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Topic: Tamoxifen and low platelets

Forum: Hormonal Therapy - Before, During and After —

Risks and benefits, side effects, and costs of anti-estrogen medications. Note: Please remember that there are good experiences and bad with ALL treatments and this is a safe place to share YOUR experience, not to be influenced or influence others.

Posted on: Jul 18, 2016 06:29AM

Nancy2581 wrote:

Hi all - I posted about this once before, but I'm still concerned. Seems like since I've been on tamoxifen my platelets slowly are going down. My onc doesn't want to jump to the conclusion it's the tamoxifen. Um ok then what is it? Last Sunday July 10th I woke up and the entire top of my foot and sides was all black and blue. Weird! I did not injure myself. I ended up going to urgent care because my husband said my foot looked worse that afternoon. So urgent care did a CBC and my platelets were at 135. I know this isn't dangerous, but it's the lowest it's been. They keep going down. They have bounced back a little a few times, but then go down even lower the next time I have them checked it seems. Tomorrow I am having another CBC to check my platelets. I have stopped tamoxifen for a week (my onc said ok) to see where my platelets are. I see her on Tuesday to discuss, but she doesn't think it's the tamoxifen. Did anyone go off of tamoxifen because of low platelet?. Maybe it's not the tamoxifen? The rest of my bloodwork is fine. My platelets held up better during chemo.

Thanks

Nancy

2.8 cm tumor with LVI Dx 6/11/2014, IDC, Right, 2cm, Stage IIB, Grade 1, 1/3 nodes, ER+/PR+, HER2- (IHC) Surgery 6/24/2014 Lumpectomy: Right; Lymph node removal: Right, Sentinel Chemotherapy 7/21/2014 AC + T (Taxol) Hormonal Therapy 1/27/2015 Tamoxifen pills (Nolvadex, Apo-Tamox, Tamofen, Tamone) Radiation Therapy 1/29/2015 Whole-breast: Breast, Lymph nodes Hormonal Therapy 12/17/2017 Femara (letrozole)
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Jul 18, 2016 11:34AM Nancy2581 wrote:

bump

2.8 cm tumor with LVI Dx 6/11/2014, IDC, Right, 2cm, Stage IIB, Grade 1, 1/3 nodes, ER+/PR+, HER2- (IHC) Surgery 6/24/2014 Lumpectomy: Right; Lymph node removal: Right, Sentinel Chemotherapy 7/21/2014 AC + T (Taxol) Hormonal Therapy 1/27/2015 Tamoxifen pills (Nolvadex, Apo-Tamox, Tamofen, Tamone) Radiation Therapy 1/29/2015 Whole-breast: Breast, Lymph nodes Hormonal Therapy 12/17/2017 Femara (letrozole)
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Jul 19, 2016 12:26PM Nancy2581 wrote:

bump

2.8 cm tumor with LVI Dx 6/11/2014, IDC, Right, 2cm, Stage IIB, Grade 1, 1/3 nodes, ER+/PR+, HER2- (IHC) Surgery 6/24/2014 Lumpectomy: Right; Lymph node removal: Right, Sentinel Chemotherapy 7/21/2014 AC + T (Taxol) Hormonal Therapy 1/27/2015 Tamoxifen pills (Nolvadex, Apo-Tamox, Tamofen, Tamone) Radiation Therapy 1/29/2015 Whole-breast: Breast, Lymph nodes Hormonal Therapy 12/17/2017 Femara (letrozole)
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Jul 21, 2016 12:21AM CassieCat wrote:

This is pretty much exactly what happened to me. I found somewhere that it is a SE of Tamoxifen, though not a common one. My onc tested for everything under the sun, and nothing came back positive. My platelets are hovering around 120,000-130,000.

43 years old at dx. 6 rounds of TCHP (DONE 12/15/14), MX on left side (DONE 1/9/15), radiation (DONE 4/1/15), Herceptin (DONE 8/19/15) and Tamoxifen (5 years). Dx 8/19/2014, IDC, Left, 2cm, Grade 2, 1/2 nodes, ER+/PR+, HER2+
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Jul 21, 2016 04:13AM - edited Jul 21, 2016 04:36AM by Nancy2581

Thanks CassieCat. I saw my onc yesterday. It's not a very common side effect you're right. My onc said less than 1%. She did another CBC on my and this time in a citrate tube to see if I am a clumper lol. Doesn't appear that I am. My platelets came back at 150,000 so they went up a little, but this is the pattern. The fall, then go up a little then fall further than before they went up. My onc also did a peripheral smear - don't know the results on that one. She says she's not worried (I am) and will do another CBC in October.

Did your onc take you off tamoxifen? Oh probably not - you are young.

