Anemia -- how have you dealt with it?

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Anemia -- how have you dealt with it?

Postby hopefulandstrong » Thu Oct 24, 2019 3:07 pm

several weeks ago I was diagnosed with a blood clot in my leg and small pulmonary embolism. I spent a week at MSK feeling that absolute garbage. I've been on blood thinners for a month, and things are stabilizing. However, 'm also anemic, bad enough to have a transfusion in early October but not bad enough to have another one. That's a relief. Trouble is, I'm still relatively weak and short-of-breadth. It's much on chemo weeks, but still noticeable on off weeks.

Wondering how others have handled this.
54, female
1/8/19 DS Stage 4 with Liver Mets; Successful Colon Resect
2/18/19 Started Folfox -- CEA 70
5/8/19 - BRAF mutation -- switch to Triplet Therapy: Encorafenib, Binimetinib, Cetximab
6/13/19 - CEA dropped from 214 to 22
8/29 - CEA jump to 30-- scans reveal liver spread, though still confined. triplet therapy abandoned; some concern about PIC3 mutation interfering with BRAF treatment
9/1 - 10/4 -- no treatment
10/4 -- folfoxfiri to stem further progression; pump placement in January (hopefully)

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Re: Anemia -- how have you dealt with it?

Postby Dionca » Fri Oct 25, 2019 3:14 am

It was severe anemia that led to my diagnosis (It got so I could hardly walk a few feet without getting winded), so I was given a couple of blood transfusions at the ER, which helped a lot. On my family doctor's orders, I also started to take iron tablets. After surgery, I had a bleed at the incision which lasted a few days, so I was given another couple of transfusions. I continued to take iron tablets for a while after chemo, but discontinued when I felt like I was back to normal (and so was my blood count).

Chemo also make me weak, low energy and out of breath at times, but not as bad as when I was severely anemic.

Maybe bumping up your iron-rich foods would also help, but let your doctor know how you have been feeling - there maybe something else that can help you. Good Luck!
stage 3b T3 N1b MX 2/27 nodes (surgery 4/2015)
moderately differentiated
PNI - positive
LVI - positive
Folfox 12 sessions (w/out oxi for 11 & 12)
Neulasta with 3-12 due to low WBC count
CEA at diagnosis 8.6
CEA after surgery 1.2
CEA during chemo 4.6 / 3.3 / 2.3
CEA after chemo 1.5 / 1.2 / 1.2 /1.2 /1.2 / 1.4 / 1.1 / 1.2 / 1.9 / 1.3 / 1.6 /1.4 /1.5
recurrence in left lung Feb 2020

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Re: Anemia -- how have you dealt with it?

Postby NHMike » Fri Oct 25, 2019 10:21 am

My onc said that I was anemic during Adjuvant Chemo but things weren't bad enough to do anything about it. I didn't know that transfusions were an option.

I would see if you could remedy it with food for now.
6/17: ER rectal bleeding; Colonoscopy
7/17: 3B rectal. T3N1bM0. 5.2 4.5 4.3 cm. Lymphs: 6 x 4 mm, 8 x 6, 5 x 5
7/17-9/17: Xeloda radiation
7/5: CEA 2.7; 8/16: 1.9; 11/30: 0.6; 12/20 1.4; 1/10 1.8; 1/31 2.2; 2/28 2.6; 4/10 2.8; 5/1 2.8; 5/29 3.2; 7/13 4.5; 8/9 2.8, 2/12 1.2
10/17: 2.7 2.2 1.6 cm (-90%). Lymphs: 3 x 3 mm (-62.5%), 4 x 3 (-75%), 5 x 3 (-40%). 5.1 CM from AV
10/17: LAR, Temp Ileostomy, Path Complete Response
CapeOx (8) 12/17-6/18
7/18: Reversal, Port Removal
2/19: Clean CT

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Re: Anemia -- how have you dealt with it?

Postby J-man » Fri Oct 25, 2019 12:12 pm

There are also bone marrow stimulants which you could discuss with your doctors( Eprex, erythrpoietin ) which act on red blood cell production the way neulasta acts of white blood cell production.

Iron and B vitamin injections may be needed but only if you are deficient in them to start with.
You issue is likely due to the chemo effects on your bone marrow, so is there any option to change the doses lower ?

Please talk with your doctors and explore all options for your well being.

Best of wishes to you.

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Re: Anemia -- how have you dealt with it?

Postby wwroam » Tue Oct 29, 2019 7:01 pm

I am currently on Alimta and Carboplatin for recurrent Non Small Cell Lung Cancer ( my Colon Cancer memories are safely deposited in the forgettery).
My 1st line treatment for NSCLC was Gemcitibine + Carboplatin and Taxol + Carboplatin. The Gem destroyed Haemoglobin and it took 18 months to recover. I had 10 units of blood.
For Alimta, it is recommended B12 injections and Folate. At my last blood test Neutrophils, Haemoglobin and Platelets were all very low. On this regimen I have already had 3 units of blood and a 1 week chemo deferral. I'm not sure if there is anything els that can be done. My recurrence is cancerous nodules, Classified as Stage 4 ( for tactical immunotherapy reasons).
Stage 3a DX 25/06/07
Folfox complete 30/01/08
7 years NED
Port scheduled for removal 8/02/10 Gone.
PSA .54 No prostate problems
Diagnosed Type 2 Diabetic
SO diagnosed CC Stage IV Liver Mets 23/03/15

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Joined: Fri Apr 06, 2018 11:40 am

Re: Anemia -- how have you dealt with it?

Postby boxhill » Tue Oct 29, 2019 7:32 pm

I've been anemic while on chemo and while having extreme bleeding due to uterine fibroids. Although I was tired, breathless, etc, no one ever suggested a transfusion. It is my understanding that the red blood cells infused in that way only live for 3 days?

Anyway, the things that worked for me were time and eating a rare steak periodically.
F, 64 at DX CRC Stage IV
3/17/18 blockage, r hemi
11 of 25 nodes,5 mesentery nodes
5mm liver met out
pT3 pN2b pM1
BRAF wild, KRAS G12D
7/18 CT NED
11/18 CT NED
12/18 MRI 5mm liver mass, 2 lymph nodes in porta hepatis
12/31/18 Keytruda
6/19 Multiphasic CT LNs normal, Liver stable
6/28/19 Pause Key, predisone for joint pain
7/31/19 Restart Key
9/19 CT stable
Pain: all fails but Celebrex
12/23/19 CT stable
5/19 MRI stable/NED
Suspend treatment

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