Hello ladies,

Does anyone have any experience of anaemia whilst on treatment? I’m on palbociclib/ letrozole regime. The treatment is working well in terms of controlling the cancer in my bones but my red blood cell count has been dropping every month. I saw a different consultant last week to my usual one, who said that as my levels were 94 I may need a blood transfusion. Having spoken to my usual consultant he now says that the levels aren’t low enough for a transfusion (not that I was looking forward to the prospect!). He also said that the anaemia can’t be treated with iron supplements because I’m not iron deficient; it’s just that my body can’t replenish the red cells fast enough due to the suppressing effects of the palbociclib. I know it’s a minor thing in the grand scheme of things but I have been feeling so tired all the time and the message I’m getting is that it’s just par for the course with this treatment. 

Hello Mateface67

Thank you for posting.  Our moderators thought it might be helpful to have a response from the nurses.

Experiencing fatigue (the feeling of tiredness or exhaustion) when receiving treatment for breast cancer is very common, particularly when your red blood count levels are lowered by your treatment. This can be difficult to cope with and can affect your everyday activities.

There may be other factors that are contributing to your fatigue, such as the emotional impact of a secondary breast cancer diagnosis; altered sleep patterns; reduced activity and poor diet. 

There are things you can try to help manage fatigue as discussed in the previous links. You may want to keep a diary to record when you feel most tired. This can help you plan activities you enjoy in the times when you have more energy. Trying to stay physically active can help. Eating a healthy well balanced diet is also important. If you are finding it difficult to sleep, the following tips for better sleep may also be helpful. 

We often hear from women that fatigue can have a real impact on their day-to-day life. It can be difficult to describe fatigue and other people may not always understand how you are feeling. You may be interested in the Macmillan booklet Coping with fatigue (tiredness).

 At your next appointment, do discuss again how you are feeling with your treatment team. It’s important they are aware of any side effects you are experiencing and how they are affecting your daily life. 

We also provide a number of services for people living with secondary breast cancer aimed at providing both information and support. These include our Living with Secondary Breast Cancer Online programme and virtual meetings. Our face to face Living with Secondary Breast Cancer monthly meet up groups also give you the chance to meet and share experiences with other people who understand what you’re going through because they’re going through it too. 

Do call our helpline if you would like to talk this through or have any further questions. The helpline team have time to listen to your concerns, talk things through and signpost you to more support and information. Your call will be confidential, and the number is free from UK landlines and all mobile networks. The number is 0808 800 6000, (Relay UK -prefix 18001).

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Best wishes


Breast Care Nurse

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i have secondaries to bones and I developed anaemia which initially was told to take iron supplements which of course did nothing as it was the Mets affecting the bone marrow causing the red blood cells and platelets to drop. My haemoglobin dropped to 8.1 and I had a blood transfusion. I was terrified but it was actually ok and doable. My haemoglobin is now 10.5 but to get to thst it has taken 10 weeks of chemo on a weekly basis.
I am now waiting for a Ct scan to see how the chemo has done. Hoping and praying it has worked.

best wishes and contact me if I can help or if you’d like a chat. I’d be more than happy to talk with you,