Low Platelets

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boxhill
Posts: 118
Joined: Fri Apr 06, 2018 11:40 am

Low Platelets

Postby boxhill » Tue Jun 12, 2018 6:59 pm

Despite feeling great, I wasn't able to be infused for Round 4 today. My platelets had sunk from 104 last time to 63. My WBC has gone down to 2.4 (I started out at 2.9), but it's the platelets that have taken a nose dive from a starting point of 179.

I told them I wanted to power on through if at all possible, but the oncologist said no way. If the platelets went down further after this treatment I could be in serious trouble. So my infusion is being put off for a week, and they are considering reducing the oxaliplatin dose going forward.

I'm frustrated, and worried that I won't derive maximum benefit with a lower dose. But it appears that there is basically nothing I can do to bolster the platelet production.
F, 64 at DX CRC Stage IV (or "3 1/2" per Dana Farber consult, LOL)
3/17/18 blockage, emergency surgery, r hemicolectomy
11 of 25 nodes
5 of 5 mesentery nodes, matted
0.5 cm sub-capsular liver met removed
pT3 pN2b pM1
Neg CEA, neg BRAF, KRAS G12D, germline mut ATM
dMMR, MSI-H, Neg for Lynch
5/4/18 FOLFOX started
Added Neulasta 6/28/18
7/9/18 CT scans show no masses or enlarged nodes, 2mm indeterminate lung nodule

DebZ
Posts: 83
Joined: Fri Nov 14, 2014 9:01 pm
Facebook Username: Bulc

Re: Low Platelets

Postby DebZ » Tue Jun 12, 2018 9:16 pm

My new norm for platelets is low 50s and I still get chemo. My oxali is around 60 to 70 % strength, and we have to stretch it out to every three weeks. We've been tossing around different things to try to get the platelets up because it's a real concern. Disqualifies me from some trials.
48 @ diagnosis Sept 2014
MSS; Kras mutant G12D
Oct 2014: right hemicolectomy
Dec 2014-May 2015: Folfox
June 2015: clean scans
Sept 2015: scans reveal ovarian mass and liver met; Folfiri
Jan 2016: liver wedge resection and hysterectomy
April 2016: multiple lung mets; Folfiri+Avastin
June 2017: lung mets growing; switch to Folfox+Avastin
Jan-April 2018: dropped oxali; CEA rising
May 2018: back on Folfox+Avastin, add pulse steroid treatment to get platelet count up (continuously in 50s)

boxhill
Posts: 118
Joined: Fri Apr 06, 2018 11:40 am

Re: Low Platelets

Postby boxhill » Wed Jun 20, 2018 8:12 pm

And this week it's neutrophils! Down to 0.7, won't treat under 1.0, afraid chemo today would push it below 0.5 and I would be open to potentially serious bacterial infections. I'm willing to risk it, but my oncologist isn't.

My platelets are back up to 175, my hematocrit has just edged up into the normal zone for the first time at 34.6, and Hgb is the highest it's been, at 11.8. The ANC was probably even lower last week, I'm told, which may be why I had a sore throat starting Thursday that went away on Monday.

Now the plan is to go back Tuesday and hope it has recovered enough. I'll receive a prophylactic shot of Neulasta on Thursday when they remove the pump. He plans to reduce the dose of Oxi, and/or possibly the bolus of 5FU. My bone marrow just isn't cooperating.

I am SO frustrated. This means I will have missed a full 2-week cycle. And I feel fine. I get all geared up for the infusion and the pump, go in, and nada. I'm trying to be philosophical, but failing. It is such a roller coaster.
F, 64 at DX CRC Stage IV (or "3 1/2" per Dana Farber consult, LOL)
3/17/18 blockage, emergency surgery, r hemicolectomy
11 of 25 nodes
5 of 5 mesentery nodes, matted
0.5 cm sub-capsular liver met removed
pT3 pN2b pM1
Neg CEA, neg BRAF, KRAS G12D, germline mut ATM
dMMR, MSI-H, Neg for Lynch
5/4/18 FOLFOX started
Added Neulasta 6/28/18
7/9/18 CT scans show no masses or enlarged nodes, 2mm indeterminate lung nodule

Aqx99
Posts: 403
Joined: Fri Mar 31, 2017 7:28 am
Facebook Username: aqx99
Location: Pfafftown, NC

