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Dr. Andrew Rynne
MD
Dr. Andrew Rynne

Family Physician

Exp 50 years

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What Causes Anemia Post Chemotherapy?

I m a 63 year old female and 12 year Stage 1 Triple Negative Breast Cancer survivor who had chemotherapy and radiation in 2004/2005. Over the last nine months I ve had a slight decrease in hemoglobin (down to 11.2 from my usual normal of about 11.8). I ve suffered from Fibromyalgia all my adult life along with Chronic Fatigue, and the added anemia of late though perhaps mild to others, has zapped my strength excessively. (It s worse than the fatigue I felt during radiation treatments.) My doctors are concerned about the cause and so am I; because of my personal history of breast cancer, several bouts of squamous and basal cell skin cancers, and a father who died of colon cancer at age 52 back in the 1970 s. Since January I ve had several CBC s (all showing the low hgb), two colonoscopies (both negative), one upper endoscopy (negative) and one abdominal CT-Scan (POSITIVE; it showed a nodule 12mm wide near the cecum. It was after this scan that the second colonoscopy was done but it was clear.) Besides the nodule on the CT-Scan, the other worrisome symptom is that recently my stools have gradually become as thin as a pencil and the situation is not resolving itself as I d hoped. An added thought; a maternal aunt died of peritoneal cancer in 2010. Now my Kaiser gastroenterologist wants to schedule a camera endoscopy of my small intestine but that department is so backed up that I won t be able to get it done for two or three months. At this point it seems that while they are genuinely worried about finding the cause of the anemia, they aren t too worried about the spot on the CT-Scan. I know from my family s history that cancer can grow on the outsides of organs. Should I press for a repeat CT-Scan now or wait several months until the camera endoscopy is completed.
Thu, 2 May 2019
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General & Family Physician 's  Response
Hi,

Based on the history you have shared, in your case if anemia persists and the cause isn't specified it's better to get bone marrow examination done to rule out any post chemo effects or any minor possibility of leukemoid changes or fibrosis in the bone marrow. Any hypocellularity in bone marrow should also be ruled out. Iron levels alongside B12 and folic acid should be regularly monitored.

Hope I have answered your query. Let me know if I can assist you further.

Regards,
Dr. Saddiq Ulabidin, General & Family Physician
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What Causes Anemia Post Chemotherapy?

Hi, Based on the history you have shared, in your case if anemia persists and the cause isn t specified it s better to get bone marrow examination done to rule out any post chemo effects or any minor possibility of leukemoid changes or fibrosis in the bone marrow. Any hypocellularity in bone marrow should also be ruled out. Iron levels alongside B12 and folic acid should be regularly monitored. Hope I have answered your query. Let me know if I can assist you further. Regards, Dr. Saddiq Ulabidin, General & Family Physician