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Dr. Andrew Rynne

Family Physician

Exp 50 years

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Suggest treatment for myasthenia gravis

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Dr. Deepak Sundriyal

Oncologist

Practicing since :2005

Answered : 1460 Questions

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Posted on Wed, 15 Mar 2017 in Cancer
Question: I had a splenectomy for ITP 15 yrs ago. I now have a DX of a 1.5cm grade 3 invasive ductal breast cancer, with clear margins and clear sentinel node, estrogen & Her2 positive. My oncologist recommends chemo + Herpecin + radiation + Arimidex. My concern is having chemo when I have no spleen. Is the risk of critical infection worth it?
Other pertinent info: I have Myasthenia Gravis, currently in close to remission status for 3 yrs. Past hx of Thymectomy, Myasthenic crisis, Plasmapheresis, long term high dose prednisone.


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Answered by Dr. Deepak Sundriyal 27 minutes later
Brief Answer:
You will require vaccination prior to chemo

Detailed Answer:
Hello dear .
I have gone through the details.

So definitely, chemo will lead to immuno suppression and you will be prone to infections. I will advise you to get vaccinated prior to chemo against pneumococcal, meningococcal and influenza infections.
Myasthenia gravis if well controlled will not interfere with chemotherapy. But as you are on steroids, you will require antifungal prophylaxis too.

Go ahead with the treatment.
Thanks
Above answer was peer-reviewed by : Dr. Vaishalee Punj
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Follow up: Dr. Deepak Sundriyal 18 minutes later
Thanks so much. Your reply adds to my confidence in my doctor. I have not been on steroids in 6+ years, just a hx of it. Already had immunizations for pneumonia, flu, shingles. Will ask doc tomorrow about meningitis vaccine..
Appreciate your reply.
doctor
Answered by Dr. Deepak Sundriyal 1 minute later
Brief Answer:
Feel free to ask further

Detailed Answer:
Hello. Welcome.
Thanks and regards
Above answer was peer-reviewed by : Dr. Vaishalee Punj
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