Are Cervical And Shoulder Pain Associated With Low Hemoglobin Count?

Posted on Sat, 17 Oct 2015

Question: Pt is a stage iv prostate cancer pt in first cycle of 3rd round of chemotherapy given Sept. 10th. Day 20 of three week cycle. On day 11, hemoglobin was 8.2, platelets 63,000; white blood cell count .6. Blood will be tested Monday, Oct 5th. Today he is having cervical/shld pain at pain level 4, seems weaker, more wobbly, unsteadier gait with FWW. Very fatigued. XXXXXXX is day 10 - 14. Does CBC need to be done before Oct. 5th? Could hemoglobin have dropped lower than 8.2? Debating whether to call nsg line at Oncologist's office. Thanks for your help.

Answered by Dr. Prakash H Muddegowda (2 hours later)

Brief Answer:
No reasons to suspect low hemoglobin at present.

Detailed Answer:
Hi,
Thanks for asking.
I am Dr. Prakash HM and I will be answering your query.
Based on your query, my opinion is as follows:
1. Cervical pain or shoulder pain is not related to hemoglobin levels.
2. Wobbly, unsteadier gait can be more due to chemotherapy induced weakness along with malnutrition.
3. If chemotherapy were to affect the bone marrow (suppression), all blood counts would be reduced. Most importantly fall in platelet count would have clinically presented in form of red spots in skin, bleeding gums, blood in urine or stools, etc.
4. As none of the low platelet count symptoms are seen, there is no reason to suspect a drop in hemoglobin levels.

You can wait till October 5th for the tests.
Presently, try to improve nutrition with protein rich diet, have good hydration (at least 5-6 liter of water per day), along with rest.

Hope it helps.
Any further queries, here to help again.

Dr. Prakash HM

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Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar