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Doctor Q&A for Dr. Matthew Fero

A 62-year-old female asked:
Dr. Matthew Fero
Medical Oncology 31 years experience
Could be worse: Nulasta is a long-acting form of GCSG (filgrastim) that reduces the duration and depth of low white blood cell count (WBC), particularly the neutrophil count (ANC) after chemotherapy. It won't completely prevent a WBC drop, so the dosage or timing of subsequent rounds of chemotherapy may need to be adjusted, in individual cases.
A 75-year-old male asked:
Dr. Matthew Fero
Medical Oncology 31 years experience
Acute vs blastic?: In the chronic and dysplastic hematologic malignancies that you mention (CMML and MDS), the term "acute" transformation means an evolution to acute leukemia. This is defined as more than 20% "blast" cells microscopically. Therefore acute and blastic transformation are the same thing.
A 30-year-old male asked:
Dr. Matthew Fero
Medical Oncology 31 years experience
Enlarged lymph nodes: ... are the most common early symptoms of lymphoma. Some patients can have so called "B-symptoms" which are night-time fevers, chills, and sweats. Enlargement of the liver or spleen can occur, or a change in the blood cell counts.
A 34-year-old female asked:
Dr. Matthew Fero
Medical Oncology 31 years experience
Lymphoma can occur..: ..at any age, but is more common in older people. Lymphoma does not usually cause visible red, painful lumps in the skin. It is usually painless and causes swellings in lymph nodes under the skin or much deeper. Red lumps in the armpits can be due to shaving and ingrown hairs, or furuncles which are like pimples or acne lesions.
A 18-year-old male asked:
Dr. Matthew Fero
Medical Oncology 31 years experience
Life Expectancy...: Is not a medical term. Cancer studies often report the "median survival" which is the time it takes for 1/2 of patients to die. The other half live longer, and the variation can be large. For highly curable diseases (like some lymphoma types) we often describe the "overall survival" which is the percentage of people alive at a late time point, and is reflective of the cure rate of the disease.
A female asked:
Dr. Matthew Fero
Medical Oncology 31 years experience
The WHO advisory...: on red/processed meats does not represent any new discoveries. We've known for decades that these are associated with slightly higher colon cancer rates. What's more important is to have a well balanced diet. Sugary foods and excess carbs are a bigger threat to our health due to the obesity and diabetes epidemic. Don't overdo the red/processed meat and follow colon CA screening guidelines.
A 23-year-old female asked:
Dr. Matthew Fero
Medical Oncology 31 years experience
Basophils are not...: ...typically increased in cancer. They might increased in CML (chronic myelogenous leukemia) but that disease pretty easy to diagnose based on blood tests alone. Basophils may be involved with parasitic infections and as tissue mast cells, with allergic reactions. You didn't state why you had an ultrasound of your chest and armpits. Moderate swelling of lymph nodes is often a sign of infection.
A 36-year-old female asked:
Dr. Matthew Fero
Medical Oncology 31 years experience
Complete Bood Counts: or "CBC" are one of the most common blood tests and give some basic parameters about the blood cells themselves. The values you've given pertain to the size of the red blood cells and platelets (MCV, MPV), and the amount of hemoglobin per red cell (MCH). These are secondary considerations, and there's nothing to be concerned about if the other values are normal.
A 63-year-old male asked:
Dr. Matthew Fero
Medical Oncology 31 years experience
Mantle Cell Lymphoma: ...is a type of non Hodgkin's lymphoma characterized by the genetic rearrangement of two chromosomes. This causes an abnormal fusion of two genes: Immunoglobulin (IgH) and Cyclin D1. Molecular studies that can detect this abnormality includes either FISH or RT-PCR. Flow cytometry is also good at identifying abnormal cells based on cell surface antigen expression.
A 30-year-old member asked:
Dr. Matthew Fero
Medical Oncology 31 years experience
Anastrozole blocks..: ... the production of Estrogen from Testosterone. This conversion happens at a low level in fat tissue. Anastrozole won't increase Testosterone production but it will lower estrogen levels. To a certain extent Estrogen has the opposite effect as testosterone In men.
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