Unfortunately 4 weeks ago I was diagnosed with cancer in my sigmoid colon for which I am due to have an operation on the 29th. I am just a little anxious about undergoing major surgery with pv and wondered if anyone had been through anything similar? I had a venesection this week (before the venesection my hct was just over 46) and take aspirin daily, and Hydroxycarbimide (18 tabs a week) I’ve told the surgeon and he has been in touch with my haematologist (they both work for the same hospital trust although different sites). I am 60 and have no history of thrombosis.
Thanks
Gordon
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Gordon335
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I have PV and in the last several years have been through four surgeries, including heart and brain surgeries. I have learned some things in the process. It is vital to ensure that you have the surgeon consult with your hematology care team. Ideally this should include a MPN Specialist, not just a regular hematologist. You need to be a key player in this communication and need to know everything that is discussed.
Your care team should already have discussed with you the fact that having PV predisposes you to various other types of cancers, including colorectal. This along with the fact that you are already taking a chemotherapy agent can have significant impact on your treatment for colon cancer. It is important for you to understand all of the factors impacting the decisions you will need to make.
It is a good thing that you have no history of thrombosis. If you also experience thombocytosis with your PV, then you are also at risk for hemorrhage. I have actually tended more towards hemorrhage with my form of PV and experience von Willebrand factors below normal. My prothrombin times tend to be long, especially when I am on aspirin or other anti-platelet therapy. It would likely be a good idea to run a von Willebrand panel including prothrombin times prior to your surgery. They may give you something like heparin post-surgery to prevent thrombosis. It is important o know how you are likely to react. This is something you want to discuss in advance with your surgeon.
It may not be a big deal if you do not have thrombocytosis as part of your PV, but do expect reactive thrombocytosis as a reaction to the surgery. This is your body's natural reaction to the blood loss/injury involved in the surgery. It matters more when your platelet levels are already too high. I have experienced this with every surgery I have had. It did not cause a problem, but we did monitor it closely.
I hope all goes well with your surgery and that you experience a complete cure. Please let us know how you get on.
hunter5582 "Your care team should already have discussed with you the fact that having PV predisposes you to various other types of cancers, including colorectal."
This is really interesting, I've had PV for many years but have never come across this. Are you able to share any further info / links on this? Thanks!
The very short and KISS explanation has to do with the impact that deregulation of the JAK-STAT pathway has on tumorigenesis and apoptosis. Add to that the role of chronic inflammation on risk of cancers.
The recommendation for us is really no different than the standard population. Routine monitoring for colon, prostate, breast, skin and other cancers. We just cannot afford to ignore the routine screening that everyone should be doing. We also cannot afford to expose ourselves to toxins/carcinogens. In addition, we need to control for systemic inflammation.
Hi Gordon, sorry to hear of your cancer diagnosis. I’ve had quite a number of surgeries, including knee replacement with my erthrocytosis (which is the same as polycythemia, without the vera) and had no problems. I’ve always had blood thinning injections post surgery but we are all unique in our medical collections, so your surgeon and haematologist will advise what is best for you. Hunter has given you great advice and knowledge.
You have your surgeon and haematologist working together and that is the main thing. Keep posting and everyone will support you on this forum. Take care and my fingers are crossed for a full and speedy recovery for you.
Thanks Ainslie you’re right whilst it is stressful at the moment it’s much better to know and have a potential cure than be taken in as an emergency and to an operation with no prior knowledge of my blood condition etcGordon
Hi Gordon, , , just to wish you all the best for your forthcoming op and a speedy complication free recovery. As Hunter suggests stress to your Nurse Specialist that you want to be in the loop regarding all aspects of your treatment particularly with your PV crossover. I've found it pays to be included and be part of the decision making process as far as possible, rather than just be done unto.
Hello Gordon - so sorry to hear of your diagnosis - I can’t help with any advice (the only surgery I have had was not major) I just wanted to send every good wish that your operation is successful and hope you have a speedy recovery. Anne-Marie x
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