MBC treatment with ibrance and tamoxifen - Low blood counts ! Help please

I am care giver for my wife (age:34). She was diagnosed with Breast cancer ER+, PR+ in 2019. We were a young couple , wanted to started a family and have kids then , instead we encountered with Cancer. She went through the cycle of Chemotherapy, lumpectomy and Radiation from 2019-2020.

Starting Aug’22, she started complaining back pain and dizziness. After a series of tests, scans (thanks to the medical system here!) , after 4 months in Dec’22 - it was diagnosed that the cancer has come back , this time in her bones at multiple places - Pelvis, abdomen and ribs. She was given radiation on her ribs because that was the worst effected.

We were unlucky that Tamoxifen did not work for her, it was supposed to stop cancer from progressing - but it didn’t. So her oncologist recommended to switch to ibrance + letrozole ( after shutting down her ovaries).

She just went through 21 days of ibrance cycle, only to find that her blood counts dropped super low. RBC at ~2, Neutrophile at 17% , Hemoglobin at 7 etc., Platelets at 18. Now her oncologist asked us to hold ibrance and she is magically expecting her to recover her blood levels automatically. They are hematologists too and I am worried that we are leaving the recovery of blood levels to chance.

Even before starting ibrance her blood levels were already low, I was told that it was expected. After ibrance, blood levels dropped further, I was told again that its a side effect of ibrance. Despite all these low level blood counts, I don’t see the doctors recommending diet to improve her WBC , Platelets , RBC etc.

We knew that her blood levels were low and since several months she has been taking Vitamin supplements. Surprisingly, it was found that her blood has high amounts of all the Vitamins (Iron,B12, Folic acid etc) she has been taking. So I dont understand why they are not being converted. WBC needs B12 and Folic acid , and still WBC counts are low.

I am no doctor , I am an engineer. I feel helpless , one thing I learnt from this whole journey is that I cannot leave anything to chance. I want to make sure I am taking right steps to save my wife from Cancer.
I would really appreciate if anyone can share their success stories, routines or any medication that they took to manage side effects with ibrance - to keep up with their blood levels.

Thanks a ton for reading this long post. Any guidance appreciated.

Welcome to the forum . It’s great that you are seeking information to support your wife with her treatment .Do you have an appointment soon or can you request one to discuss all this with your wife’s Oncologist / treatment team ?  
You could maybe ask about this also in the Ask the Nurses section of the forum ? Best wishes Jill x

Sheriff009, how are you and your wife doing? 

We have been given the sickening news my wife’s cancer is back after a biopsy of a lump in her neck. Due to meet doctors to discuss diagnosis today 

Tearful times