Hi, Thanks for asking. Based on your query, my opinion is as follows. 1. Low iron levels could be due to reduced absorption from diet or reduced intake given then iv route. Repeat iron studies, to check improvement every month along with reticulocyte counts. 2. However, increased hemolysis also require evaluation, in view of the drop every month. Hemoglobin electrophoresis is necessary for evaluation of hemolytic anemias along with serum bilirubin levels. 3. Joint pains could be secondary to weakness or hemolytic anemia leading onto crisis. Get x-ray of the joints, to rule out any local abnormalities. 4. None of these are signs of cancer. Continue with nutritious diet. Based on lab reports, further opinion possible. Hope it helps. Any further queries, happy to help again.