Anemia, iron, in cancer patient

I am a young woman who has been battling advanced breast cancer for over 7 years taking various chemos..  I was mildly anemic even before diagnosis, but over the last several years of treatment was able to keep my hemoglobin in the 10's with an occasional Epogen shot.  Over the last several months (still on chemo) my hemoglobin has been in the 8's. It recently reached 7.7.  My cbc test showed rbc 2.3, HCT 22, RDW23.9(elevated for over a year or more) and all other red blood cell indicators are normal.  My iron profile (Ferritin, 12, Transfrrn sat, 20, Iron, 72, TIBC, 361) showed low (but still in range) Ferritin -12 and Transfrrn-20.  My earlier iron profiles showed much higher Ferritins in the 200's (2yrs ago)  and 300's (7 yrs ago).  My B vitamins are ok and my occult stool tests are negative   1.  Is it reasonable, given the ferritin leval, to try iron supplementation?   I have heard about the dangers of iron overload, especially for a cancer patient.     2.  Is it harmful to take iron supplementation if one has had a transfusion recently?   I respect your opinion and  look forward to hearing from you.-  Amma

[Kevin Pho, MD]

I cannot give specific treatment recommendations over the internet.

1) If iron deficiency is suspected, looking for a cause of bleeding should be done.  The GI tract is normally the first one looked it, so you can discuss an endoscopy with your personal physician.

Note that cancer itself can lead to anemia, and it has to be ensured that this isn't the cause.

2) In general, iron supplementation does not have major side effects.  However, before starting, I would discuss this option with both your personal physician and oncologist.

Followup with your personal physician is essential.

This answer is not intended as and does not substitute for medical advice - the information presented is for patient education only. Please see your personal physician for further evaluation of your individual case.

Kevin, M.D.
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