Nancy

2.8 cm tumor with LVI Dx 6/11/2014, IDC, Right, 2cm, Stage IIB, Grade 1, 1/3 nodes, ER+/PR+, HER2- (IHC) Surgery 6/24/2014 Lumpectomy: Right; Lymph node removal: Right, Sentinel Chemotherapy 7/21/2014 AC + T (Taxol) Hormonal Therapy 1/27/2015 Tamoxifen pills (Nolvadex, Apo-Tamox, Tamofen, Tamone) Radiation Therapy 1/29/2015 Whole-breast: Breast, Lymph nodes Hormonal Therapy 12/17/2017 Femara (letrozole)
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Jul 21, 2016 07:58AM CassieCat wrote:

My onc always fears the worst and has no bedside manner. So he had me worried about everything, when in fact I am certain it's the Tamoxifen combined with chemo just being hard on our marrow, period. And no, I'm still on the Tamoxifen. It's been about 15 months of it now. Glad to hear your counts were at 150K today. Gotta' celebrate the good news when you get it. :)

43 years old at dx. 6 rounds of TCHP (DONE 12/15/14), MX on left side (DONE 1/9/15), radiation (DONE 4/1/15), Herceptin (DONE 8/19/15) and Tamoxifen (5 years). Dx 8/19/2014, IDC, Left, 2cm, Grade 2, 1/2 nodes, ER+/PR+, HER2+
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Jul 21, 2016 08:14AM KateB79 wrote:

Had the same thing going here, too, along with mild neutropenia. Just had another CBC, and my platelets are up to 155k; my ANC is still a little low, but my absolute leukocytes are on the upswing, too. Still waiting on smear results (that sounds so ominous), but I've made a conscious decision not to worry about this anymore.

Tamoxifen and Herceptin (only one infusion to go--we had to hold my last one--how anticlimactic is THAT?) can both do this, and carboplatin can cause wacky counts for up to two years, so all things considered my guess is that we're gonna be okay.

:)

Scars are tattoos with better stories. BMX (flat and fabulous!), TCHP x 6, Herceptin x 18. Chest-wall rads. Tamoxifen and Zoladex. Dx 7/2/2015, IDC, Left, 2cm, Stage IIA, Grade 3, 0/2 nodes, ER+/PR+, HER2+ (FISH)
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Jul 21, 2016 08:31AM - edited Jul 21, 2016 08:32AM by Nancy2581

thanks ladies. My onc called me and says I have psuedothrompicena. She says my peripheral smear showed my platelets normal (don't know the count) and that I'm a clumper. I should be happy right? It still bothers me that my platelets have gone down consistently since starting tamoxifen. I guess I won't worry about it. Another CBC in a citrate tube in October so we shall see. Glad my onc is monitoring it closely though

2.8 cm tumor with LVI Dx 6/11/2014, IDC, Right, 2cm, Stage IIB, Grade 1, 1/3 nodes, ER+/PR+, HER2- (IHC) Surgery 6/24/2014 Lumpectomy: Right; Lymph node removal: Right, Sentinel Chemotherapy 7/21/2014 AC + T (Taxol) Hormonal Therapy 1/27/2015 Tamoxifen pills (Nolvadex, Apo-Tamox, Tamofen, Tamone) Radiation Therapy 1/29/2015 Whole-breast: Breast, Lymph nodes Hormonal Therapy 12/17/2017 Femara (letrozole)
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Jul 21, 2016 10:20AM SpecialK wrote:

nancy - pseudo-thrombocytopenia means that your platelets are normal and the issue is that they are clumping in your blood sample and giving a "false" low platelet count. This is a testing anomaly, not a physical one - that is why your MO referred to you as a "clumper" and let you know that your count is normal.

BMX w/ TE 11/1/10, ALND 12/6/10. 15 additional surgeries. TCHx6 2/17-6/2/11. Herceptin until 1/19/12. Femara 8/1/11, Arimidex 6/20/12, back to Femara 6/18/13-present. Dx 9/27/2010, IDC, Right, 2cm, Stage IIB, Grade 3, 2/14 nodes, ER+/PR+, HER2+ (IHC) Dx 9/27/2010, DCIS, Stage 0, Grade 3
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Jul 21, 2016 10:50AM Nancy2581 wrote:

Thanks SpecialK. I'm not going to worry about it anymore. All of my bloodwork looks great and I'm happy that I don't have to go through all kinds of testing to figure it out. My onc guessed this before she ran the tests, but I was skeptical lol