Re: Low Platelets

Postby Aqx99 » Fri Jun 22, 2018 11:30 am

I know how you feel. My final cycle of chemo had to be delayed twice because my platelets were too low. The first week they were at 78, the second they dipped to 69, then when I went back the third week they were just at 100.
Anne, 40
Stage IIIB Rectal Cancer
T3N1bM0
2/21/17 Dx, Age 39
2/21/17 CEA 0.9
3/23/17 - 5/2/17 Chemoradiation, 28 treatments
6/14/17 Robotic LAR w/temp loop ileostomy, ovaries & fallopian tubes removed, 2/21 lymph nodes positive
7/24/17 - 12/18/17 CapeOx, 6 Cycles
7/24/17 Dx w/ovarian cancer
9/6/17 CA 125 11.1
11/27/17 CEA 2.6
12/5/17 CT NED
12/13/17 CEA 2.9
1/11/18 CA 125 8.6
1/23/18 Reversal
3/21/18 CT enlarged thymus
4/6/18 PET NED
7/10/18 CT NED
7/11/18 CEA 2.6
9/18 Bilateral Prophylactic Mastectomy

User avatar
mobrouser
Posts: 81
Joined: Wed Apr 11, 2018 1:44 pm
Location: Ontario

Re: Low Platelets

Postby mobrouser » Fri Jun 22, 2018 10:18 pm

I have posted here previously about my platelet and neutrophil issues. My oxaliplatin was reduced to 90% for round 3, and has been at 75% since round 5.
I just completed round 9 last Friday and I am 6 weeks behind schedule because of low counts. It is a constant in the back of my mind that all of this could be increasing the potential for mets to develop.
I console myself with the fact that I started off with no mets, and have done everything the doctors have asked of me to get through the treatments.

Prior to round 8 I was prescribed Grastofil, the generic version of Neupogen, to help with my neutrophil levels as even with the oxali reductions my platelet and neutrophil levels were tanking each round.
I give myself daily injections for 7 days following completion of each round. One of the side effects is bone pain. I was pleasantly surprised to find that so far I have not had any.
The preferred injection site is the lower abdomen, but I have been doing it in the upper thigh area and found that the skin there is less sensitive so there is no pain inserting the needle.
I am also on daily blood thinner injections, even with my platelet issues, so my abdomen is so sore from 6+ months of those daily injections.
But I have to believe that I will get through this with flying colours. And you will too!!!

8) mob
CC Dx Oct 2017 @ age 58
Laparoscopic hemi-colectomy Dec 2017
Adenocarcinoma ascending colon – 6cm x 6cm x 2cm, Low Grade, penetrates to peritoneum
T4a N2a M0, Stage IIIC
lymph nodes 6 positive out of 18
FOLFOX started Jan 16 2018; finished Aug 2 2018 (felt like a year)
CEA - 01/15/18 - 2.8; 07/29/18 - 5.3
CT scan Aug 8 2018 - Clear
PET scan Sept 6 2018 (thought about bringing the cat :wink: ) - Clear

stu
Posts: 851
Joined: Sat Aug 17, 2013 5:46 pm

Re: Low Platelets

Postby stu » Sat Jun 23, 2018 4:51 pm

My mum had reductions , delays , the lot . It sill worked . Keep on going !!
Stu
supporter to my mum who lives a great life despite a difficult diagnosis
stage4 2009 significant spread to liver
2010 colon /liver resection
chemo following recurrence
73% of liver removed
enjoying life treatment free
2016 lung resection
Oct 2017 nice clear scan . Two lung nodules disappeared

lovelife789
Posts: 114
Joined: Thu Aug 24, 2017 5:28 am

Re: Low Platelets

Postby lovelife789 » Sat Jun 23, 2018 10:22 pm

hmm... I kept revisiting this thread, many times I wanted to share my experience but hesitated thinking probably people is not gonna believe me. BUTT, oh well, even if one person believes me and I can help that ONE person, it's all worth it.

So, I did 13 rounds of FOLFOX, full dosage of Oxi. I never missed one round, I got all my treatments on time - one time my platelet count was at about 55 just three days before infusion and the doctor wanted to put a hold, but I got it back up on the infusion day to 110. I also didn't get any shots to help get my counts up. I really didn't want anymore needles and side effects. :cry: :cry: :cry: Starting round 3 my platelets started to drop and by the 9th round, my WBC went down as well, but they never gone down to the point they would delay treatment. I was able to keep my platelets up with a tea that my mom made for me at home, nothing funky but the ingredients are not that easy to get.

