Questions about Blood Tests Results after PRRT treatment

Posted by markmark007 @markmark007, Nov 11, 2023

My wife completed her 4th PRRT treatment in late August 2023.
We are aware of the impact of the treatment relative to CBC (Hemogram) test results, however, there remains concerns about which test results are too low.
We have been told by one of her providers that her post - treatment results maybe "the new norm". Frankly, this appears to be a lame response.
Some of the latest results (units omitted for brevity):
WBC: 2.61
RBC: 3.26
Hemoglobin: 10.4
Hematocrit: 32
Platelet Count: 149
Four other test results are within "normal range".
Questions: (I understand everyone is different ....but)
1. Is there specific test(s) that we need to more concerned about?
2. We know diet is very important - what food) recommendations help to improve these results?
3. Any suggestions / comments / recommendations will be sincerely appreciated!
She is consulting with a nutritionist but she believes other suggestions may be helpful.
Thanks,
Mark

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Hello Markmark00
I just had my 3rd round of PRRT Oct 30.numbers just before were:
WBC 4.10
RBC 4.21
Hemoglobin 10.4
Hematocrit 34.2
Platelet 114
Dr said although mildly anemic good to proceed. Drs
say blood numbers would go back up after last PRRT. Recommended iron supplements. Increase in protein. It may take more time
for her numbers normalize.
Hard to believe Dr just threw that out there without
being more specific and providing an explanation.
Hopefully next blood test will
show positive results.
(Hopefully she feels ok)
Good Luck ! Wish I had more
Info.

REPLY
@lyons1234

Hello Markmark00
I just had my 3rd round of PRRT Oct 30.numbers just before were:
WBC 4.10
RBC 4.21
Hemoglobin 10.4
Hematocrit 34.2
Platelet 114
Dr said although mildly anemic good to proceed. Drs
say blood numbers would go back up after last PRRT. Recommended iron supplements. Increase in protein. It may take more time
for her numbers normalize.
Hard to believe Dr just threw that out there without
being more specific and providing an explanation.
Hopefully next blood test will
show positive results.
(Hopefully she feels ok)
Good Luck ! Wish I had more
Info.

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lyons:
Many thanks for the response - my wife & I sincerely appreciate sharing some of your experience and suggestions.
All the best to you,
Mark

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@markmark007

lyons:
Many thanks for the response - my wife & I sincerely appreciate sharing some of your experience and suggestions.
All the best to you,
Mark

Jump to this post

My wife completed her 2nd of 4 PRRT treatments scheduled, and I also will find the counts to share to give us all information to share. We are scheduled for CAT scan this week to determine if we will continue the remaining treatments, or go a different route. I will share asap. Hang in there, we got this!

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Good questions, @markmark007. In addition to the helpful responses you've received from @kim1965 and @lyons1234, I'm also adding @firepowr @sherryboynton @kwan @lu7 to add to this discussion.

Mark, can you share what you and your wife have learned from the nutritionist?

REPLY

Hi Colleen:
Many thanks for your post and adding additional contacts to this topic.
Regarding the nutritionist - so far ... some suggestions I believe to be standard e.g. eggs, lean meat, salmon, sardines. iron supplement (no definitive quantity / day was given).
We will continue to explore & will comment when we find a good path forward which helps in her future blood test results.
As always, all recommendations are appreciated.
Thanks again,
Mark

REPLY

Hello, all! I had to look back, but in May 2023, after 3 rounds of PRRT, my blood values were generally all in the normal range. My platelets were only slightly "low" at 135, but even then, were nowhere near being low enough to stop treatment. However, scans showed PRRT wasn't working for me, so we switched to cabozantanib in early June. I did have some impacts on bloodwork from that chemotherapy--mostly low platelets and other WBC counts, but neutrophils were in normal range. Switched to FOLFOX in August and did 4 rounds. Had pretty significant impacts on WBC counts, low platelets, had to use Neulasta for neutrophils. I'm on immunotherapy now (Ipinivo). With regard to diet, my doctors noted generally, there's little that can be done to motivate bone marrow to do more than it's going to do once impacted by these treatments. Of course, I was encouraged to follow all typical "healthy" eating suggestions--focus on protein, dark colored fruits and veggies (kale, spinach, blueberries, blackberries, beets--anything that stains), stay well-hydrated and get plenty of rest. They also said my bloodwork was pretty much out of my hands. I need to let my body recuperate as best as it can--and support it with good food choices, exercise (within reason), hydration, and rest.

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@firepower:
My wife and I sincerely appreciate your response !!

Mark

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@colleenyoung

Good questions, @markmark007. In addition to the helpful responses you've received from @kim1965 and @lyons1234, I'm also adding @firepowr @sherryboynton @kwan @lu7 to add to this discussion.

Mark, can you share what you and your wife have learned from the nutritionist?

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@colleenyoung
my son had his 2nd treatment of PRRT mid September. His SBRT showed a lot of activities around the bone lesion and the platelet then dropped to 75. He had his petscan dotatate and FDG done end of October. He went for his blood test earlier this week and saw the doctor. His platelet has gone up to 115. The bone lesion had disappeared and the tumor on the pancreas doesn't show up as bright as before. The doctor recommended to continue with the third treatment of PRRT in December as it seems to be tolerated except the fatigue that lasted for a whole week.

He is on Mediterranean diet and feels okay.

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@kwan:
Your response is sincerely appreciated.
Mark

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@markmark007

@kwan:
Your response is sincerely appreciated.
Mark

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How is your wife feeling, @markmark007? Does she have an appetite, and is her weight stable?

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