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Suggest treatment for low platelet count with history of prostate cancer

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General & Family Physician
Practicing since : 2009
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My husband just saw an oncologist today because of low platelet count. It has dropped from 150,000 to 119,000 over the last two weeks. His hemoglobin is on the high side at 17.9 (HCT 49.2) and eosinophils are elevated at 0.21. He has a history of prostate cancer and is very concerned. Do these lab results point to anything obvious?
Posted Wed, 6 Aug 2014 in Cancer
 
 
Answered by Dr. Luchuo Engelbert Bain 7 hours later
Brief Answer:
No worries yet, control complete blood count

Detailed Answer:
Hi and thanks for the query,

I am afraid they really do not point to anything very specific. They however, especially with regards to the decreasing platelet count deserve a keen follow up. Continually decreasing platelet count could indicate some problems at the level of the bone marrow. It might be of interest to do a complete screen to know if there is a residual spread of the prostate cancer he once had, or if its a new condition all together.

It is important however to get another platelet count done again. False positives or problems with manipulation of samples or machines could alter results at times. It is also important to know if the tests were run in the same laboratory or not. It is important in my opinion to get the test run in a few days. Seriously decreased platelet counts could predispose to recurrent or spontaneous bleeds.

The hemoglobin level is on the high side. It is within normal limits and no major call for concern at this point in time. Raised eosinophil count is a finding compatible with someone who has had a cancer before. However, other causes like allergy to some drug or substance should be checked. In my opinion, with regards to his clinical state is no concern here.

I strongly suggest the test be taken again to monitor the evolution of the platelets especially. An abdominal ultrasound to better visualize the structure and size of the spleen could be useful. An overactive spleen can cause reduced platelets. It might be important to note that platelets are destroyed and removed from the body by the spleen. It s however to early to start thinking of a splenic removal as an option.

No worries yet, get another control first. Kind regards. At above 100.000, this platelet count does not expose your husband to any risk yet .

Thanks and kind regards,

Dr Bain



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