I'm Asian, so the recipe we had was peanut skins (not the peanut, if you put in peanuts, you get a nasty oil layer on top of the tea and you don't want that) with black dates. The question from folks in North America may wonder where do you get the peanut skins? Well I ran a search on Amazon, and I found a few shops selling them. I emphasize NOT the WHOLE peanut, just the skin and better not buy a whole bag of peanut and peel the skin off, just not worth the time. And you also wanna order black dates from Amazon. You put in a FULL adult man palm size of peanut skins with 5 rice bowls of water with about 10 black dates (better slit it on the sides to give it more flavor), bring it to a boil and let it on medium heat until it looks like there's only one bowl is left.

Drink it once everyday. If you put enough dates, it won't taste bad. It is tiny little bit bitter which is often covered by the sweetness from the dates. I personally did not really believe in it, I just drank it to calm my mom down... until my platelet went down to 55 and I got it back up to 110 in 2 days drinking two bowls of this tea daily.

So here is my sharing, in case there's anybody who wants to give it a try. Both are edible stuff so it's nothing that will hurt you. The worst is just not working as well in you as it did in me. It mainly works for platelets, WBC was a bit tougher, I just ate a lot of protein and drank massive amount of date tea...
F/38 - Dx 8 Mar 17, CEA 80.5
Stage IV Sig. Colon, 6 Liver mets, T3N0M1a, KRAS NRAS Wild, G2=Moderately differentiated
3/17- 6/17 - 6 rounds of FOLFOX + Erbitux - CEA 2.5
7/17 - 1st Liver resect/Colon/Gall, all clear margin
8/17 - 2nd Liver resec
9-12/17' - completed 13 rounds of FOLFOX - CEA 1.0
1/18 - Clear PET SCAN - CEA 1.4
3/18 - Clear MRI - CEA 0.8
6/30 - PET SCAN showed a lung nodule that grew from 5mm to 8mm - CEA 1.0
Aug - VATs done, colon met cfm

boxhill
Posts: 118
Joined: Fri Apr 06, 2018 11:40 am

Re: Low Platelets

Postby boxhill » Sun Jun 24, 2018 6:59 am

So, is it the peanut skin part that is supposed to work, and the dates are just there for sweetening? I ask because I have T2 diabetes and thus have to avoid carbs.
F, 64 at DX CRC Stage IV (or "3 1/2" per Dana Farber consult, LOL)
3/17/18 blockage, emergency surgery, r hemicolectomy
11 of 25 nodes
5 of 5 mesentery nodes, matted
0.5 cm sub-capsular liver met removed
pT3 pN2b pM1
Neg CEA, neg BRAF, KRAS G12D, germline mut ATM
dMMR, MSI-H, Neg for Lynch
5/4/18 FOLFOX started
Added Neulasta 6/28/18
7/9/18 CT scans show no masses or enlarged nodes, 2mm indeterminate lung nodule

lovelife789
Posts: 114
Joined: Thu Aug 24, 2017 5:28 am

Re: Low Platelets

Postby lovelife789 » Sun Jun 24, 2018 9:45 am

boxhill wrote:So, is it the peanut skin part that is supposed to work, and the dates are just there for sweetening? I ask because I have T2 diabetes and thus have to avoid carbs.


Mainly the peanut skin, but according to the herbal tea guru and acupuncturist (mine does both) black dates are supposed to bring benefits to blood cells. I have thalassaemia, so the dates were extra important to me... (now I come to think of it... it was amazing that I could keep my blood work so perfect the whole time!), but if you have diabetes, I wouldn't put the dates in or put much less. I have some patient friends who used my recipe but without so many black dates, just 2-3, the tea still works.
F/38 - Dx 8 Mar 17, CEA 80.5
Stage IV Sig. Colon, 6 Liver mets, T3N0M1a, KRAS NRAS Wild, G2=Moderately differentiated
3/17- 6/17 - 6 rounds of FOLFOX + Erbitux - CEA 2.5
7/17 - 1st Liver resect/Colon/Gall, all clear margin
8/17 - 2nd Liver resec
9-12/17' - completed 13 rounds of FOLFOX - CEA 1.0
1/18 - Clear PET SCAN - CEA 1.4
3/18 - Clear MRI - CEA 0.8
6/30 - PET SCAN showed a lung nodule that grew from 5mm to 8mm - CEA 1.0
Aug - VATs done, colon met cfm

boxhill
Posts: 118
Joined: Fri Apr 06, 2018 11:40 am

Re: Low Platelets

Postby boxhill » Wed Jun 27, 2018 4:04 pm

Went in yesterday, Tuesday, and hurrah! My blood counts were all good, so I had infusion #4, two weeks late. The oncologist reduced my oxi dose by 20%, in hopes of keeping my platelets up, and I am scheduled to get a shot of Neulasta on Thursday when I am unplugged to combat the white blood cell problem.

