Anemia During/After Radiation

Peetie1

I am wondering if anybody else experienced anemia during radiation. When looking at the results of my blood tests toward the end of radiation I noticed that my results were low for RBC, Hemoglobin, and HCT. I am now three weeks out of radiation and just had more blood work taken today for my regular yearly physical with my Primary Care, and I am still low with all three tests. I will meet with my Primary Care in a week, but should I worry about these results? Is anemia something to worry about? Is it a normal SE of radiation? Thank you for any insight!

SpecialK

Do you have bloodwork from prior to diagnosis and hav your results fallen from your pre-treatment levels? Are they actually below the bottom number of the range, or just in the low end? It is important to note that lab ranges correlate to healthy males - women often fall into the low end of the the range as their normal.

Peetie1

SpecialK- Thanks for responding! I don't if this is something that I should worry about, but I haven't heard other women mentioning this...

I did not have blood work taken right before I began treatment (surgery), but I did have blood work taken before I began radiation. Before radiation I was in the low normal range for women. Two weeks into radiation I had blood work taken, and only my Hemoglobin was below the correct range for women. At the end of radiation, more blood work was taken and I was below the correct range on RBC, Hemoglobin, and Hemocrit. I am now below the reference range in RBC, Hemoglobin, and HCT three weeks after radiation. The numbers are not drastically low about 1% below where they should be, but three weeks after radiation, they have not returned to normal.

christinarose

One of the info sheets I have from my radiologist says that cancer treatments like chemo, radiation and a few others can cause anemia, which of course leads to fatigue.

ChiSandy

My pre-lumpectomy bloodwork showed normal (12.5) hemoglobin. 10 months after rads it had slipped to 12, then 11.8, 11.7 and last week 11.5 with concomitant lowering of ferritin levels too. Last time it had slipped below 12 (found out when I was rejected as a blood donor) in 2013; my PCP had a hunch and ordered an upper GI endoscopy, or “EGD" (the one I had two years earlier along with my colonoscopy showed some gastric and esophageal irritation). Sure enough, it revealed a "small area of esophageal irritation, likely of chemical origin," which made sense since I had taken NSAIDs daily as part of rehabbing from knee replacement surgery after giving up opioids. Also showed a hiatal hernia (which I'd suspected for >20 yrs).

So with my long history of GERD, I'm getting a repeat EGD Aug.3 (the first date I could get) to see if there's a new GI bleed. If it's negative, then I do a “capsule" endoscopy (swallow a pill containing a camera). If it shows nothing, then it's possible that radiation may have affected my bone marrow. Possible, but unlikely: my RBC & WBC are normal, as are my various cell type counts; and I had only 16 hypofractionated (extra-strength) treatments, targeted just to the tumor cavity.

But anemia and other bone marrow disorders are more likely with the 33-treatment whole-breast protocol, and likelier still if one also had chemo.

Peetie1

ChiSandy-Thank you for your reply! I do have problems with GERD and I take daily Protonics. I have had two EGDs and I have had my esophagus expanded due to scar tissue (believe me, I hope that this is what is going on!)

My numbers are:

RBC 4.00 (range 4.01-5.47) This has improved in the last three weeks

Hemoglobin 11.0 (range 12-16) No change in three weeks

HCT 35% (range 36-48) No change in three weeks

My doctor wanted more tests run before we meet on Monday, so she has now tested Iron and Ferritin

Iron 34 (range 50-170)

Iron Saturation 8% (range 20%-50%)

Ferritin 5 (range 8-252)

I am trying not to worry, and to believe the best, but I have had a tough few months (diagnosis in March). It is hard for me to believe that it could be radiation though because I had such an easy time with it. I had 20 hypofractionated treatments, 5 were boosts.

ChiSandy

Your hemoglobin is low, your ‘crit slightly low (but better than mine), iron, iron sats and ferritin very low. Your anemia is most likely iron deficiency, probably related to the cause of your GERD (just like mine). I used to take Protonix twice a day, but switched six years ago to Dexilant—it’s a dual-phase release lansoprazole that you take at bedtime—it puts out a booster dose and and then 4 hrs later pumps out another 24 hrs. worth of lansoprazole. Unfortunately, the patent doesn’t expire till 2020, and even with Medicare Part D my out-of-pocket is >$120/mo. (I could take store-brand OTC lansoprazole, but I’d have to take one at bedtime and then get up 4 hrs later to take another two—not gonna happen). But nothing else works as well for me. I still do get “acid brash” if I have chocolate or fried stuff too close to bedtime.

We probably both have slow GI bleeds going on.

Peetie1

I am going to ask about Dexilant on Monday. My insurance will probably refuse to cover it, but it doesn't hurt to ask! I also have break through problems even on medication if I eat the wrong thing. I have given up coffee, tea, alcohol, fried food and red meat all trying to relieve the symptoms of GERD. Now that I have been diagnosed with breast cancer I am eating a vegetarian diet and exercising an hour a day, but I still have the problems with GERD, so it makes more sense to me that this could be the cause of the anemia. Thank you so much for the insight, it puts my mind at ease!