as when you didn't have cancer/chemo. The spleen does the "quality control" of the red blood cells by inflating them as they circulate thru the spleen--if the red blood cells burst, the iron stays in the body but the red cell count goes down. This is why some people with anemia have their spleen REMOVED just to keep their red cells going longer.

Just because you are tired and anemic that doesn't mean iron is going to help. Do a Google search on "anemia of chronic disease" and get yourself knowlegable about this. When you get a blood transfusion, you are getting more iron in the form of hemaglobin. Unfortunately, those donated red cells aren't going to circulate the ususal 120 days as they did BEFORE you had cancer. So the benefit is temporary--but often very needed.

Hope this helps. Just an FYI: any MAN that is found to be iron deficient needs to be screen for colon cancer (unless he has bleeding hemorrhoids).

Carolen

RoseyR
Posts: 464
Joined: Feb 2011

THANKS, Carolenk, and the rest of you, for your advice.

I was reluctant to take iron even before I saw your messsage--and now even more so. My integrative doctor told me a few months ago that my ferritin levels were "robust"--so you're right, this low hemoglobin probably has nothing to do with low iron.

Will do all the research I can to figure out what if anything I can do that won't "feed" cancer.

And in the meantime, unless hemo continues to plunge, am not SO tired that I can't teach my four college courses and climb six to eight flights of steps a day. (All our elevators are out and being replaced at work ...)

Appreciatively,
Rosey

carolenk's picture
carolenk
Posts: 909
Joined: Feb 2011

RE: that "robust ferritin level," you don't want to see a high ferritin level either. I don't understand it, but ferritin also happens to be a marker of inflammation. No cancer survivor wants a ferritin level that is so high that it is over 200. Your integrative doctor is probably already on top of this.

Be careful of bread and wheat products as most commerically-prepared wheat products are supplemented with folate/folic acid. Many cancers feed on folate (not sure about uterine)...which makes me rethink the thought that "green leafy veggies are good for us." Methotrexate is an anti-folate therapy.

RoseyR
Posts: 464
Joined: Feb 2011

Carolenk,

Thanks so much for your advice.

Will check those iron levels Monday with my integrrative doctor.

However, isn't our CRP a marker of our inflammation levels? I've been watching them carefully via blood tests because Keith Block says they ideally should be below .01--and mine have been for months. So apparently my inflammation level is quite low.

But WILL try to make sure my iron level isn't too high. I know that green tea lowers iron levels in our bodies but haven't drunk much of it lately because platelets were so low.

Appreciatively,
Rosey

RoseyR
Posts: 464
Joined: Feb 2011

Carolenk,

Thanks so much for your advice.

Will check those iron levels Monday with my integrrative doctor.

However, isn't our CRP a marker of our inflammation levels? I've been watching them carefully via blood tests because Keith Block says they ideally should be below .01--and mine have been for months. So apparently my inflammation level is quite low.

But WILL try to make sure my iron level isn't too high. I know that green tea lowers iron levels in our bodies but haven't drunk much of it lately because platelets were so low.

Appreciatively,
Rosey

carolenk's picture
carolenk
Posts: 909
Joined: Feb 2011

Dear Rosey

There are several inflammatory markers that can be monitored. The CRP is also called "cardiac C-reactive protein" and usually indicates the risk for heart/cardiovascular disease but it can be elevated with infection, tissue necrosis, autoimmune conditions as well as cancer.

Fibrinogen (a component involved in blood clotting) can indicate generalized inflammation if elevated. While a high fibrinogen level is not good, a low fibrinogen level is more ominous as it indicates a serious condition where the clotting factors are being consumed.

Another blood test is the "sedimentation rate" (aka "sed rate") which would be elevated in generalized inflammatory conditions like arthritis and autoimmune conditions. When inflammation is present in the body, certain proteins cause red blood cells to stick together and fall more quickly than normal to the bottom of the tube. These proteins are produced by the liver and the immune system under many abnormal conditions, such as an infection, an autoimmune disease, or cancer.

Finally, the ferritin level can be used as a marker of inflammation. An elevated ferritin level is a non-specific finding. It is well known that both acute and chronic inflammation, such as found with infections, autoimmune disorders, chronic renal failure and also cancer are associated with high ferritin levels. High levels of ferritin are also found with a genetic condition called "hemachromatosis." When women have hemachromatosis, it usually shows up after they stop having periods.

It's good that your CRP is low. You might have tired adrenal glands that need attention.

Carolen

RoseyR
Posts: 464
Joined: Feb 2011

Carolen,

My integrative doctor has ordered a test of my ferritin levels as well as "iron-binding" capacity. Not sure what the latter reveals but recall that it's significant in determining if low hemoglobin is due to low iron or just to the effects of chemotherapy.

Thanks for the other insights about inflammation, however.

Block believes that soome prognostic factors for cancer include the following:

our albumin level
our CPR level
our hemoglobin level
our blood glucose level (want to keep it as low as possible)

Thanks for the information.

Best,
Rosey

JoAnnDK
Posts: 276
Joined: Jun 2011

I have never had a blood test for anything that was the least bit "off". ....I am talking lifelong! My results were always stellar. But I STILL got cancer and none of my tests were bad, so no warning. As I tell my primary care doctor, I am the healthiest cancer patient ever.

JOANN

daisy366's picture
daisy366
Posts: 1493
Joined: Mar 2009

Other than ca125 (only tested upon hospitalization for acute pain) I'm in the same club as you, JoAnn. The "healthy" cancer patient.

jackson26
Posts: 1
Joined: Nov 2011

Actually, I did not have any problem with blood count after treatment. But, my friend suffering from low Red blood problem. I think, there are many things you can do to help manage your low red blood count i.e. rest between activities, ask others for help and eat a diet with vitamins.
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