I have abdominal and thoracic CAT scans with contrast scheduled for July 10th, and an appointment with the oncologist--and presumably Cycle 5 infusion--on the 12th if my numbers hold up.

The one thing I would really like to stop is the dexe-whatever steroid, but of course that's not happening. I've discovered that it sends my blood glucose through the roof. As in, I was waking up with a 109-111, which is good, and today I woke up with a 202, which is dreadful. I've never had a reading like that. I ate about 90 minutes ago, maybe 20 gms of carbs max, and it's up to 255. That's dreadful. I wonder how many days this is going to last...
F, 64 at DX CRC Stage IV (or "3 1/2" per Dana Farber consult, LOL)
3/17/18 blockage, emergency surgery, r hemicolectomy
11 of 25 nodes
5 of 5 mesentery nodes, matted
0.5 cm sub-capsular liver met removed
pT3 pN2b pM1
Neg CEA, neg BRAF, KRAS G12D, germline mut ATM
dMMR, MSI-H, Neg for Lynch
5/4/18 FOLFOX started
Added Neulasta 6/28/18
7/9/18 CT scans show no masses or enlarged nodes, 2mm indeterminate lung nodule

lovelife789
Posts: 114
Joined: Thu Aug 24, 2017 5:28 am

Re: Low Platelets

Postby lovelife789 » Wed Jun 27, 2018 6:41 pm

boxhill wrote:Went in yesterday, Tuesday, and hurrah! My blood counts were all good, so I had infusion #4, two weeks late. The oncologist reduced my oxi dose by 20%, in hopes of keeping my platelets up, and I am scheduled to get a shot of Neulasta on Thursday when I am unplugged to combat the white blood cell problem.

I have abdominal and thoracic CAT scans with contrast scheduled for July 10th, and an appointment with the oncologist--and presumably Cycle 5 infusion--on the 12th if my numbers hold up.

The one thing I would really like to stop is the dexe-whatever steroid, but of course that's not happening. I've discovered that it sends my blood glucose through the roof. As in, I was waking up with a 109-111, which is good, and today I woke up with a 202, which is dreadful. I've never had a reading like that. I ate about 90 minutes ago, maybe 20 gms of carbs max, and it's up to 255. That's dreadful. I wonder how many days this is going to last...


Awesome to know the numbers went back up!! Keep your spirit up!!!
F/38 - Dx 8 Mar 17, CEA 80.5
Stage IV Sig. Colon, 6 Liver mets, T3N0M1a, KRAS NRAS Wild, G2=Moderately differentiated
3/17- 6/17 - 6 rounds of FOLFOX + Erbitux - CEA 2.5
7/17 - 1st Liver resect/Colon/Gall, all clear margin
8/17 - 2nd Liver resec
9-12/17' - completed 13 rounds of FOLFOX - CEA 1.0
1/18 - Clear PET SCAN - CEA 1.4
3/18 - Clear MRI - CEA 0.8
6/30 - PET SCAN showed a lung nodule that grew from 5mm to 8mm - CEA 1.0
Aug - VATs done, colon met cfm

User avatar
mobrouser
Posts: 81
Joined: Wed Apr 11, 2018 1:44 pm
Location: Ontario

Re: Low Platelets

Postby mobrouser » Wed Jun 27, 2018 9:24 pm

How often do you take the dexamethasone?