Nancy

2.8 cm tumor with LVI Dx 6/11/2014, IDC, Right, 2cm, Stage IIB, Grade 1, 1/3 nodes, ER+/PR+, HER2- (IHC) Surgery 6/24/2014 Lumpectomy: Right; Lymph node removal: Right, Sentinel Chemotherapy 7/21/2014 AC + T (Taxol) Hormonal Therapy 1/27/2015 Tamoxifen pills (Nolvadex, Apo-Tamox, Tamofen, Tamone) Radiation Therapy 1/29/2015 Whole-breast: Breast, Lymph nodes Hormonal Therapy 12/17/2017 Femara (letrozole)
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Dec 2, 2016 03:59AM Ribbonrep wrote:

my Onc just had me overnight in hospital due to platelets dropping to 6000. Had a transfusion and they climbed to 25000. They immediately took me off of tamoxifen and put me on high dose steroid for 4 days. I had only been on for six weeks! They have only seen it twice, but it does happen. Today I am up to 46000 and will have daily blood draws until it gets into normal range.

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Dec 2, 2016 05:55AM Nancy2581 wrote:

Wow Ribbonrep I'm so sorry that happened. Glad they took you off and your platelets are climbing now. So scary. Mine have never been that low and my rad oncologist feels they are going up some now. I'm having a blood draw on Monday so I will see where they are at. Feel better soon! Hugs

Nancy

2.8 cm tumor with LVI Dx 6/11/2014, IDC, Right, 2cm, Stage IIB, Grade 1, 1/3 nodes, ER+/PR+, HER2- (IHC) Surgery 6/24/2014 Lumpectomy: Right; Lymph node removal: Right, Sentinel Chemotherapy 7/21/2014 AC + T (Taxol) Hormonal Therapy 1/27/2015 Tamoxifen pills (Nolvadex, Apo-Tamox, Tamofen, Tamone) Radiation Therapy 1/29/2015 Whole-breast: Breast, Lymph nodes Hormonal Therapy 12/17/2017 Femara (letrozole)
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Dec 2, 2016 07:15AM Denise-G wrote:

I had very low platelets during chemo and MO said no chemo the next week if platelets don't improve.

So I started researching and researching.  I found Papaya Leaf Extract increases platelets. 

I ordered some organic on Amazon, took 2 tablespoons a day, and the next blood count my

platelets were normal.  My MO was shocked.  You know, I never told him what I did, but hey,

it worked!

www.denise4health.info my BC Blog with over 200 informative posts - stop by and say hello! Myself, my mom, and sister were all diagnosed with BC within 3 years. What a ride! Dx 10/10/2011, IDC, Left, 6cm+, Stage IIIA, Grade 2, 9/14 nodes, ER+/PR+, HER2+ (FISH) Surgery 11/23/2011 Lymph node removal: Left, Underarm/Axillary; Mastectomy: Left Chemotherapy 12/27/2011 AC + T (Taxol) Targeted Therapy 2/28/2012 Herceptin (trastuzumab) Hormonal Therapy 10/11/2012 Arimidex (anastrozole)
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Dec 17, 2016 06:50AM ChgoDeb wrote:

so glad it worked! Still taking it? Do you recall what brand you ordered? I just looked on Amazon.com and quite a few options. I also checked a few stores, but they only carry papaya enzymes. Wonder if it works the same. Did you ever try the tea?

So glad I'm not the only one with low platelets. Thanks!






Dx 12/2013, IDC, Stage IA, Grade 1, 0/3 nodes, ER+/PR+, HER2-
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Jan 7, 2017 09:15AM Ribbonrep wrote:

crazy, I am still having issues! After Four days of heavy steroids my platelets went up. Then when I stopped taking they went back down to 95,000. Then I did another round of steroids that decreased over 16 Days my numbers were up to 210,000. Then one week being off they dropped to 170,000. I really need them to normalize so I can start the AI

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Jan 7, 2017 09:18AM Ribbonrep wrote:

Do you have to continue to take the papaya extract or did u stop

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Mar 29, 2018 07:08AM cjafarm wrote:

At my annual appointment, all blood work was good with the exception of platelets. Previous tests were 334 and this one was 50. Retested using same draw and a new draw. Both were 50. Blood sent for smear and report has the 50 being correct. Pathology did not think it is a marrow problem.

I don’t trust the Tamaxofen to not be a contributor. Have been taking two years

Any thoughts apprec

Dx 10/6/2015, IDC, Right, <1cm, Stage IA, Grade 1, 0/3 nodes, ER+/PR+, HER2- Surgery 11/5/2015 Lymph node removal: Sentinel; Mastectomy: Right; Prophylactic mastectomy: Left Hormonal Therapy Tamoxifen pills (Nolvadex, Apo-Tamox, Tamofen, Tamone)

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