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Ronni Gordon
Ronni Gordon is  a cancer survivor and long-time journalist who has written about her journey, about health and fitness, and about how she and others have prevailed in difficult situations. She brings to her writing a mix of personal experience with knowledge about the health-care system and how cancer patients can navigate it. A graduate of Vassar College with a master's degree in journalism from Boston University, she is a freelance writer who worked in daily newspapers for more than 30 years. She has been published in The New York Times, The Philadelphia Inquirer, Dana FarberCancer Institute magazine, and Cancer Today magazine. She lives in Western Massachusetts with her dog, Maddie, short for Madison (Avenue) in honor of her hometown, New York, and is mother of three grown children, Ben, Joe, and Katie

Ronni Gordon

Tags: cancer | iron | chemotherapy | liver

Cancer Treatments Can Lead to Iron Overload

By    |   Tuesday, 11 February 2014 03:00 PM EST

Sometimes the things that save you can do you harm. For example, radiation can cause heart attack, heart failure, and arrhythmia, while chemotherapy agents can damage the heart or peripheral blood cells.
A good friend of mine who received radiation therapy to fight lymphoma ended up with a weakened heart. Years after his treatment, he died from a heart attack.
Like many patients undergoing chemotherapy for blood cancer, I have had so many transfusions that I’ve lost track. Chemotherapy for leukemia drains your own system while attacking the cancer, and my red blood cells and platelets required constant replenishing.
Later, I learned that these transfusions had a harmful side effect of their own: the accumulation of ferritin, the protein that stores iron in your body in many cells, including the liver. Normal ferritin levels for women are 12 to 150 nanograms per milliliter of blood. My level was over 5,000.
High ferritin levels can lead to:

Heart failure

• Joint pains

• Liver cirrhosis

• Type 2 diabetes

• Darkening of skin
When my nurse practitioner at the Dana-Farber Cancer Institute in Boston told me about these potential problems, she introduced me to one of my least favorite drugs: Exjade (deferasirox), which binds to iron and removes it from the blood stream.
And this drug has side effects of its own, potentially harming the liver and kidneys, and possibly causing stomach or intestinal bleeding.
I dance around this medication the same way I dance around going to the gym. Sometimes I vacuum and at other times I lie under a blanket on the couch, watching the morning news shows, procrastinating as best I can. I go through all the reasons I would like to skip it, but ultimately it comes down to one thing: It’s good for me, so I’d better do it.
Once, I jokingly asked my nurse practitioner whether they could remove some of the excess ferritin from my body with a round of good old-fashioned bloodletting. She said that yes, there is a treatment called “therapeutic phlebotomy,” in which blood is removed — just like when people donate blood.,
So now, every couple of months, I go to the blood donor center, feeling like an imposter among the good Samaritans. Because my blood is donated to the trash.
This, combined with the Exjade and the blood removed when I get my routine blood tests, has reduced my ferritin level to the 3,000 range.
I still have a long way to go.

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Sometimes the things that save you can do you harm. For example, radiation can cause heart attack, heart failure, and arrhythmia, while chemotherapy agents can damage the heart or peripheral blood cells.
Tuesday, 11 February 2014 03:00 PM
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