8) mob
CC Dx Oct 2017 @ age 58
Laparoscopic hemi-colectomy Dec 2017
Adenocarcinoma ascending colon – 6cm x 6cm x 2cm, Low Grade, penetrates to peritoneum
T4a N2a M0, Stage IIIC
lymph nodes 6 positive out of 18
FOLFOX started Jan 16 2018; finished Aug 2 2018 (felt like a year)
CEA - 01/15/18 - 2.8; 07/29/18 - 5.3
CT scan Aug 8 2018 - Clear
PET scan Sept 6 2018 (thought about bringing the cat :wink: ) - Clear

User avatar
LPL
Posts: 410
Joined: Fri Apr 22, 2016 12:49 am
Location: Europe

Re: Low Platelets

Postby LPL » Thu Jun 28, 2018 4:57 am

boxhill wrote:....The one thing I would really like to stop is the dexe-whatever steroid, but of course that's not happening. I've discovered that it sends my blood glucose through the roof. As in, I was waking up with a 109-111, which is good, and today I woke up with a 202, which is dreadful. I've never had a reading like that. I ate about 90 minutes ago, maybe 20 gms of carbs max, and it's up to 255. That's dreadful. I wonder how many days this is going to last...

How are feeling now? Please be careful, contact your Oncologist. See my signature. My husband’s blood glucos just kept going up and he had 408 (!!!) when we got him to the hospital. That was after chemo Nr3. From Nr4 and so on they stopped the steroids. He had to be treated with Insulin for a rather long time due to this.
I didn’t know this but here they say the following:
"Glucocorticoid-induced hyperglycemia is common in patients undergoing cancer treatment ... We recommend that all cancer patients receiving gc be screened for hyperglycemia at least 4–6 hours after gc administration." 2013 http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3851349/
DH @ 65 DX 4/11/16 CC recto-sigmoid junction
Adenocarcenoma pt 35x15x9mm G3(biopsi) G1(surgical)
Mets 3 Liver resectable
T4aN1bM1a Stage IVa 2/9 LN
MSS, KRAS-mut G13D
CEA & CA19-9: 5/18 2.5 78 8/17 1.4 48 2/14/17 1.8 29
4 Folfox 6/15-7/30 (b4 liver surgery) 8 after
CT: 8/8 no change 3/27/17 NED for now :D
:!: Steroid induced hyperglycemia dx after 3chemo .. hospitalized, insulin -> Metformin
Surgeries (open):
3/18 Emergency colostomy 5/23 Primary+gallbl+colostomy reversal (+port) 9/01 Liver mets

boxhill
Posts: 118
Joined: Fri Apr 06, 2018 11:40 am

Re: Low Platelets

Postby boxhill » Thu Jun 28, 2018 9:27 pm

I only get the dexe at infusion.

Today--unplugging day--my fasting BG in the morning was 166, which is still way over what I would like, but definitely a big improvement over yesterday. It will be interesting to see how long it takes to get all of the way back down.
F, 64 at DX CRC Stage IV (or "3 1/2" per Dana Farber consult, LOL)
3/17/18 blockage, emergency surgery, r hemicolectomy
11 of 25 nodes
5 of 5 mesentery nodes, matted
0.5 cm sub-capsular liver met removed
pT3 pN2b pM1
Neg CEA, neg BRAF, KRAS G12D, germline mut ATM
dMMR, MSI-H, Neg for Lynch
5/4/18 FOLFOX started
Added Neulasta 6/28/18
7/9/18 CT scans show no masses or enlarged nodes, 2mm indeterminate lung nodule

User avatar
LPL
Posts: 410
Joined: Fri Apr 22, 2016 12:49 am
Location: Europe

Re: Low Platelets

Postby LPL » Fri Jun 29, 2018 3:53 am

boxhill wrote:I only get the dexe at infusion.

Today--unplugging day--my fasting BG in the morning was 166, which is still way over what I would like, but definitely a big improvement over yesterday. It will be interesting to see how long it takes to get all of the way back down.

My husband also only got the steroids at infusion. And after he reacted with hyperglycemia they removed it.
Good to hear that your BG is improving :-)
DH @ 65 DX 4/11/16 CC recto-sigmoid junction
Adenocarcenoma pt 35x15x9mm G3(biopsi) G1(surgical)
Mets 3 Liver resectable
T4aN1bM1a Stage IVa 2/9 LN
MSS, KRAS-mut G13D
CEA & CA19-9: 5/18 2.5 78 8/17 1.4 48 2/14/17 1.8 29
4 Folfox 6/15-7/30 (b4 liver surgery) 8 after
CT: 8/8 no change 3/27/17 NED for now :D
:!: Steroid induced hyperglycemia dx after 3chemo .. hospitalized, insulin -> Metformin
Surgeries (open):
3/18 Emergency colostomy 5/23 Primary+gallbl+colostomy reversal (+port) 9/01 Liver mets


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